What is scabies?
In short, scabies is a skin condition that is caused by infection with the human itch mite. It has also been called the ‘seven-year itch’, but when properly diagnosed, it is known as scabies. The disease is becoming more widespread in the population.
If you have scabies, you have an infection with a tiny mite that is yellowish brown in colour. It is a parasite with four pairs of legs – and it lives under the skin surface. The female is about 0.3-0.4 mm long, and is larger than the male. When the female is ready to lay eggs, she burrows under the top skin layer, forming passages, where she lays her eggs, and dies shortly afterwards.
When the eggs have been laid, it takes about three weeks before they hatch. Then a new generation of mites will burrow along new passages and begin to reproduce. The symptoms of scabies, with violent itching, may not appear until two or three weeks after the first infection. The scabies burrows are often visible, if you look carefully. The burrows may be up to 10 mm long, thin and twisty, and greyish white. At the end of each burrow you can see the mite as a black dot.
Many people are afraid of this skin disease, but it is not dangerous, although it is painful and extremely uncomfortable to have microscopic mites crawling under the skin, and treatment is required to get rid of it.
Why do people get scabies?
Scabies is caused by infection with the itch mite, with the scientific name Sarcoptes scabiei var hominis. You can catch it from another person who has the skin condition.
How is scabies passed on?
Scabies is a highly infectious condition, which can spread like wildfire if it is not stopped. That is why it is important to get treatment, so that the infection does not spread. Well, how do you get scabies?
The tiny scabies mites are transferred by close contact from one person to another. That is why it is often seen in nurseries, where children are in close physical contact, or boarding schools, where young people live close together in a small space. Itch mites prefer to live in areas such as between the fingers, on the wrist, in the armpits, or around the navel and genitals. So you can in fact be infected by shaking hands – and especially through sexual contact with someone who is infected. Infection occurs through close physical contact, and everyone can catch scabies.
Even though it is usually passed on through direct physical contact with an infected person, you can also catch scabies from bed linen or other textiles. This is very rare, however. Itch mites usually only survive in textiles for up to three or four days. You can be unlucky, however, and pick up scabies from textiles if you touch them a short time after they have been in contact with someone infected with scabies.
In older people and those with a reduced immune response, scabies may progress into what is known as crusted scabies. This is not caused by a different type of itch mite burrowing through the skin layers, but by large numbers of mites reproducing in skin with crusts or scurf. It means that those who suffer from crusted scabies are even more infectious than people with ‘ordinary’ scabies.
Symptoms of scabies – what to look out for
There are some quite clear signs and symptoms of infection with itch mites. The symptoms which usually appear are:
- Intense itching, which is very troublesome. The itching sensation is caused by a strong reaction of the immune system to the mites themselves, their eggs and their excrements. The itching sensation will typically begin two to three weeks after exposure to infection. If you have had scabies previously, the symptoms may appear after just a few days.
- A rash, which appears as red patches on the skin, similar to eczema. There will often be scratch marks and open wounds in the skin, because the itching rash is so irritating that the patient scratches through the skin.
- Spots often appear together with the itch and the rash. These are small and red, especially on the arms and body.
The tiny itch mites thrive best in warm conditions, so the itching and discomfort is often worst at night, when you are lying under a warm duvet. This wakes the mites, so they move around and cause intense itching. The itch is often more bearable during the day.
Typical places for scabies attacks
The infections are usually localised to the fingers and palms, the wrists, navel and genitals. The itch is worst where the itch mite is located, but can spread over the entire body.
However, scabies may develop in different places in different age groups:
- Children – in children scabies infections often appear on the face, scalp, palms and soles of the feet. Especially in children under two years old, the scabies mites are visible on the soles of the feet, in curving burrows that are visible with a magnifying glass.
- Adults – in adults the mites usually settle in warm areas between the fingers, around the wrist, in the armpits and near the genitals. Especially on the genitals, the disease shows as small, hard red spots in the skin.
- Older people – in older people scabies is often seen as a diffuse rash. It is also in this group that crusted scabies – sometimes called Norwegian scabies – is most frequently seen. It is often due to a reduced immune response. When an older person is infected with ordinary scabies, it can progress into crusted scabies, which appears as scurf or crusts on the skin with large numbers of itch mites. It is seldom accompanied by the same degree of painful itching.
Since scabies appears with symptoms such as itching and a red rash, it can easily be confused with other skin diseases, for instance eczema and allergies.
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Treatment for scabies – how to get rid of the mites
Even though scabies is not a dangerous skin condition, it is extremely uncomfortable and irritating for the patient. Besides, it is a highly infections skin condition, so it is very important to get treatment as soon as possible if you suspect you have caught scabies.
How it is treated
As stated, it is important to treat scabies in order to break the chain of infection. If you suspect that your rash could be scabies, but you are not sure, it is vital to contact a doctor. Then treatment can be started as soon as possible. The doctor will examine the skin thoroughly to be sure of the diagnosis.
