WHAT CAUSES SCABIES?
Scabies—also known as “the itch”—is an intensely itchy rash caused by a tiny mite (similar to a chigger) that lives in the skin. Because it is only 1/60 inch long, the scabies mite is almost impossible to see without magniﬁcation. The mite causing scabies usually lives on the hands, wrists, ankles, groin, and armpits. The rash of scabies is caused by allergy to the mite and may affect the entire skin except for the face. You may have only six or seven scabies mites but be covered with hundreds of itchy spots. The itching areas are an allergic reaction, and usually no mite can be found in them.
Scabies often resembles other rashes. The only way to determine if you have scabies is for your dermatologist to scrape off one of the inflammatory papules on the skin and examine it under a microscope. But it may be very difficult to find the mite (like the expression “looking for a needle in a haystack). Therefore, we treat scabies because we suspect it, even though we cannot ﬁnd the mite.
Scabies is spread by skin-to-skin contact. All members of your family and any sexual partners you may have must be treated at the same time you are being treated. The early stages of scabies may not itch; be sure all close personal contacts are treated, even if they are not itching. All contacts must be treated at the same time to prevent back-and-forth spread of the mites.
Scabies is not spread by clothes, towels, bedding, or eating utensils. There is no need to sterilize sheets, towels, blankets, or clothing.
Cats and dogs can get a type of scabies and because of their scratching, may also get mange. There have been rare cases where the infected individual is your pet and the scabies has affected the pet owners. They can be treated with permithren dips.
Treatment consists of applying a mite-killing medication to the entire skin of the body except the face and scalp. It is very important to apply the medicine to every bit of your skin below the face, including the genital area, feet, and hands (especially in between the fingrs and toes). The medicine should remain on the skin for 24 hours. Please follow these directions exactly:
1. At bedtime, apply the medicine thinly to the entire skin from the neck downward. Rub it on every bit of skin, including the genital area, and be sure to apply it well to the hands, wrists, feet, and ankles.
2. If you wash your hands in the next 12 hours, put more of the medicine on your hands and wrists afterward.
3. The next day, reapply the medicine to your hands and wrists after breakfast and again after lunch. Try not to wash your hands for 1 hour after putting the medicine on your hands.
4. Shower 24 hours after applying the medicine to thoroughly remove it. Some physicians recommend a second treatment two weeks after the first.
After the treatment, avoid soap, because scabies causes sensitive skin. If your skin is dry, apply a lotion or Vaseline at bedtime. The itching and rash may continue and even get worse for a week or two even though all the mites have been killed. This results from allergy to the mites and is called postscabetic dermatitis. Postscabetic dermatitis is not scabies, and it requires special treatment. Don’t try to treat it with the mite-killing medicine. We advise a return visit 10 to 14 days after treatment to be sure that you are cured and comfortable.