What are scabies?

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Scabies is an itchy, highly contagious skin disease caused by an infestation by the itch mite Sarcoptes scabiei.

Direct skin-to-skin contact is the mode of transmission. A severe and relentless itch is the predominant symptom of scabies. Sexual contact is the most common form of transmission among sexually active young people, and scabies has been considered by many to be a sexually transmitted disease (STD), although not all cases are transmitted sexually.

Signs and symptoms of scabies include a skin rash composed of small red bumps and blisters that affects specific areas of the body. Other symptoms can include tiny red burrows on the skin and relentless itching. The itch leads to frequent scratching, which may predispose the skin to secondary infections.

Treatment includes oral or topical scabicidal drugs. Over-the-counter remedies are not effective in eliminating scabies.

We all know that there are bacteria and viruses that we cannot see that can cause infection. However, scabies is causes by a bigger but still invisible bug called a mite. Unlike dust mites though these Sarcoptes Scabiei mites can burrow into the skin and lay eggs. Over time scabies can irritate the skin and cause red and itchy bumps, especially between the fingers and wrists but sometimes on the hands, and feet. It is not a highly contagious disease but people with prolonged skin to skin contact to scabies can be infected. Much less often, people can be infected from wearing clothing, sleeping in the same bed, or sharing a towel that has recently come from someone with scabies. What makes it difficult to contain is that it can take a few weeks from being infested until you get the itchy red bumps so they may have found this individual and removed him or her from school but they could have another person infected who could spread the mites but won’t have symptoms for another 2-6 weeks.

There are over the counter creams that contains permethrin that can be used and several prescription creams that doctors can prescribe to treat scabies. Once a person is treated, they are considered scabies free and can return to school or work as long as they have not been re-exposed to their clothes, towels, or bedding that may have been contaminated. Their clothing, bedding, and towels need to be washed in hot water and dried using hot blown air or they can be dry cleaned. After cleaning, they should be stored in plastic for 72 hours before being returned to use in the house. People who are known to have had prolonged skin contact with someone with scabies can be treated even though they have not had any symptoms yet.

The CDC believes that this was an unnecessary step unless the person had crusted scabies which is a very severe form that occurs in people with compromised immune systems. I think they did it out of an abundance of caution and to make parents feel better. They most important things they can do is to isolate the person who had scabies, get them treated, and identify those people who came in close contact with that person to treat them prophylactically as well. They also need to make sure that everyone understands that having scabies doesn’t mean that the person wasn’t clean, anybody who has close skin contact with someone with scabies can be infected regardless of the amount of soap used or their parents average income.

Michael White; Dept. Of Pharmacy Practice, UConn School Of Pharmacy

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