Scabies is an itchy skin condition caused by microscopic mites. It causes rashes and spreads mostly through direct contact with an infected person. The prevalence of this contagious disease in India ranges between 13% and 59%. 

Scabies have no age or hygiene barrier, and they rapidly spread in close living conditions. Having a comprehensive knowledge of the causes, symptoms, diagnosis, and treatment of scabies is crucial for its proper management and prevention. 

For NEET PG exam aspirants, a thorough knowledge of scabies and other diseases is essential. DocTutorials provides an innovative curriculum and expert study materials that help students easily grasp its complex medical aspects.

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What is Scabies?

Scabies is a worldwide health problem, especially common in crowded and tropical areas. Scabies is caused by the Sarcoptes scabiei mites, which infest the skin to deposit their eggs, causing intense itching and rashes. If not treated on time, scabies can cause skin infections and severe health problems, such as septicaemia, heart disease, and kidney disease. 

Since scabies are infectious, it is spread by direct skin contact. If one family member is infected, it is crucial to contact a healthcare provider who can treat and evaluate other family members and close contacts simultaneously. This condition is treated with either topical creams or oral drugs.

Types of Scabies

Scabies are classified into 4 categories based on their nature and occurrence. Following are the types of scabies: 

1. Crusted Scabies

Also known as Norwegian Scabies, this is the most severe form of the disease. It usually happens in people with weakened immunity power. This type is most often observed in patients with neurological disorders, Down syndrome, and immunocompromised patients, such as those with HIV. 

In such instances, the inability to scratch causes the burrows to accumulate mites, leading to the development of thick crusts, which are referred to as crusted scabies.

2. Infantile Scabies

This form of scabies occurs within the palms, face, and soles of the feet. As the name suggests, infantile scabies occur in infants or toddlers. It is characterised by intense itching and usually presents with a rash of small red bumps, particularly in areas where the mites burrow. 

3. Nodular Scabies

Nodular scabies are more common in children and usually occur in areas like the genitals, groin, or armpits. The inflamed nodules can last for a long time, even after the mites are eliminated.

4. Genital Scabies

Genital scabies are an STI caused by small mites that tunnel into the genital skin. Individuals with genital scabies have itching in the affected area. Others may have symptoms like rash, bumps, or redness on the skin of the genital area, fever, sleeplessness, fatigue, etc.

Causes of Scabies

Scabies is caused by an infestation of small, eight-legged mites known as Sarcoptes scabiei. These microscopic mites burrow into the upper skin layers, where they stay, feed, and lay eggs. The immune system’s reaction to the mites and their wastes results in the intense itching and rash of scabies. The primary causes of scabies transmission are as follows:

• Direct Skin-To-Skin Contact: This is the most frequent mode of transmission, mainly multiplied by bodily contact with the infected individual.
• Indirect Contact: Scabies may also be transmitted through contaminated clothing, bedding, towels, or furniture that has come into contact with an infected individual. Though less frequent, this is another mode of transmission.
• Densely Populated Living Situations: Scabies epidemics occur more often in settings where intimate physical contact is frequent, including nursing homes, child care centres, detention facilities, and homeless encampments.
• Weakened Immune System: Individuals with weakened immune systems can be more prone to scabies and more severe infestations.

Risk Factors of Scabies

Scabies is a very contagious disease that is transmitted mainly by direct skin-to-skin contact. Therefore, some groups are more at risk of infestation, such as:

• Daycare or school-aged children
• Parents or guardians of infants
• Sexually active young adults
• Long-term care facility residents
• Those with multiple sexual partners
• Aged people
• People with HIV infection, organ transplant recipients, and others receiving immunosuppressive treatments.

Symptoms of Scabies

Scabies causes an extremely uncomfortable and itchy skin rash. If you have never had scabies previously, it can take a maximum of six weeks for the rash to develop. If you have suffered from scabies previously, the rash tends to develop in a matter of days. The most common symptoms of scabies are:

• Itching: Extreme itching that becomes worse at night, possibly keeping you awake.
• Lesions of Scabies: Scabies lesions are small, superficial, red bumps or blisters that usually occur in groups.
• Bumps: Tender sores or bumps that become infected if scratched.
• Redness and Inflammation: The immune reaction may cause inflammation and redness in the affected areas of the skin.
• Scabies Burrows: They are characterised by small, greyish lines on the skin in which the mites have burrowed. The scabies burrows are typically located on the wrists, fingers, and between the toes.

Where are Scabies Most Likely to Spread?

Normally, scabies occur in the folds of skin but can develop in other regions throughout the body. In adults and older children, the most frequent places where scabies can be found are: 

• Along the inner wrists
• Around the waistline
• Around the belly button
• Around the genitals
• Around the nipples
• Between the toes and fingers
• In the groin area
• In the underarms 
• On the chest
• On the inner elbows
• On the soles of the feet
• On the buttocks

In infants and toddlers, the common places affected by scabies are:

• Fingers
• Face, scalp, and neck
• Palms of the hands
• Soles of the feet

Diagnosis and Treatment of Scabies

The presence of scabies burrows on the skin signifies an infestation and requires immediate intervention. To diagnose scabies, your healthcare provider will check your skin for mite evidence. 

