SCABIES
Cause
of scabies
Scabies
is caused by a tiny mite that burrows into the skin. The commonest sites of
the burrows are the palms, fingers and wrists. The widespread itchy rash is
caused by an allergy to the mite and takes some weeks to develop after the
infection has been caught.
<<<<A female mite burrowing under the skin. The eggs she
lays in the skin are on the right
Spread
Transfer of the mite is by
physical contact between people. This may be as little as lifting or holding
or shaking hands. Infection commonly occurs between people in the same
household. Because the itch takes weeks to develop, the affected person has
no itch or rash at first and is unaware of the infestation for a while, so
that it may be difficult to say where it came from. Transfer on fabrics is
rare. The mite is not caught from animals. Scabies has nothing to do with
hygiene.
Treatment
The usual treatment is permethrin (Lyclear™). Malathion (Derbac
M™, Quellada M™) is sometimes used. These are insecticides
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Treatments
should be applied to cool dry skin
and not immediately after a hot bath.
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The
lotion or cream must be applied to the complete
skin surface including the face and scalp, taking care not to get
the lotion or cream into the eyes, nose, or mouth.
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The
advice leaflet with your treatment may recommend application to the head for
babies and young children only, but although scabies mites are uncommon on
the head in older children and adults, they are occasionally found there, so
include
the head at all ages
for the best chance of a quick recovery.
Use
the same preparation on the head, for the same duration, as for the rest of
the body.
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If
your treatment is Lyclear Dermal Cream, you will need most of a tube to
cover the scalp. Cream will inevitably get on the hair, but it is the skin of the scalp which needs to be treated.
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Take
care to cover all areas of the scalp
surface.
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The
cream washes out of the hair easily. (Lyclear Crème Rinse is intended
mainly for a different condition, head lice, and is not particularly
recommended for scabies, but if it is used it should be kept on for 8 hours
like the cream).
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Include
the soles of the feet. Pay
particular attention to the skin
between fingers and toes, under the nails, behind the ears, and wrinkled
skin such as nipples and scrotum.
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Application
of liquid lotions is easiest with a 1.5 - 2 inch width paintbrush.
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The
lotion or cream should be left on for 8
hours in the case of Lyclear, and for
24 hours for other treatments. It may then be washed off in the bath or
the shower.
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If
the hands are washed during the treatment time, remember to reapply the
cream or lotion to the hands.
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Everyone
at home, and others in close contact with you, should be treated, even if they have no itch or rash. This should be done as far as
possible on the same day.
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Repeat
the treatment as above after 1 week.
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Although
transfer of scabies on fabrics is rare, it is a sensible precaution to
change washable items (underwear, nightwear, shirts, bed sheets, etc.) the
day after each treatment is done. Normal
washing is all that is required. Clothes which are not washable such as
wool jackets, trousers or skirts do not need to be cleaned.
Problems
The
more thoroughly the above rules are followed, the higher the cure rate, but
even with proper treatment there are occasional failures. Sometimes the mite may be transferred back to
you from an untreated contact. Even
with successful treatment, the itch may get worse within a week or so
after treatment due to release of material from the killed mites. However,
if the itch has not settled within 2 - 4 weeks the treatment may have
failed. If so, a repeat treatment may
be required as advised by your doctor.
