Scabies: symptoms and treatment

Scabies: symptoms and treatment

Scabies is a skin disease caused by parasites, specifically itch mites. It is not for nothing that the infection is popularly referred to as “scabies” – a typical symptom is a nagging itch that – especially in the warmth of the bed – makes those affected feel the need to scratch themselves continuously. Read about the symptoms and treatment of scabies and learn how to recognize scabies here.

What is scabies?

The itch or scabies, colloquially referred to as mange or scab, were already known in ancient times. As early as 1,000 years ago, the Arab At-Tabari meticulously described the animal pathogen, how it is found in the skin, and the options for controlling the disease.

The faeces of itch mites trigger the symptoms of scabiesThe tiny pests are about 0.2 to 0.5 millimetres in size and like to make themselves comfortable in clothing, bed linen, upholstered furniture or carpets at room temperature. They can survive up to three days (up to two weeks in the cold) without a human host.

If a suitable victim is within reach, the fertilized females burrow under their skin within a few minutes, digging angled burrows 1 cm long and 0.5 to 2 mm wide. They remain seated for the rest of their lives, i.e. for about a month, laying faeces and one or two eggs daily. The hatched larvae burrow outwards, and after about two weeks, a new cycle begins.

The common scabies is also known as Sarcoptes scabiei variety hominis.


Scabies: symptoms and course

In the case of initial infection with itch mites, symptoms can be felt after two to five weeks, and in the case of a renewed infection after 24 hours (due to the already activated immune system). In the early stages, scabies are initially noticeable through burning and itching. After a short time, other signs of scabies can appear.

The following symptoms are typical of scabies:

  • Skin irritations in the form of blisters, bumps, and redness occur due to drilling.
  • Mites, balls of faeces and eggs cause severe itching.
  • Comma-shaped, usually reddish, ducts may be present on all body parts except the face and hairy head.

The little animals like to stay in the following body regions:

  • between the fingers
  • in the armpits
  • in the elbows
  • on the nipples
  • at the navel
  • on the genitals
  • at the inner edge of the foot and the ankle

Due to the pronounced scratching, a bacterial infection can also develop on the corresponding skin areas. Without treatment, it can heal itself after about three months.

contagion in scabies

The itch mite is still found worldwide. This parasite is highly contagious and is most commonly transmitted through close physical contact.

This does not necessarily have to be sexual intercourse, although there must be prolonged skin contact (at least five minutes) for transmission. Unfavourable living conditions with many people in a small space can also contribute to the spreading of scabies mites. This is why there are often frequent infections with scabies in communal facilities, such as youth or nursing homes.

In principle, infection with scabies via skin flakes, for example, on the sofa or bed, is possible but rather unlikely since the itch mites are only found there in tiny numbers.

Scabies mites are usually transmitted from person to person. Pets can also get scabies, but they are attacked by another mite species that die when they move to humans.


How long is scabies contagious?

After the first medical treatment, those affected are usually no longer contagious. An exception is the scabies crustose, which usually has to be treated as an inpatient in the hospital.

diagnosis of scabies

The diagnosis is often made based on the typical symptoms. It is not always possible to detect the mites microscopically on a skin scraping or after dissection with a needle since the proportion of mites on these skin flakes is very small. Nevertheless, if there is sufficient suspicion, therapy is recommended.

Another way to detect scabies is to use a dermatoscopy as part of a dermatological exam. The mites can be seen under the dermatoscope. A blood test for antigens or antibodies can also be done.

Scabies: treatment and home remedies

So-called anti-scabiosa are used for the drug treatment of scabies. These can be used locally, i.e., in ointments or sprays, or systemically, i.e., in the form of tablets against scabies. Tablets are only used in particularly severe cases of scabies. The active ingredient ivermectin is usually used for this. People who have close physical contact with the affected person should always be treated as well.

To be on the safe side, a follow-up examination should be carried out after the treatment.

There are no classic home remedies for scabies, but a few rules of conduct should be heeded in your own four walls in the event of scabies. This includes:

  • the frequent changing and washing of towels, bed linen and underwear (60 degrees)
  • thorough vacuuming of upholstered furniture, carpets and pillows
  • the storage of non-washable textiles in closed plastic containers (for at least three days, at least 21 degrees)
  • Dry cleaning outerwear and blankets is even better.

This can also prevent infection with scabies.


Special form: Scabies crustosa (bark itch)

The itch mite also triggers the symptoms of Scabies crustose, formerly known as Scabies novice. However, these differ from the symptoms of common scabies. In the case of bark scabies, horny crusts with scales form on the affected skin areas. The adjacent skin is red. The face, neck, elbows, knees, palms, soles of the feet, and nails are particularly often affected. The itching typical of scabies is usually hardly or nonexistent in scabies crustose.

Scabies crustose occurs mainly in people with a weakened immune system since the itch mites can multiply significantly more in this group. The number of mites per square centimetre of skin can be quadrupled compared to ordinary scabies. This makes bark scabies more contagious. Even brief skin contact can lead to infection.

Is scabies notifiable?

According to the Infection Protection Act, there is only an obligation to report scabies if the disease breaks out in community facilities because the cause of the infestation by the scabies mites must be investigated. Any suspected infestation must also be reported immediately to the responsible health authority.

Institutions such as:

  • kindergartens
  • schools
  • retirement homes
  • children’s homes
  • other community facilities
  • Affected people cannot stay or work in such community facilities during the illness phase.

Seven essential facts about scabies

The most crucial information about scabies can be found here at a glance:

  1. Scabies is contagious and occurs worldwide.
  2. The so-called itch mite causes scabies.
  3. Scabies are mainly transmitted through direct physical contact but can also occur indirectly through laundry or upholstery.
  4. A typical symptom is severe itching, especially at night.
  5. Family members and sexual partners must also be treated.
  6. In addition to the specific therapy with an anti-mite agent, general hygienic measures must also be taken.
  7. Scabies only have to be reported when they break out and when it is suspected in community facilities.

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