Scabies

Overview on Scabies

• Skin infection caused by a mite (Sarcoptes scabiei)
• Mite makes burrows into and lives under the skin, setting off an allergic reaction.
• Easily and readily transmissible, especially throughout the household, by:
• Skin-to-skin contact with an infected person (e.g. nursery, schoolmates, bed partners).
• Clothing, bedding or towels that have been in direct contact with skin.
• The mites that infect us cannot survive or reproduce on pets.

Symptoms

• Onset: 4-6 weeks after initial infestation – an infected person is contagious for some time before symptoms are noticeable!
• Generalized itching particularly at night.
• Red, elevated areas on skin (papular eruption).
• Distinctive raised, wavy silvery lines on skin especially at interdigital folds, the wrist and elbows, genital areas, umbilical areas and feet.
• Young infants and immune-suppressed patients (e.g. HIV infected, on immunosuppressive drugs) may exhibit an extensive rash with thick scaling. This is called Norwegian scabies.
• Rash could become secondarily infected, if scratching had led to broken skin.
• Consult a doctor if yellow discharge/yellow crusts observed

Self-Care: Control Measures

• Do not scratch – scratching could break the skin leading to infection.
• Change bedding, nightclothes and towels on the night when treatment is administered. Launder these in hot cycle wash and hot drying cycle.
• A child should not return to nursery or school until the treatment is completed.

Treatment

• Treat all family/household members or close contacts at the same time - even if symptoms are absent!

Topical

Benzyl benzoate

• Benzyl benzoate 25% for children over 10 years
• Benzyl benzoate12.5% for children between 6-9 years
• Adult
• Applied to the entire body from neck downwards and left overnight for 12 hours. Repeat for 3 consecutive days.
• Less toxic but can cause asthmatic and allergic reactions (Ask a doctor/pharmacist).

• Low toxicity with satisfactory results.
• Wash off after 8-12 hours.
• Do no mistake this for permethrin 1% solution, which is used to treat head lice but not effective in treatment of scabies.

Oral

• Antihistamine may be effective in relieving itchiness, which may continue 1-2 weeks after treatment. This does not indicate ineffective treatment. Your body is still exhibiting an allergic response towards the dead mites left in the skin. Dead mites will eventually be removed naturally by the body’s shedding.

Preventing Reinfection

• Ensure all household members are treated at the same time.
• Clean the house thoroughly house.