Scabies or scabies is a contagious skin infection that can usually be treated with appropriate lotions without complications. There are various ways to prevent scabies, which are explained in detail here.
What is scabies?
In most cases, the symptoms of scabies show up within two to six weeks. Then there are inflammatory reactions of the skin and severe itching. See AbbreviationFinder for abbreviations related to Scabies.
Scabies is a skin disease caused by the so-called itch mite (Sarcoptes scabiei). In technical jargon, scabies is also referred to as scabies. Typical symptoms of scabies is a scaly or crusty skin that is interspersed with nodules.
The symptoms of scabies are often associated with severe itching. Skin changes caused by scabies are often found in adults on the wrists, armpits or genitals. Affected children may also develop skin changes on the face or on the palms of hands and feet.
Although people are affected by scabies worldwide, the number of infected people varies depending on time and region: while the disease hardly occurred in Germany in the 1950s, for example, the number of people infected with scabies has been increasing again since the 1960s.
The cause of the occurrence of scabies is a corresponding infection with the itch mite. The female animals of these parasites are primarily responsible for the clinical picture.
Female itch mites cause small holes in the horny layer of the skin in the course of scabies, in which they lay their eggs. Scabies mites feed on skin and lymph cells, damaging the skin. This damage causes the body’s immune system to become active, which causes some of the symptoms of scabies (such as itching).
Scabies is contagious and can be transmitted through physical contact. Since such a transmission is possible through sexual intercourse, among other things, scabies is a sexually transmitted disease and one of the sexually transmitted diseases.
Many people usually associate scabies with dirty and unhygienic living conditions. This can indeed be a reason for the spread of the itch mite. However, itch mites are also found in schools, hospitals, retirement homes and kindergartens, i.e. in places where many people bump into each other every day. Similar to lice, these facilities are ideal for spreading scabies quickly.
Symptoms, Ailments & Signs
In most cases, the symptoms of scabies show up within two to six weeks. Then there are inflammatory reactions of the skin and severe itching. Particularly warm areas with a thin epidermis are primarily affected. These include, for example, the spaces between the fingers and toes, the armpits, the navel region, the nipple region and the genital region. The back and head are rarely or never affected by scabies.
The affected areas are red and sometimes nodules form. These nodules are very small and delicate. Children are more likely to have blisters than nodules, and they can also get scabies on their heads. The itching increases with increasing heat. The warmth of the bed in particular leads to severe itching.
Scratching the itchy areas causes scaling and cornification of the skin. The complexion can therefore be severely damaged. In some patients, mite tunnels can be seen with the naked eye. Sometimes single mites can also be seen.
Bark scabies, which occurs only rarely, has other effects on the skin. So the itching here is weak or stays away. The keratinization and scaling of the skin is particularly pronounced on the hands and feet and most of the body is red.
Diagnosis & History
A diagnosis of scabies is initially possible based on the typical skin changes. These can be shown especially with the help of a reflected light microscope. If this diagnosis of scabies still needs to be secured, another option is the so-called ink method:
Diluted ink can be used to visualize the burrows of the itch mite on a skin nodule. In addition, to diagnose scabies, an existing skin nodule can be removed in order to then examine it for itch mites.
In most cases, with adequate treatment of scabies, a positive course of the disease can be expected. In some cases, itching can persist beyond successful treatment. Complications can occur with scabies, among other things, due to a lack of personal hygiene: germs can penetrate the injured skin and cause erysipelas or blood poisoning, for example.
Bacterial inflammation in the area of the previously damaged skin is the most common complication of scabies. Frequently, the bacterial colonization is streptococci or staphylococci, which result in erysipelas accompanied by fever and chills or swelling of the lymph nodes (lymphadenopathy). can trigger. If the germs spread further via the lymph vessels, they can become inflamed (lymphangitis).
If the infection remains untreated, in the worst case, the pathogens present in the lymphatic vessels penetrate the bloodstream and lead to life-threatening blood poisoning (sepsis). Streptococci can also cause rheumatic fever and a specific type of kidney infection called glomerulonephritis. All of these infections usually respond well to antibiotics, so prompt treatment can usually prevent serious sequelae from scabies.
In some cases, the skin reacts hypersensitively to the anti-mite agent used for therapy, cracked skin areas and reddening indicate eczema caused by dehydration. A rare complication of scabies is persistent itching, which can be attributed to overactivation of nerve cells: These report a stimulus to the brain long after the trigger has been eliminated.
When should you go to the doctor?
