What is scabies?
Scabies is a skin disorder caused by the scabies mite (a small parasite that is present in the skin of infected patients) leading to persistent itching. This itching is worse at night and commonly affects hands, wrists and fingers, elbows, armpits, nipples & buttocks. Scabies is quite infectious and can affect the entire family. Scabies usually occurs in unhygienic conditions and with overcrowding.

How is scabies transmitted?
Scabies spreads by close person-to-person contact and by sharing same bed or clothes. It is especially seen in people with poor hygiene. Scabies is highly contagious and can be spread by scratching, picking up the mites under the fingernails and simply touching another person's skin. The scabies mite can survive up to 14 days away from a host, but often do not survive longer than two or three days away from human skin. The adult mites live 3,4 weeks in the skin.

How does the mite cause scabies?
The female scabies mite tunnels into the skin and deposits eggs in the burrow. This produces intense, itchy skin. The larvae hatch in 3,10 days, move on the skin, molt into a nymph and then matures into adult mites.

How is the diagnosis of scabies made?
Generally diagnosis is made by finding burrows. When a suspected burrow is found, skin surface scrapings are taken and examined under a microscope. Diagnosis is made when the mite, egg or fecal pellets are found.

What is the treatment for scabies?
Scabies mite is killed by various medications such as benzyl benzoate, Malathion, permethrin and lindane. For infants and young children, crotamiton or permethrin is more preferable. The medication is to be applied on the entire body from neck downwards at bed time. The lotion is to be removed by bathing next morning. The lotion is not to be applied on the face. Benzyl benzoate may be repeated for 3 days, malathion for one use, crotamiton for 5 days. Any family member who has itching or close body contact, whether affected or not should have the same treatment at the same time.

Do not apply the anti-scabies medication on your own as the drugs are toxic and can lead to severe dermatitis if used excessively.
Sometimes, itching may persist after treatment. This may be because of hypersensitive reactions to the dead mites. Antihistamine or steroids may be required to control the itching.

Ivermectin is a medicine that is swallowed can also be used. One dose is enough to reduce the load of scabies but another dose is required after 2 weeks for full eradication.

The other aspect to be considered is eradicating the mites completely. All undergarments should be washed in warm water & dried and ironed. Shirts and trousers should be washed in hot water and ironed inside out in the seams. Bed linen, pillow covers, pillows, mattresses should be dusted & sunned.