How to Cure Scabies.

A common skin condition, scabies causes intense itching. It is easily caught through physical, skin-to-skin contact with people who already have the condition. Scabies is caused by mites burrowing under the surface of your skin. As they do this, they lay eggs. Small blisters and red patches will form on the skin above each mite and turn itchy as a result of reacting to the mite and its feces. Scratching causes infections, as bacteria is able to infect the scratched areas. It's important to realize that scabies is not caused by being dirty. And while it is highly contagious, it is able to be treated effectively, to quell the itching and restore your life to the way it was pre-scabies. Here is how.

Steps

Familiarize yourself with the signs of scabies. Caused by the mite Sarcoptes scabiei, the infection is easily spread from person to person. Scabies should be considered as a possible cause for any cases of severe itching lasting over weeks or months. Scabies signs include.

 

Intense itch and scratching all over your body.

The itching is worse at night, or when you're warm such as following exercise, a bath, or a shower.

Red patches or blisters in your skin, especially between the fingers, on the wrists, elbows, ankles, armpits, sides of fingers, genitals (males), hands, and feet. Infants will also have infections on the soles of feet where they're not able to walk yet.

Tiny bumps in the skin. Sometimes these are the only sign.

Burrow lines on the skin. These will appear as small threadlike lines of a grayish color approximately 5 to 10mm (up to 1/2 inch) long. They'll be slightly raised. They can be anywhere on the body except the face.

Expect itching to occur faster if you've already experienced scabies before. If not, the reaction to the mites not occur until weeks after the mites have infested your skin. Note that while a rash in reaction to scabies may appear in only some parts of the body, it is the whole body that is affected.

Visit the doctor. The doctor will usually only need to see the rash to diagnose the condition but might also take a sample by scraping under the bumps and looking for the presence of mites, eggs, and feces under the microscope. Be sure to tell your doctor if you are pregnant or have any problems such as serious illness, or other severe skin diseases.

Once diagnosed, your doctor will prescribe a mite killing cream or lotion that contains 5 percent permethrin.[1] (CreamMe). 

For those who prefer an herbal cure, oil of neem is available from Mideastern markets and natural foods stores, and many people report that it does the job.

For people with a severe infestation and weakened immune system, Invermectin can be prescribed as an oral treatment.

If you have a severe bacterial infection, your doctor may also prescribe antibiotics.

Organize for someone else to cook meals and do any cleaning work requiring washing etc. over the next day. This will ensure that you can get the best impact from the treatment, which can be removed if you get water on your skin (such as from washing dishes or preparing food). If you live alone, have pre-made meals ready to heat and eat and wash items in the dishwasher until you're able to use water freely again.

It's easiest to apply the cream - www.CreamMe.eu or lotion before going to bed and wash it off in the morning, so that your daily routine is the least disrupted.

Apply the cream www.CreamMe.eu or lotion. While the cream is usually one application, this will depend on your doctor's or pharmacist's instructions so be sure to follow what has been prescribed.

Shower and towel-dry your body using a fresh, clean towel.

Wait until your body has cooled down.

Apply the cream or lotion. Start behind the ears and from the jawline and work your way down. Apply using cotton wool swabs, a paintbrush, a sponge, or any item supplied with the treatment for the purpose.

Don't leave out anywhere – your genitals, soles of your feet, between your toes, back, and buttocks must also be covered. Get help for areas you're not able to reach yourself.

Once it is applied, take care of your hands. Apply between the fingers and under your nails. You will need to reapply the www.CreamMe.eu to your hands every time you wash them.

Leave on for the amount of time required, usually between 8 to 24 hours. The length of time will depend on the product and your doctor's instructions.

Shower off the cream or lotion. Once the aloted time is up, wash it off under a warm shower. Be aware that you may remain itchy for a few weeks after the treatment. This is because your allergic reaction to the mites continues while the mite bodies remain in the skin a while longer. If it's concerning you, speak with your doctor again.

You may need to use a corticosteroid cream and antihistamines to control continued itching.

Some treatments need to be reapplied a week later. If so, your doctor or pharmacist will make this clear.

Treat everyone in the house. All household members need to be treated, even if they aren't showing signs of scabies. This will prevent reinfestation.

Clean the house. To take care of mites that might reinfest you after treatment, it's vital to clean the parts of your house that you've had direct skin contact with, such as bedding. A scabies mite can live for one to two days off the body. Washing will ensure that remaining mites are killed.

Vacuum floors, carpets, and rugs. Dispose of the bag or contents in an outside trash can immediately and dispose of as quickly as possible.

Wash all towels, bedding and recently worn clothes in hot water. Wash bedding daily until you’ve not seen new bumps for at least a week. Wear disposable gloves when stripping beds. If you have a heavy comforter, take if off your bed and have it dry cleaned or throw it away, because it needs to be washed daily and if it’s too big, the hot water can’t saturate the layers.

