The word Scabies is derived from the Latin word Scabere, which means “to scratch”.
Scabies is caused by infection of the skin with a small (0.5mm) insect called Sarcoptes Scabiei. The infection is most often spread by direct skin contact with an infected person or less often by sitting or sleeping in a space where an infected person has been. Once the female mite is on the skin it burrows into the top layer of the skin where she will lay her eggs.
The symptoms of Scabies starts a few weeks after exposure in people that have never had Scabies before. If someone had Scabies previously, reinfection can cause symptoms to appear in a few days. The rash can appear anywhere on the skin, but is more common in the skin folds areas, genital area, around the wrists, elbows, side of the hands and between the fingers. In young children the side of the feet is commonly affected. The initial sign of infection is a small, red, scaly or pearly-looking bump. Itching can be severe, especially at night. As the condition persists signs of scratching will start to
dominate and eventually the affected areas start looking eczema-like.
The diagnosis of Scabies is made by scraping a red bump, mounting the scraping sample on a glass slide and then seeing the insect under the microscope. Sometimes the mite cannot be found in this way in which case the diagnosis is based on the patients symptoms and the clinical signs found on examination of the skin.
Scabies can be treated easily in most cases. Ascabiol lotion (Benzyl benzoate) is an often used treatment option. Tetmosol soap (Sulfiram 5%) is often prescribed by some practitioners, but does not work very well if used in isolation. Ascabiol lotion is applied from the neck downwards and left overnight. In the morning it is washed off. The procedure is repeated after one week.
The symptoms of Scabies might take weeks to resolve, even after the Scabies mites have been killed by treatment. This is because parts of the dead mite will remain in the skin and need to be shed off over time.
Overzealous use of Ascabiol lotion can lead to skin irritation, which is often the presenting complaint when patients come to our clinic.