Doctors warn: scabies symptoms should not be ignored

Scabies, also known as sarcoptic mange, is a skin disease caused by the microscopic mite Sarcoptes scabiei. This parasite feeds on keratin, a protein found in the skin’s outer layer. The condition is highly contagious, and although more common in environments with poor hygiene or overcrowding, it can affect anyone. General practitioners are emphasizing the importance of not underestimating scabies symptoms, as early detection can prevent serious complications and the spread of the disease.

Main symptoms of scabies

The hallmark symptom of scabies is intense itching, which typically worsens at night. This occurs because of an allergic reaction to the presence of the mites. Other common signs include:

• Small blisters or papules: These skin lesions often appear in skin folds, such as between the fingers, in the armpits, around the waist, on the wrists, and in the genital area.
• Lines or tunnels under the skin: These are caused by the mites burrowing under the skin, creating tiny, visible tracks.
• Irritation and crusting: In advanced stages, persistent scratching can lead to crusted areas and possible secondary skin infections.

These symptoms can take weeks to appear after the initial infestation, making scabies a sneaky condition. During this time, a person can unknowingly spread the mites to others.

How does scabies spread?

Scabies is primarily transmitted through direct, prolonged skin contact with an infected person, such as through close physical relationships. It can also spread through contaminated objects, like bedding, towels, and upholstered furniture. This makes the disease spread quickly in crowded environments, such as daycares, schools, prisons, and nursing homes.

It’s important to note that animals, such as dogs and cats, can be infected by a different type of scabies mite. While humans can temporarily contract scabies from animals, the mites do not survive long on the human body because they prefer their specific host.

At-risk groups

Although scabies can affect anyone, certain groups are more vulnerable. Immunocompromised patients, such as those with AIDS, lymphoma, or those taking immunosuppressive medications, are at higher risk for developing severe forms of the disease, like crusted scabies. This variant is characterized by thick crusts that cover large areas of the body and is highly contagious due to the higher number of mites.

Diagnosis and treatment

The diagnosis of scabies is usually clinical, meaning it is based on the patient’s symptoms and medical history. In some cases, a doctor may perform a skin scraping test to confirm the presence of mites or their eggs. The visual observation of lesions, their typical locations (such as hands, wrists, and genitals), and the nocturnal itching are key factors in diagnosing the condition.

Treatment involves the use of scabicides, which are medications that kill the mites. These are often applied topically, in the form of creams or lotions, like permethrin 5% and benzyl benzoate. Additionally, in more resistant cases or outbreaks affecting multiple people, such as in households or institutions, oral ivermectin may be prescribed. Ivermectin is typically taken in a single dose, with a follow-up dose two weeks later.

It is essential that all family members or close contacts also receive treatment, even if they show no symptoms, to prevent reinfestation. The mites can survive outside the human body for a short period, making reinfection a possibility if proper precautions aren’t followed.

Prevention and additional care

To prevent the spread of scabies, doctors recommend a series of hygiene practices:

• Washing clothes and bed linens in hot water: The mites are killed by temperatures above 55°C (131°F), so personal clothes, towels, and bedding must be washed in hot water and dried on high heat.
• Avoid sharing personal items: Towels, clothing, and even combs and brushes should not be shared.
• Regular cleaning of surfaces and objects: Upholstered furniture and other shared objects should be disinfected regularly to minimize the risk of indirect transmission.

In addition to these precautions, infected individuals should avoid close physical contact with others until the treatment is completed and the mites have been eradicated. Those working in environments that require close interaction, such as schools and hospitals, may need temporary isolation until fully treated.

Scabies complications

If left untreated, scabies can lead to severe complications. One of the most common is secondary bacterial infections, caused by scratching that breaks the skin’s protective barrier. This can lead to impetigo, a skin infection that, if untreated, can spread and lead to further complications.

Another potential complication is crusted scabies, a more severe form of the disease affecting mainly immunocompromised individuals. This type is marked by thick crusts and can cover large areas of the body, making it far more challenging to treat than typical scabies.

The importance of awareness

Doctors emphasize that scabies, while common, can be prevented and treated successfully. The key is recognizing the symptoms early and seeking medical attention. Early diagnosis leads to more effective treatment, preventing prolonged suffering and reducing the risk of transmission.

Awareness about scabies is crucial to reducing the stigma surrounding the disease. Many people still associate scabies with poor hygiene or unsanitary living conditions, but the reality is that anyone can be affected. Educating people about the symptoms, transmission, and available treatments helps decrease the incidence of cases and ensures that patients receive the care they need.