Overview. Scabies is a parasitic
Crusted scabies is a severe form of scabies that can occur in some persons who are immunocompromised (have a weak immune system), elderly, disabled, or debilitated. It is also called Norwegian scabies. Persons with crusted scabies have thick crusts of skin that contain large numbers of scabies mites and eggs.
The severe itch can lead to constant scratching. With non-stop scratching, an infection can develop. Non-stop scratching can even lead to sepsis, a sometimes life-threatening condition that develops when the infection enters the blood. Scabies can develop anywhere on the skin.
Severe itching (pruritus), especially at night, is the earliest and most common symptom of scabies. A pimple-like (papular) itchy (pruritic) “scabies rash” is also common. Itching and rash may affect much of the body or be limited to common sites such as: Between the fingers.
See a GP if: your skin is still itching 4 weeks after treatment has finished.
Most cases of scabies resolve on their own, but some can get so severe that they require medical attention.
Treatment can get rid of the mites, eliminate symptoms such as itch, and treat an infection that has developed. For the first few days to a week, the rash and itch can worsen during treatment. Within four weeks, your skin should heal. If your skin has not healed within 4 weeks, you may still have mites.
The scabies rash takes the form of small, red bumps that may look like pimples, bug bites, hives or knots under the skin. You might be able to see the burrow tracks created by the mites, which appear as raised lines of tiny blisters or bumps. Some people develop scaly patches that resemble eczema.
The infestation with scabies poses a high burden on respective patients, often due to an intense unbearable itch. The symptom lasts as long as scabies lasts, however, it might become chronic due to persistence after therapy of the infestation.
The developmental stages of S. scabiei consist of egg, larva, protonymph, tritonymph and adult. This life-cycle is typical of that for other astigmatid mites.
If left untreated, the infestation may last for years, and has been called the seven year itch. This is a photomicrograph of a skin scraping that contains a scabies mite, eggs, and feces.
In addition, when treating infants and young children, scabicide lotion or cream also should be applied to their entire head and neck because scabies can affect their face, scalp, and neck, as well as the rest of their body.
A broad differential diagnosis of scabies can include atopic dermatitis (AD), allergic contact dermatitis, nummular eczema, arthropod bites, dermatitis herpetiformis, etc. (1, 7).
The mites have been reported to be capable of survival for 19 days at 10 °C and 97% relative humidity, although they are unable to move and penetrate skin at temperatures below 20 °C [4,21]. Scabies mites survive less than 24 h in a temperature of 34 °C [2].
Permethrin kills the scabies mite and eggs. Permethrin is the drug of choice for the treatment of scabies. Two (or more) applications, each about a week apart, may be necessary to eliminate all mites.
Scabies will not go away without treatment 1. First have a warm bath or shower. 2. Then cover the whole body with cream/lotion, from the chin down to the soles of the feet, in between the fingers, under the nails and on the private parts.
Scabies is a common, yet neglected, skin disease. Scabies occurs across Australia, but most frequently in socioeconomically disadvantaged populations in tropical regions, including in remote Aboriginal and Torres Strait Islander communities. In temperate settings, the disease clusters in institutional care facilities.
The itch of scabies is insidious and relentless. The itch is typically worse at night. For the first weeks, the itch is subtle. It then gradually becomes more intense until, after a month or two, sleep becomes almost impossible.
Scabies life cycle
The mite undergoes four stages in its life cycle: egg, larva, nymph and adult. The female mite burrows into the skin and lays eggs. Eggs hatch after 2–3 days, and larvae travel to the skin surface, where they moult into nymphs and become adult mites.
Scabies can lead to skin sores and serious complications like septicaemia (a bloodstream infection), heart disease and kidney problems.
Items that cannot be dry-cleaned or laundered can be disinfested by storing in a closed plastic bag for several days to a week. Scabies mites generally do not survive more than 2 to 3 days away from human skin. Children and adults usually can return to child care, school, or work the day after treatment.
If left untreated, scabies can continue for many months. It is important to remember that recurrence of symptoms after attempted treatment does not exclude the diagnosis of scabies because patients may not have treated themselves correctly or may have been reinfested by an untreated contact.
Scabies sometimes leave noticeable burrows on the skin. The result of female tunneling, burrows looks like small, raised lines on the surface of the skin and may appear skin-colored or grayish-white. Burrows can be difficult to find if only a few mites are living in the skin.