Scabies is very contagious and the most common mode of transmission is the direct skin-to-skin contact. Scabies mites can only live off of a host body for 24-36 hours under most conditions. The transmission of the mites involves close person-to-person contact of the skin-to-skin variety, so risk factors include close contact with an infected person. It is hard to catch scabies by shaking hands or hanging your clothes next to someone who has it. Sexual physical contact, however, can transmit the disease.
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What does scabies rash look like? What are scabies symptoms and signs?
The first symptom of scabies can be seen in form of a skin rash with small red bumps and blisters present on specific areas of the body. Usually, scabies rashes occur on the areas where skin folds, such as webs between the fingers, the knees, the wrists and the backs of the elbows, around the waist and umbilicus, the axillary folds, the breasts, the sides and backs of the feet, the genital area, and the buttocks. The bumps, which are medically termed papules, may contain blood crusts.
These bumps or red zigzag lines on the skin appear as the scabies mites start making burrows or tunnels and laying eggs into these burrows within your skin. These are tiny threadlike projections, ranging from 2 mm-15 mm long, which appear as thin gray, brown, or red lines in affected areas. Often these burrows are mistaken as linear scratch marks or welts that are large and dramatic and appear in people with an itchy skin condition.
What does scabies feel like?
You may not see these symptoms even after two months of infestation with the scabies mites. Even though symptoms do not occur, the infested person is still able to spread scabies during this time. When the symptoms start developing, the infested person feels extreme itching - the most common symptom of scabies. The itch of scabies is insidious and relentless and often worsens over a period of weeks. The itching is typically worse at night - as during this time mites are more active and lay eggs within the burrows. For the first weeks, the itch is subtle but gradually becomes more intense until, after a month or two. It’s also very difficult to sleep due to the intensely itchy skin.
If the condition becomes worse, it may even catch other itchy skin conditions like eczema, hives, etc. These additional skin conditions may keep people from falling asleep at night for a little while, however, they rarely prevent sleep or awaken the sufferer in the middle of the night.
The most common and effective treatment for scabies if to apply a mite-killer like permethrin 5% (Elimite). This cream needs to be applied from the neck down, left on overnight, then washed off in the morning. This application is usually repeated for seven days. Permethrin is approved for use in people 2 months of age and older and is considered to be the safest medication for scabies in all age groups.
An alternative treatment is 1 ounce of a 1% lotion or 30 grams of cream of lindane. It is also applied from the neck down but washed off after approximately eight hours. Since lindane can cause seizures when it is absorbed through the skin, it should not be used if the skin is significantly irritated or wet, such as with extensive skin disease, rash, or after a bath. Lindane should not be used during pregnancy or in nursing women, the elderly, people with skin sores at the site of the application, children younger than 2 years of age, or people who weigh less than 110 pounds.