What is scabies?
Scabies, also known as “craw-craw,” is a common skin disease caused by mites. These mites burrow into the skin and lay eggs, causing itchy rashes (eruptions) on various parts of the body. The itching is especially severe at night and can lead to scratching, which can sometimes cause secondary bacterial infections. Children are commonly affected, but scabies can also affect adults of both sexes equally.
What causes scabies?
The culprit behind scabies is a mite called Sarcoptes scabiei var hominis. The female mites burrow into the skin and lay eggs daily for up to six weeks before dying. The number of mites increases for about four weeks before the immune system starts fighting back and reducing their population. Animals like dogs and cats can also get scabies, but from a different mite species. While animal mites can cause itching on human skin, they cannot reproduce on humans and will die within a week. Scabies in humans spreads through prolonged close skin-to-skin contact, including sexual contact. Direct transmission typically requires about 15-20 minutes of close contact.
Factors that encourage the spread of scabies: Overcrowding is a major factor in scabies transmission. People living in close quarters, such as those in communities and institutions, are at higher risk. Scabies outbreaks can happen within families, daycare centers, and schools. Sharing clothes or bedding of infected individuals also contributes to the spread of scabies, as mites can survive outside the body for up to 3 days in suitable environmental conditions (temperature and humidity). Large-scale scabies outbreaks can occur during wars or economic crises.
Clinical manifestations (symptoms): Scabies symptoms typically appear about two weeks after the initial mite infestation. Itching occurs between the fingers, wrists, elbows, shoulders, ankles, under breasts (in women), and genitals (including the scrotum and penis in men). Scratching can lead to scratch marks, small bumps (papules/pustules), and burrows (raised or flattened tunnels made by the mites) on the skin. It’s important to note that someone in the same household might also have scabies, although their symptoms may be less severe. Sometimes, the initial rash can become infected with bacteria or develop into larger bumps (nodules) due to an allergic reaction to the mites. People with weakened immune systems are more susceptible to a crusted form of scabies. This form is less itchy but highly contagious. Close family members of someone with crusted scabies usually develop the normal form. Scabies infection can rarely lead to a kidney disease called acute glomerulonephritis, especially in cases with superimposed bacterial infection by group A streptococci.
Prevention of scabies: Public awareness about scabies is crucial. Knowing the cause, spread, and symptoms of scabies can help people seek early diagnosis and treatment, preventing further spread. Anyone with a rash resembling scabies should see a dermatologist for proper diagnosis and treatment.
Management of scabies: Infested individuals should avoid close physical contact until they and their sexual partners complete treatment. Children with scabies should be treated before returning to school. Prompt treatment of infected individuals and contact tracing are essential. This often involves treating close family members as well. Clothing and bedding used by infected individuals should be washed in hot water, dried under direct sunlight, and ironed thoroughly before reuse. Maintaining good personal hygiene (daily baths, regular changes of clean clothes, etc.) and avoiding overcrowding are also important preventive measures. Additionally, practicing safe sex helps reduce transmission.
Treatment options for scabies are available. Please consult a dermatologist near you for proper diagnosis and treatment.