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Doctors' Answers to "Frequently Asked Questions" - Scabies


These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Scabies
Question: What is scabies, and how do you get it?

Answer: Scabies is the commonly used term referring to infestation with a mite known as Sarcoptes Scabici. With this infestation, which involves the skin, intense itching develops which is typical, but not always, worse at night. In addition to itching, a rash develops in the effected areas. It is important to realize that the rash and the itching are due to a natural sensitivity by your body to the mite and not due to something the mite is doing. Therefore, both the rash and the itching may persist as long as several days after successful treatment. Scabies is most often seen in children, and the typical "rash" one sees is that of thread-like long ridges, anywhere from 0.5 to 1 inch in length, on the skin with a tiny clear pimple at one end which contains the mite. These ridges represent burrows by the mite and they most often appear on the hands, wrists, groin, chest, feet, or abdomen. The diagnosis can be made on the basis of the appearance and location of the rash alone, but it can also be confirmed by scraping on of the pimple/burrows with a scalpel and examining the contents under a microscope to look for the mite itself. The mite can be transferred to any person in contact with anyone who has scabies, and therefore treatment of the patients, as well as their family is recommended. Overnight skin lotion applications using Lindane or Permethrin is suggested therapy, washing the lotion off after 8-12 hours, typically. Lindane, it should be noted, can be toxic to the nervous system when used in excess (too many doses, or left on for too long). Remember, symptoms may persist even after the lotion has been applied and eradicated the mites. Lindane should also be avoided in pregnant or lactating women, in infants, in patients with seizure or other central nervous system disorder (confer with your physician if this is the case), or in patients with areas of exposed skin (which increase absorption of the lotion and nervous system exposure). Also, be sure to wash bed sheets, towels, or any other potentially exposed article in hot water, and place them in a hot dryer.

Scabies
Question: My middle income,very clean and healthful family has just been diagnosed as having scabies. My wife is freaking and washing,ironing and cleaning everything. I got medicine for this yesterday and will be taking my kids in tommorrow for medicine. Why us? How can we kill this parasite in the house and can we reinfect after medicine taken if parasite not killed immediately in house. Please help for our sanity. very ashamed for some reason. dad with scared family...

Answer: Scabies refers to an infection by a small external parasite named Sarcoptes scabiei. This is a common problem and is easily spread by person to person contact. These are common infections seen in day care and elementary schools as well as by sexual contact or any close personal contact. Physicians and nurses are particularly prone to infection when they inspect infected patients. The itching is caused by burrowing of the female under the skin. Curiously, the reaction is a hypersensitivity or allergic reaction to the animals excrement. Consequently, one's initial infection will be felt about four weeks after infestation and re-infection much sooner. The most usual symptom is severe itching worse at night or after a hot shower or bath. The burrows tend to be in the web spaces between the fingers, elbows, penis and pelvic area and back side of the wrists. The little parasite has difficulty living off a host and sheets, etc. will be infectious for short periods of time 1-2 days. Treatment involves a topical anti-scabies lotion applied after a shower or bath. Changing sheets, etc. is usually recommended-although an uncommon vector of infection. The itching may persist for some time since it represents an allergic reaction and not the actual parasite itself.

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