Clothes that cannot be washed need to be bagged and placed in the freezer for 24 hours or left in the airtight bag in a room for one week. Freeze stuffed animals, brushes, combs, shoes, coats, gloves, hats, robes, wetsuits, etc. overnight in a plastic bag.

Dry clothing and bedding in a hot dryer or on the clothesline in hot weather under direct sunlight. Dry cleaning is also appropriate.

Disinfect floor and bathroom surfaces by mopping (this only needs to be done after the first treatment).

Hot dry pillows for 30 minutes.

Quarantine things that cannot be washed, hot dried, frozen or dry cleaned in a plastic bag for two weeks.

Reassess after six weeks. If you're still itching after six weeks, this can indicate that the treatment has not worked. See your doctor for more advice and new treatment options.

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Norwegian scabies.

Norwegian scabies

 Also known as crusted scabies, is a serious form of scabies infection first discovered in Norway in the mid-nineteenth century. This form of scabies usually afflicts people with impaired immunity, including individuals with AIDS, lymphoma and mental or physical impairments. Norwegian scabies is also common among the elderly since this group generally has a weaker immune system. In Norwegian scabies, people are infected with hundreds of scabies mites, compared with a normal infection, where only about 15 scabies mites are present on the human body. The large number of scabies mites is due to a compromised immune system which allows the scabies to multiply drastically. The overwhelming number of scabies mites on the body means that risk of infection is not limited to family members as in normal scabies, but also extends to health workers and other people who have any form of body contact with the patient.

In Norwegian scabies, the primary sites of infection are usually the soles of the feet, knees, elbows, palms and scalp; hands may swell and nails may become discolored. The damage is extensive and may resemble blistering that spreads rapidly. Norwegian scabies poses a major risk of additional infections, including with Streptococcal bacteria, since the damaged areas of the body are more susceptible to bacterial infection. Intense itching, which is the most common symptom of scabies, does not occur to the same extent in Norwegian scabies, or may not occur at all in some individuals. 

What is scabies?

Scabies is caused by a mite (like a tiny insect) called Sarcoptes scabiei. The mite is a parasite, meaning it lives off the host (a human) with no benefit to the host.

Scabies mites are tiny. They have a cream-coloured body, bristles and spines on their back, and four pairs of legs. The female mite is bigger (about 0.4 mm x 0.3 mm) compared with the male (0.2 mm x 0.15 mm). The female mites tunnel into the skin and lay eggs. About 40-50 eggs are laid in the lifetime of a mite. The eggs hatch into larvae after 3-4 days, these then grow into adults within 10-15 days. Less than one in 10 eggs becomes an adult scabies mite.

Most of the symptoms of scabies infestation are due to the immune system response to the mites themselves, their saliva, their eggs or their faeces.

The average number of mites on an infested person is 12. Neglected children with scabies in underprivileged communities may have 100s of mites.

How common is scabies?

Scabies is common. In the UK, about 1 in 1,000 people develops scabies each month. Scabies is more common in urban (town) areas, in women and children (probably due to close contact), in the winter (again when people spend more time closer together), and in the North of the country.

How do you get scabies?

You need close skin-to-skin contact with an infected person to catch scabies. This is because the scabies mite cannot jump or fly.

Most cases of scabies are probably caught from prolonged hand-holding with an infected person. The hand is the most common site to be first affected.

Close skin-to-skin contact when having sex is another common way of catching scabies.

The skin-to-skin contact needs to be for a reasonable time to catch the mite. Therefore, you are unlikely to catch scabies from an infected person by casual short contact such as a handshake or a hug. The rate of transmission (spread) is higher the greater the number of mites.

The mites live in skin and can survive away from the host human for about 24-36 hours. You are unlikely to catch scabies from bedding and towels unless you use them immediately after being used by someone with scabies. However, due to the potential risk, it is best to treat bedding and towels by hot washing (described later).

Sometimes outbreaks of scabies occur in places such as nurseries and residential homes, where people are in regular close contact.

Scabies symptoms

• Mite tunnels (burrows). These may be seen on the skin as fine, dark, or silvery lines about 2-10 mm long. They most commonly occur in the loose skin between the fingers (the web spaces), the inner surface of the wrists, and the hands. However, they can occur on any part of the skin. You may not notice the burrows until a rash or itch develops.
• Itching. This is often severe and tends to be in one place at first (often the hands), and then spreads to other areas. The itch is generally worse at night and after a hot bath. You can have widespread itching, even with only a few mites.
• Rash . The rash usually appears soon after the itch starts. It is typically a blotchy, lumpy red rash that can appear anywhere on the body. The rash is often most obvious on the inside of the thighs, parts of the abdomen and buttocks, armpits, and around the nipples in women. The appearance of the rash is often typical. However, some people develop unusual rashes which may be confused with other skin conditions.
• Scratching. Scratching due to intense itching can cause minor skin damage. In some cases the damaged skin becomes infected by bacteria - a secondary skin infection. If skin becomes infected with bacteria it becomes red, inflamed, hot, and tender.
• Aggravation of pre-existing skin conditions. Scabies can worsen the symptoms of other skin conditions, particularly itchy skin problems such as eczema, or problems such as psoriasis. Scabies can be more difficult to diagnose in these situations too.