The skin will be examined under a microscope, either to identify a live itch mite, or to show up a mite burrow, which is also a sure sign that there is scabies under the skin. Treatment will then be started with cream. Crusted scabies will often require further examination by a dermatologist, who may supplement the treatment by prescribing pills to get rid of the mites.
Self treatment with cream
Patients with scabies carry out the treatment themselves at home. The remedy for scabies can be bought over-the-counter at the pharmacy. Here you can get a cream, which you must apply over your entire body, from the jaw down, and not only on the affected areas where the itch mites live. If a child under the age of three is affected, the scalp and face must also be treated with cream, except for the areas around the eyes and mouth.
The cream is to be applied at bedtime and washed off the next morning after eight to twelve hours. When eight to twelve hours have elapsed, you are considered to be free of infection, so there is no need to take time off work, keep children away from school or nursery, or in other ways avoid social activity. It is also important to put on clean clothes and change the bed linen. All clothes and textiles that have been in direct contact with the skin should be washed at minimum 60 degrees to be sure to kill the mites. If it is not possible to wash clothes at such a high temperature, they should be placed in an enclosed bag and kept at 25 degrees for at least three days. Everyone in the household must be treated with the cream at the same time.
Effective treatment for scabies
Creams with a high content of Tea Tree Oil have proved particularly effective against infection with scabies. Studies have shown that use of Tea Tree Oil, compared with other standard treatments, is faster and more effective. In several cases, the classic treatment for scabies has proved not to be sufficiently effective, and sometimes resistance to the treatment develops, so it does not reduce the skin inflammation caused by the infection.
In these cases, Tea Tree Oil has produced good results fast, while at the same time the nurturing and healing properties of the oil reduce irritation and inflammation in the skin. You can still get help, therefore, if the classic treatment for scabies is not entirely effective against the disease.
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Alternative treatment for scabies
There are also alternative ways of stamping out itch mites. Treatment with sulphur has been used for many decades as an alternative method of killing itch mites. You can get cream, ointment or soap that contain a quantity sulphur.
It is neither poisonous nor dangerous to use sulphur as a treatment, but the concentration of sulphur in the remedy may dry the skin. It is therefore a good idea to moisturise the skin well between treatments.
There are in fact several methods of treating scabies. It is important to note, however, that even though your treatment has been successful, the symptoms will not disappear immediately. For the great majority, the itch continues for up to four weeks after treatment is completed. Even though the itch mites are dead, they are still there in your skin – and they do not disappear until the skin is shed naturally. Since the immune response reacts to the itch mites, even though they are dead, the itching will continue until the mites are out of your skin.
Prevention of scabies
Everyone can catch scabies. Thus you can be unlucky enough to catch scabies if you have been in close contact with someone who is infected. Naturally, it is impossible to avoid all physical contact with other people, and therefore it may be difficult to prevent infection with scabies entirely.
Nevertheless, the most important means of prevention is to react fast if you suspect that you or your child may have caught scabies. It can spread like lightning in a very short time, so the best way to break the chain of infection is to visit a doctor or get treatment quickly. If it turns out that you are infected, it is important to carry out the treatment thoroughly and make sure that everyone in the household is treated, and close relatives as well, so that the chain of infection is effectively broken.
FAQ about scabies
You can find answers here to some of the most usual questions about scabies.
What is scabies?
Scabies is caused by tiny mites, which bore into the skin and form burrows, where they lay eggs. The mites live there until they are treated with an effective remedy for scabies.
Why do people get scabies?
You catch scabies if you are infected by someone else who is infected with itch mites. Infection results from close physical contact – or in rare cases from towels, bed linen or textiles which an infected person has been in contact with.
What does scabies look like?
Scabies is caused by a tiny yellowish-brown mite. It may be difficult to see with the naked eye. Under a microscope you can see the small, curving passages made by the female mite, who makes burrows and lays her eggs at the end. The tiny burrows look like pencil marks on the skin, while the mite itself looks like a small blackish-brown dot at the end.
Where does scabies come from?
Scabies comes from people whose skin is infected with these tiny mites. If you come into close contact with someone who is infected, you risk catching the skin disease from them.
Is scabies dangerous?
Scabies is not a dangerous skin disease – but on the other hand it is very troublesome and uncomfortable. Even though scabies is not dangerous, it is important to get treatment as soon as possible, to avoid infecting others.
How easily is scabies passed on?
Scabies is a relatively infections skin disease which is passed on through close physical contact with an infected person. Often the risk is greatest in care institutions and boarding schools where many pupils live together in small areas. In rarer cases, an infection can be passed on from bed linen or other textiles.
What are the symptoms of scabies?
Scabies can be seen as an itching red rash, sometimes accompanied by small red spots on the skin. The itch is worst at night, when the warmth from the duvet activates the itch mites. Skin changes also appear on areas where the mites have not settled.
