A tiny mite has infested humans for at least 2,500 years. It is often hard to detect and causes a fierce, itchy skin condition known as scabies. Dermatologists estimate that more than 300 million cases of scabies occur worldwide every year. The condition can strike anyone of any race or age, regardless of personal hygiene. But there is good news: with better detection methods and treatments, scabies need not cause more than temporary distress.
More than an Itch: How Scabies Develops
The microscopic mite that causes scabies can barely be seen by the human eye. A tiny, eight-legged creature with a round body, the mite burrows within the skin. Within several weeks the patient develops an allergic reaction. This results in severe itching, often intense enough to keep sufferers awake all night.
Human scabies is almost always caught from another person by close contact - it could be a child, a friend, or another family member. Dermatologists, who frequently treat patients with scabies, point out that scabies is not a condition only of low-income families, neglected children, or poor hygiene. Although, more prominent in crowded living conditions, and poor hygiene - everyone is susceptible.
Scabies skin mite is about 0.4mm, just visible to the human eye
Attracted to warmth and odor, the female mite burrows into the skin, lays eggs, and produces secretions that cause allergic reactions. Larvae, or newly hatched mites, travel to the skin surface, lying in shallow pockets where they will develop into adult mites. If the mite is scratched off the skin, it can live in bedding up to 24 hours. It may be up to a month before a newly infested person will notice the itching, especially in people with good hygiene and who bathe regularly.
What to Look for
The earliest and most common symptom of scabies is itching, especially at night. Early on, little red bumps, like hives, tiny bites, or pimples appear. In more advanced cases, the skin may be crusty or scaly.
Scabies prefers warmer sites on the skin such as skin folds where clothing is tight. These areas include between the fingers, on the elbows or wrists, buttocks or belt line, around the nipples, and on the penis. Mites also tend to hide in, or on, the skin under rings, bracelets or watchbands, or under the nails. In children, the infestation may involve the entire body, including the palms, soles, and scalp. The child may be tired and irritable as a result of loss of sleep from itching or scratching all night long.
Bacterial infection may occur secondarily with scabies due to scratching. In many cases, children are treated because of infected skin lesions rather than for the scabies itself. Although treatment of bacterial infections sometimes provides relief, recurrence is almost certain if the scabies infection is not treated.
Crusted Scabies
Crusted scabies is a form of the disease in which the symptoms are far more severe than usual. Large areas of the body, including hands and feet, may be scaly and crusted. These crusts hide thousands of live mites and their eggs, making treatment difficult because medications applied directly to the skin may not be able to penetrate the thickened skin. This type of scabies occurs mostly among the elderly, in some AIDS patients, or in people whose immunity is decreased. These cases are extremely infectious.
Diagnosis
A thorough head-to-toe examination in good lighting, with careful attention to skin crevices, will usually be recommended and performed at your dermatologist's office.
Scabies masquerading as contact dermatitis
Many cases of scabies can be diagnosed by dermatologists without special tests. To confirm scabies your dermatologist can perform a painless test that involves applying a drop of oil to the suspected lesion. The site is then scraped and transferred to a glass slide which is then examined using a microscope. A diagnosis is made by finding scabies mites or their eggs.
Who is most at risk?
Scabies is most common in those who have close physical contact with others, particularly children, mothers of young children, and elderly people in nursing homes.
All in the family - Studies of families have shown that children under two years of age are most at risk, followed by mothers and older female siblings, and then by other family members who have frequent and close physical contact.
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