Note: the itch and rash of scabies are due to an allergy (reaction) to the mites (or their saliva, faeces or eggs). Scabies symptoms usually take 2-6 weeks to occur after you are first infected. The itch and rash can develop on any part of the skin, away from where the mites are actually burrowing. This means that you are infectious (and can spread scabies) before you even know you have scabies.

The picture above shows some typical mite tunnels (burrows) either side of the wrist skin crease. It does not show the typical rash that occurs as a reaction to the mites.

Symptoms with recurring infection

The itch and rash normally take 2-6 weeks to develop when you have a first scabies infection. However, if you have scabies, it is cleared with effective treatment and then you are re-infested, the symptoms may be slightly different. In such instances the rash and itching develop much more quickly - often within a day or two. This is because the first scabies infestation has already sensitised your immune system - which reacts much more quickly with this second bout of scabies.

How is scabies diagnosed?

Scabies tends to be diagnosed clinically. This means on the basis of typical symptoms and the typical appearance of the skin rash.
Often, a doctor will find one or more mite burrows on the skin to confirm the diagnosis.

It is sometimes difficult to tell the difference between the rash caused by scabies and some other skin conditions. Therefore, a scraping from the skin is sometimes sent to the laboratory to look for mites under the microscope if there is doubt about the diagnosis.

If itching and a rash develop in several people who live in the same home at about the same time, then scabies is a likely cause.

Who should be treated?

Scabies will persist indefinitely if not treated. Treatment is needed for:

• Anybody who has scabies AND ...
• All household members, close contacts, and sleeping/sexual partners of the affected person - even if they have no symptoms. This is because it can take up to six weeks to develop symptoms after you become infected. Close contacts may be infected, but have no symptoms, and may pass on the mite.

Note: everyone who is treated should be treated at the same time - that is, on the same day.

Note: you will still be itchy for a while after successful treatment

It is normal to take up to 2-3 weeks (and sometimes up to six weeks) for the itch to go completely after the mites have been killed by treatment.

Also, even after successful treatment, in a small number of cases there remain some itchy brownish-red lumps (nodules) up to 2 cm in diameter. If these remain, they most commonly occur on the genitals and armpits. These lumps are neither infectious, nor mean that the mite is still present. They occur in some cases as a prolonged skin reaction to the scabies mite. If they occur, they usually go within three months, but occasionally last up to one year.

Treatment for itching

Itching can be a distressing symptom. It can be eased either with topical treatments that you apply to the skin (such as creams or lotions), or with medication taken by mouth. Your GP or pharmacist can usually advise regarding suitable products. Even cold moisturisers (emollients), especially if they contain menthol, can provide temporary relief. Avoid applying strong steroid creams, especially if the diagnosis of scabies is uncertain.

• Crotamiton cream or lotion has soothing qualities and may help to relieve itch. Apply crotamiton 2-3 times a day (but only once a day for children under three years old).
• Hydrocortisone cream. This is a mild steroid cream that may ease any inflammation and help to ease itch. It can be applied once or twice per day, for up to a week.
• An antihistamine medicine that makes you drowsy, such as chlorphenamine (brand name Piriton®). This does not ease the itch directly, but can help you to sleep if itching is a problem at night (particularly for children). It is not licensed for this use, but can be safely used under the direction of a doctor.

Crusted scabies (Norwegian scabies)

This type of scabies is unusual, and most people who develop scabies do not get Norwegian scabies.

It is a more severe form of scabies with a hyperinfestation of scabies mites. This means that there are thousands or millions of the mites, causing excessive flaking of the skin. Because there are so many mites, and because the skin is flaking off, it is very highly contagious. The rash is crusting (and looks a bit like psoriasis). It can be very extensive and can, if severe, lead to serious secondary bacterial skin infections.

Crusted scabies mainly occurs in people who are immunocompromised (have a poor immune system). This includes people with HIV/AIDS, people having chemotherapy and frail people who are elderly or ill with other conditions. Other people at risk are those who are malnourished, have learning difficulties (meaning they cannot comprehend or respond to the itch) or nerve-related problems (meaning they cannot feel the itch.

Crusted scabies is more easily transmitted through contact with towels, bedding and upholstery. In crusted scabies, the mites can survive for up to a week. Even minimally exposed people, such as cleaners and laundry personnel, are at risk from crusted scabies and need insecticide treatment if they are working in an institution with an outbreak. An outbreak in a institution with many vulnerable people, such as a nursing home, can be extremely challenging. It is likely that all residents and all staff would require treatment.

A healthy person with a normal immune system would develop 'normal' scabies if infested with the scabies mite following contact with someone who had crusted scabies.Crusted scabies may be impossible to eradicate in people with HIV infection, and recurrences are common.

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