Scabies: Causes, Symptoms and Treatment
Scabies is a contagious skin condition caused by the mite Sarcoptes scabiei, leading to intense itching and a characteristic skin rash.
Wissenswertes über "Scabies"
Scabies is a contagious skin condition caused by the mite Sarcoptes scabiei, leading to intense itching and a characteristic skin rash.
What is Scabies?
Scabies is a highly contagious skin condition found worldwide, caused by the microscopic mite Sarcoptes scabiei. The female mite burrows into the outermost layer of the skin, lays eggs, and triggers an allergic immune response that results in intense itching. Scabies can affect people of all ages and social backgrounds and is not a sign of poor hygiene.
Causes and Transmission
Scabies is spread primarily through prolonged, direct skin-to-skin contact with an infected person. Indirect transmission through shared clothing, bedding, or towels is less common but possible.
- Close physical contact (e.g., within families, care homes, or shared living facilities)
- Sexual contact
- Rarely: shared textiles if recently contaminated
Symptoms
The classic symptoms of scabies include:
- Intense itching that worsens at night or after a warm shower
- Skin rash consisting of small red bumps, papules, or blisters
- Burrow tracks: thin, winding lines on the skin surface, commonly found between the fingers, on the wrists, elbows, armpits, abdomen, or genital area
- Secondary scratch marks and crusting from persistent scratching
In people with a weakened immune system, a more severe form known as crusted scabies (Norwegian scabies) can develop, characterized by thick, crusted skin lesions harboring millions of mites.
Diagnosis
Diagnosis is typically made by a dermatologist based on the characteristic skin appearance and the presence of burrow tracks. A dermatoscope (a handheld magnifying device) can help visualize the burrows or even the mite itself. In some cases, skin scrapings are examined under a microscope to confirm the presence of mites, eggs, or fecal matter.
Treatment
Scabies is effectively treatable. Therapy involves antiparasitic agents applied to the skin or taken orally.
Topical Treatment
- Permethrin 5% cream: First-line treatment; applied over the entire body and washed off after 8 to 12 hours. A second application after 1 to 2 weeks is often recommended.
- Benzyl benzoate lotion: An alternative for those with permethrin intolerance.
- Sulfur-based preparations: Suitable for infants and pregnant women.
Oral Treatment
- Ivermectin (tablets): Used for extensive infestations, crusted scabies, or when topical therapy is not feasible.
Additional Measures
- All close contacts (household members, intimate partners) should be treated simultaneously, even if they have no symptoms.
- Clothing, bedding, and towels should be washed at a minimum of 60 °C or sealed in a plastic bag for at least 72 hours to kill the mites.
- Itching may persist for several weeks after successful treatment, as dead mites and their byproducts can continue to trigger an immune response.
Prevention
Since scabies is highly contagious, the following preventive measures are important:
- Avoiding close physical contact with infected individuals until treatment is complete
- Informing and simultaneously treating all household members
- Proper hygiene measures for clothing and bedding
- Notifying schools, nurseries, or care facilities, as scabies may be subject to mandatory reporting requirements depending on local public health regulations
References
- World Health Organization (WHO): Scabies – Fact Sheet. Available at: https://www.who.int/news-room/fact-sheets/detail/scabies
- Sunderkötter C. et al.: S1 Guideline on Scabies. German Dermatological Society (DDG), 2021.
- Centers for Disease Control and Prevention (CDC): Scabies – Epidemiology and Risk Factors. Available at: https://www.cdc.gov/parasites/scabies
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Related search terms: Scabies + Sarcoptic mange + Sarcoptes scabiei infection