They can also take a skin sample for a microscopic examination to confirm the existence of any eggs or mites. Based on the diagnosis, the doctor will choose the treatment method. 

The treatment of scabies involves eliminating the mites and eggs by using medicated cream or oral drugs. Since scabies are extremely contagious, doctors generally advise that everybody in the home and close contact should be treated, even though they are free from symptoms.

Medications of choice for the treatment of scabies are:

• Permethrin Cream (5%): This is often prescribed for the treatment of scabies and is FDA-approved for patients 2 months and older, including pregnant women.
• Benzyl Benzoate Lotion (25%): This can be used for crusted scabies cases.
• Crotamiton Cream or Lotion (10%): This is approved for use in adults and generally needs to be applied twice, with the second application 24 hours after the first.
• Lindane Lotion (1%): Although FDA-approved for the treatment of scabies, this drug is generally used only if other treatments have been unsuccessful and not during pregnancy or lactation.
• Sulfur Ointment (5% – 10%): While some patients may not like the scent of this medicine, this treatment is safe for infants under 2 months.
• Spinosad Liquid (0.9%): This is a newer treatment also used for head lice. It is approved for use in patients 4 years of age and older.

Prevention Tips for Scabies

To successfully prevent the transmission of scabies, it is crucial to adhere to a complete treatment and prevention programme. These guidelines will assist you in controlling the spreading of scabies:

• Treat Close Contacts Simultaneously

Scabies are transmitted by close, personal contact. To avoid reinfection, treat all household members, sexual partners, and close contacts at the same time, even if they are not symptomatic.

• Avoid Sexual Contact

Do not have sex until you and your partner have received the full treatment and are scabies-free. This prevents the transmission of the mites and reduces the chances of reinfection.

• Use Prescribed Medication Properly

Follow your dermatologist’s directions exactly when applying the prescribed medication. Wash your skin by bathing or showering first, then apply the medicine from neck to toes, including between fingers, toes, and in folds of skin. Leave the medicine on for 8 to 14 hours, then wash it off.

• Clean Your Bedding and Clothing

On the first day of treatment, wash everything in warm water, including garments, bedding, towels, etc. Dry them in bright sunlight to exterminate any mites that may be left alive.

• Vacuum Your Home

Mites can survive for a short while on surfaces like carpets, rugs, and upholstered furniture. Vacuum your entire house thoroughly on the day you begin treatment to eliminate any mites that might have migrated to these surfaces.

• Look for Re-infestation

If you see developing symptoms again after treatment, seek your doctor’s advice urgently. Treat all involved areas and contacts early enough to prevent reinfection.

• Practice Good Hygiene

Since scabies can happen to anyone, it is better to practice some healthy hygiene habits, which can reduce the chances of infestation. These include bathing regularly, drinking plenty of water, washing hands from time to time, avoiding sharing personal clothing, and so on.

FAQs About Scabies

1. How to identify scabies?

The two most common drugs, malathion lotion and permethrin cream are the most rapid ways of getting rid of scabies. Both of these drugs contain insecticides that destroy the scabies mites efficiently. Permethrin cream is normally the drug of choice, but malathion lotion comes into play in case permethrin is ineffective. 

2. How to cure scabies quickly?

Diagnosis of scabies requires the identification of its symptoms, which are characterised by intense itching and rashes. The rash appears with red spots, pimples, or bites.

3. How do scabies spread in a human being?

In general, scabies are not caused by poor hygiene. They can easily be transmitted through direct skin contact, even during sexual intercourse. It will take between 3 to 6 weeks for symptoms to develop after exposure, and transmission to others may happen during incubation.

4. What is the survival period of scabies?

Scabies mites are tiny insect-like organisms that live in the skin by burrowing underneath it to feed and multiply. They can live for about 1 to 2 months on a human body. However, in the absence of the mites in a host, their life expectancy is usually around 48 to 72 hours.

5. Are there any tablets to cure scabies?

Ivermectin tablets are an effective scabies treatment. This broad-spectrum anthelmintic agent acts on the nervous system of the scabies mite, eventually killing it.

Conclusion

Scabies is a widespread but very curable skin disease caused by a tiny mite. It results in severe itching and the development of typical scabies lesions. Early diagnosis and immediate treatment are the most important factors in managing the disease and avoiding further spread. 

DocTutorials provides a thorough and detailed curriculum for students who are interested in a career in medicine and wish to appear for the NEET PG exam. Our creative NEET PG study materials help students like you to understand complicated medical topics such as scabies and other diseases for better understanding. 

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