What is scabies?
Scabies is an itchy skin condition caused by an infestation by the itch mite Sarcoptes scabiei. Mites are small eight-legged parasites (in contrast to insects, which have six legs). They are tiny, just 1/3 millimeter long, and burrow into the skin to produce intense itching, which tends to be worse at night. The mites that cause scabies are not visible with the naked eye but can be seen with a magnifying glass or microscope.

How do you get scabies?
Scabies mites are very sensitive to their environment. They can only live off of a host body for 24-36 hours under most conditions. Transmission of the mites involves close person-to-person contact of the skin-to-skin variety. It is hard, if not impossible, to catch scabies by shaking hands, hanging your coat next to someone who has it, or even sharing bedclothes that had mites in them the night before. Sexual physical contact, however, can transmit the disease. In fact, sexual contact is the most common form of transmission among sexually active young people.

However, other forms of physical contact, such as mothers hugging their children, are sufficient to spread the mites. Over time, close friends and relatives can contract it this way, too. School settings typically do not provide the level of prolonged personal contact necessary for transmission of the mites.

What is the treatment for a scabies infestation?
Curing scabies is rather easy with the administration of prescription scabicide drugs. There are no approved over-the-counter preparations that have been proved to be effective in eliminating scabies. The following steps should be included in the treatment of scabies:

1. Apply a mite-killer like permethrin (Elimite). These creams are applied from the neck down, left on overnight, then washed off. This application is usually repeated in seven days. Permethrin is approved for use in people 2 months of age and older.


2. An alternative treatment is 1 ounce of a 1% lotion or 30 grams of cream of lindane, applied from the neck down and washed off after approximately eight hours. Since lindane can cause seizures when it is absorbed through the skin, it should not be used if skin is significantly irritated or wet, such as with extensive skin disease, rash, or after a bath. As an additional precaution, lindane should not be used in pregnant or nursing women, the elderly, people with skin sores at the site of the application, children younger than 2 years of age, or people who weigh less than 110 pounds. Lindane is not a first-line treatment and is only recommended if patients cannot tolerate other therapies or if other therapies have not been effective.

3.Ivermectin, an oral medication, is an antiparasitic medication that has also been shown to be an effective scabicide, although 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. Although taking a drug by mouth is more convenient than application of the cream, ivermectin has a greater risk of toxic side effects than permethrin and has not been shown to be superior to permethrin in eradicating scabies. It is typically used only when topical medications have failed or when the patient cannot tolerate them.


4.Crotamiton lotion 10% and cream 10% (Eurax, Crotan) is a another drug that has been approved for the treatment of scabies in adults, but it is not approved for use in children. However, treatment failures have been documented with the use of crotamiton.









 

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