by Rose Broyles

A few weeks ago, Josie went to visit her mother-in-law in the Bay Area. Betty had this terrible rash on her skin. It was so scaly and inflamed that it caused some worry. So, Josie took her into the on-campus doctor at the retirement community she lives in. The doctor suspected scabies. This was odd, because how on earth could she have gotten scabies? She lives in her own home and not in an institutional setting where she is sharing space with others.

What is Scabies?

Scabies is an itchy skin condition caused by an infestation of  mites called Sarcoptes scabiei. They are 8-legged parasites naked to the human eye,  that burrow into the skin  to produce intense itching.

Causes of Scabies

Scabies mites can only live about a day off the body, so in order for an infestation to occur there must be close skin-to-skin contact. It is almost impossible to get scabies by shaking someone’s hand or sharing coats or sharing a blanket that had mites in it. Many times scabies is contracted  through sexual contact. Hugging someone might be a possible cause.

Scabies can be misdiagnosed because  the beginning symptoms may resemble other skin conditions: pimples, light rash, etc. In some cases, no symptoms are present until weeks later. If left untreated, the person may develop a secondary bacterial infection especially if they are scratching so much that they break skin.

Symptoms of Scabies

The person affected can feel no symptoms for a couple of months before they start to feel the itch. At first, the itch might be more or less of a nuisance. However, as time goes by, the itching gets worse and to a point where it becomes difficult to sleep. What sets it apart from other skin conditions such as eczema is that it is so bad there is never a break. With eczema, symptoms may come and go; with scabies, the symptoms seem to get worse.

Treatment

Unfortunately, there are no over-the-counter drugs as what is available for lice. However, if you get a prescription from a doctor it’s easy to cure the problem.

1. Permethrin (Elimite) cream. These creams are left on overnight, then washed off. This application is usually repeated in one week. Permethrin is approved for use in people 2 months of age and older
2. Ivermectin, an oral medication, is an antiparasitic medication that has also been shown to be effective, it is not FDA-approved for this use. The CDC recommends taking this drug at a dosage of 200 micrograms per kilogram body weight as a single dose, followed by a repeat dose two weeks later. It is typically used only when topical medications have failed or when the patient cannot tolerate them.
3. Crotamiton lotion 10% and cream 10% (Eurax, Crotan) is a another drug that has been approved for the treatment of scabies in adults but not children. It is not as effective as other methods.
4. Antihistamines, such as diphenhydramine (Benadryl), can be useful in helping provide relief from itching. Maybe try Calamine lotion (the kind used for chicken pox)
5. Wash linens and bedclothes in hot water. Because mites don’t live long away from the body, it is not necessary to dry-clean the whole wardrobe, spray furniture and rugs, and so forth.
6. Treat sexual contacts or relevant family members who may have been affected

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