Treating scabies can be an itchy situation | Health | The Daily News - Galveston County Daily News

Scabies is a common infestation in childhood. It has been called a "scourge," isn't limited to childhood and affects all age groups. Scabies is an extremely itchy, contagious skin infection that is caused by microscopic bugs (mites).

The mite is spread mostly by skin-to-skin transmission as it can't live more than 48 hours off human skin and can't run, jump or fly. These microscopic bugs have eight legs, and the female mite burrows just beneath the skin making a tunnel to lay her eggs. The scabies mite live their entire 30-day life in human skin. In most infections, 10 to 15 female mites make shallow burrows and lay three eggs per day. The eggs hatch in three days and the larvae mature in 10 days.

Unfortunately, children have a higher rate of infection and complications. Drs. R. Brockman and S. Leitenberger report in "Pediatrics in Review" there's an estimated incidence of more than 200 million affected people worldwide. It occurs in all regions and socioeconomic sectors of the United States. It's most common in overcrowded conditions.

The main symptom of an infestation is intense itching, which is cause by the body's hypersensitive reaction to the mites burrowed in the skin. This reaction is to the proteins, eggs and excretions of the mites and usually takes up to 6 weeks to occur, sometimes longer. This allows the mites to be spread by people who don't know they've been infested. If the child is reinfected, the body's reaction and itching can occur in one to four days.

Infants usually have more mites and have a rash that appears on the palms, soles of the feet, the head and neck. Older children have a rash found between the fingers, in the folds and creases of the wrist and elbows, as well as at the waist line, thighs and buttocks. Sometimes threadlike gray or white lines can be seen unless the burrows have been scrapped away.

The itching is more severe at night. The intense itching causes intense scratching that causes sores. They can become infected causing serious complications. Breaks in the skin allow bacterial infections such as impetigo. Some people with chronic health conditions can have severe, crusted scabies.

A health care provider can make a diagnosis by looking at the rash and taking the history of the itching. Does it itch more at night? Sometimes a scraping of the rash is taken to be microscopically examined to see the mites or the eggs.

Recommended treatment is 5 percent topical permethrin (prescription) to the entire household, applied to the entire skin (except eyes and central face), left on overnight, paying attention to fingernails and washed off in the morning and then repeated in 7 days. All bedding and clothes should be washed in hot water and shoes/non-washable clothing can be stored in a sealed plastic bag for 48 hours.

Itching may persist after treatment and antihistamines and low-mid dose topical steroids may be needed for several weeks.

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