Scabies is a disease with a high risk of infection. So that the infection does not spread to other people and does not spread further in your own body, you should see a doctor at the first sign. If the person concerned suffers from skin abnormalities, these should always be clarified by a doctor. Skin infections are red flags that should be followed up. The hands, the spaces between the fingers, the armpits and the genital area are considered to be particularly endangered body regions for scabies. If there are changes to the skin on these parts of the body, it is advisable to consult a doctor. If you have itching or open wounds, you should also consult a doctor.
If the symptoms spread or increase in intensity, a doctor’s visit is necessary. If gangrene develops, pus develops or a burning sensation develops on the skin, a doctor is needed. In severe cases, the person affected is at risk of blood poisoning. A scaly, dry, or crusty skin surface requires a doctor’s visit to determine the cause. If lumps, swellings or small ulcers form, the changes in the skin must be examined by a doctor. Reddening of the skin, inner restlessness or sensitivity disorders must be presented to a doctor so that appropriate therapy can be initiated as quickly as possible.
Treatment & Therapy
If a scabies disease is not associated with complications, successful treatment is usually possible through the use of topical lotions. The effects of such therapy against scabies are both to destroy the mites and to prevent reinfection.
It can often be necessary to treat people from the private environment of an affected person against scabies. This can also be useful for people who do not yet have any acute symptoms of scabies, since symptoms can sometimes only appear a long time after an infection.
Active ingredients that are sometimes contained in ointments for the treatment of scabies are the substances permethrin (an artificially generated insecticide) or benzyl benzoate. Corresponding ointments usually require a certain exposure time after they have been applied before they are then rinsed off again.
The duration of treatment for scabies depends, among other things, on the severity of the disease and the remedy used. If the above-mentioned complications occur during the course of scabies, they are treated with antibiotics, for example.
Outlook & Forecast
The prognosis and prospects of scabies depend on whether the patient consistently completes the treatment and observes the appropriate precautionary measures. If left untreated, scabies can become chronic. Affected patients then sometimes suffer for years from worsening symptoms. Larger and larger areas of skin are then affected by the lesions.
This increases the risk of a deterioration in general health. Because if pathogens get into the typical scratch wounds, purulent infections or even life-threatening sepsis can be the consequences. In rare cases, however, untreated scabies can heal on its own after a few years.
The prognosis for scabies is significantly better if the patient takes medication and observes hygiene recommendations. In this case, the scabies almost always heals without any problems, without those affected having to fear serious long-term consequences.
Unlike some infectious diseases, the body does not develop any immunity after surviving scabies. Especially after the illness has just been overcome, a new infestation can occur, for example if people in the immediate vicinity have contracted scabies, often without noticing it.
Scabies can be prevented, for example, by avoiding close physical contact with people who have scabies . If scabies is already present, preventive treatment by private contacts can prevent re-infection. In order to prevent a protracted course of scabies, in addition to the correct use of the medication, regular living space and body hygiene can also contribute, which makes it more difficult for the scabies mites to reproduce.
Special follow-up care is not an option after successful therapy. The patient is considered cured. Skin changes and itching may still be present for a short time. However, these can be treated with creams. If a patient wants to prevent re-infection, he must take preventive measures himself.
He alone is responsible for this. There is no direct medical support. However, doctors provide information about transmission routes. Appropriate measures include, above all, compliance with high hygiene standards. Especially in foreign accommodation you should take a critical look at the sleeping arrangements and sanitary facilities. Infected people must be avoided at all costs.
Patients with a weak immune system and small children should not take reinfection lightly. Hospital treatment is inevitable. There is a risk of complications such as blood poisoning or lymph node inflammation in these groups of people. The treatment period is extended.
In rare cases, scabies can also become chronic. Then there is a need for long-term treatment. The medication is increased or changed, another treatment with anti-mite ointments is started. Affected patients have to severely limit their everyday life. Avoid close contact with other people. Items of laundry and textiles must be adequately cleaned.
You can do that yourself
Anyone suffering from scabies should first observe a few hygiene measures. It is advisable to wash the bedding and clothing with hot water and to shower at least twice a day. In addition, close contacts should be informed about the disease in order to avoid infection.
Typical measures such as cold compresses against the itching, soothing ointments against the pain and cosmetic measures such as natural make-up against the redness help against the actual symptoms. If the scabies is not very advanced, various home remedies can also help. Tea tree oil kills the parasites and supports the skin structure. Lavender oil helps against skin itching and redness, while aloe vera oil has an overall pain-relieving effect. Herbs such as sage, St. John’s wort or peppermint are just as effective, which are boiled and applied directly to the skin. A tried and tested home remedy is onion skins – also boiled and applied to the itchy areas.
From homeopathy, the preparation Psorinum offers itself, which kills the parasites and relieves the pain. Sulfur is also said to have a soothing effect. The use of these remedies is best clarified first with the doctor treating you.