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Scabies

Sexually Transmitted Disease Facts

Type of Infection: Scabies is caused by the mite Sarcoptes Scabiei.

Modes of Transmission for Scabies: Scabies can be transmitted by extensive skin contact or any sexual activity. However, a person with severe crusted scabies can spread the infestation by even brief skin-to-skin contact or by sharing bedding, clothing, or furniture.

Symptoms of Scabies: Symptoms of scabies include rashes, sores, and most notably severe itching over the body. These rashes and sores are caused from the scabies mites burrowing into the skin and producing pimple-like sores. Symptoms most commonly occur where there is hair or folds of the skin, such as armpits or creases of the groin. Small children when infested may have involvement of the face, scalp, palms of the hands, and soles of the feet, but this is rare in adults. Itching is most common at night. Rashes and itching may not be apparent until six weeks after contracting scabies. Some people can be carriers and not know it or show it. Some may have allergic reactions to scabies and will develop areas of inflamed, reddened, itching skin.

Symptoms tend to appear from two to six weeks in people who have not previously been exposed to scabies infestations. People who have previously had scabies may show symptoms within one to four days after subsequent re-exposures.

Scabies are parasites. Some people have a severe form of scabies called crusted, or "Norwegian," scabies. People with crusted scabies have thick crusts of skin that contain large numbers of scabies mites and eggs. The mites in crusted (Norwegian) scabies are much more numerous — up to 2 million per patient). Poeple with crusted (Norwegian) scabies are very contagious to others. In addition to spreading scabies through brief skin-to-skin contact, people with crusted scabies may shed mites that contaminate items such as their clothing, bedding, and furniture.

Treatment of Scabies: Once the diagnosis is established, scabies is generally treated with skin lotions. The most common skin lotions contain permethrin, lindane or crotamiton, and are available through a physician's prescription. The lotions are applied to the whole body except the head and neck. After treatment, itching may last for one or two weeks but should not be regarded as treatment failure or reinfestation. Persons who have had skin contact with an infested person (including family members, roommates, direct care providers and sexual contacts) should also be treated. Treatment usually consists of an application of a creme or lotion containing the scabies-killing insecticide. Sometimes two or more cremes or lotions are prescribed, but usually only one is necessary. If crusted sores are present on the skin, often a warm bath is recommended prior to application of the lotion or creme to soften the crusts.

Items used within the week prior to treatment, such as bedding, clothing, and towels, should be washed. These should be washed in hot water and dried on the hot cycle. Items that can not be washed or dry cleaned may be put in a sealed plastic bag for 5 days to eliminate mites.

Possible Consequences of Scabies for the Infected Person: Itching may get worse over time. Tiny blisters can also occur on infested areas and when scratched, small infected sores can develop.

Possible Consequences of Scabies for the Fetus and Newborn: Most treatment of scabies is toxic, including lindane and permethrin, and should be used in consultation with a physician in pregnant women or infants.

Prevention of Scabies: Avoiding extensive skin contact, including sexual contact, is the best way to prevent scabies. Avoid sleeping in the same bed or sharing towels or clothes with someone who is infested.

Source of Information: Centers for Disease Control and Prevention, National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED), updated 10/1/2008, www.cdc.gov/scabies.
Photo Source: Centers for Disease Control and Prevention, Division of STD Prevention, "Pubic Lice & Scabies," STD Clinical Slides, 2003, www.cdc.gov/std/training/clinicalslides.