Out of the various forms of Scabies, Norwegian scabies are very deadly. The term "Norwegian scabies" refers to a rare, but severe form of scabies, which is also known as crusted scabies. This form of scabies has been named as ‘Norwegian’ scabies because this condition was first seen in Norway in the mid-19th century. It was first described among leprosy patients in Norway in 1848.
Norwegian scabies is extremely contagious because of the presence of large number or scabies mites in and on the skin. Crusted scabies mostly occur in those with a poor immune system. In these cases, spread of infection can take place even during a brief contact, either directly or indirectly.
People with weaker immune systems act as a more fertile breeding ground for the scabies mites, which spread over their body, leaving the face. The presence of innumerable mites on the body of sufferers of crusted scabies makes eradication of mites particularly difficult.
This form of scabies may occur in:
- People with certain serious ailments like nutritional disorders, infectious diseases, cancer, or weakened immune systems (such as people suffering from AIDS).
- People with neurological disorders, which mask the itching. When scabies itching goes unnoticed, the infestation gets severe, turning into crusted scabies.
- Crusted scabies can also sometimes occur in a paralyzed limb or a limb with sensory neuropathy, probably due to the absence of itch or the helplessness to scratch.
Characteristics of this form of scabies include:
- Scaling and crusting of blisters on the hands, feet, scalp, torso, and pressure-bearing areas such as the elbows.
- Facial skin may chip off, and patient might experience hair loss.
- Mild itching.
- Slow response to treatment. On the failure of multiple treatments, oral treatment with the medicine ivermectin may be used.
- People with crusted scabies have been recognized as “core-transmitters” and as sources of reinfection following intervention programs.
- Sufferers of Norwegian scabies may remain infectious for long periods of time because of the difficulty in eradicating mites.
- Fissure development and secondary infections are common. High mortality rates for this form of the disease are also common.
Treating Norwegian scabies
Norwegian scabies are very difficult to cure; presence of thousands of mites being the reason. However, there are a number of agents available in the market to treat scabies. The selection of the agents depends largely on the age of the sufferer, state of their health, extent of excoriation, potential toxicity, and availability.
- Earlier, Lindane (gammabenzene hexachloride) was the topical agent most commonly preferred for treatment of crusted scabies in Western nations. However, due to the potential neurotoxicity, it has now been banned in Australia and much of Europe.
- Five percent permethrin is often prescribed today as a topical treatment in prosperous countries. However, its heavy cost excludes its use in many regions where scabies is widespread.
- Dr. Scabies – a natural and safe topical formula is today the most popular way to treat scabies. Its low-cost, easy availability and 100% effectiveness has made it a top recommendation of dermatologists today.
- Besides topical application of active substances, oral Ivermectin is increasingly used to treat crusted scabies.
- In areas where scabies is prevalent, empirical treatment is often more economical than laboratory-based diagnoses.
- A combination of topical agents like Dr. Scabies and oral dose of Ivermectin can also result in dramatic reductions in the prevalence of scabies and skin sores.
- Regions in which the occurrence of crusted scabies among children is between 5 and 10%, eradicating epidemics of scabies with effective treatments and using a sensitive tool able to determine both clinical and subclinical infestations are important.
In severe cases of crusted-scabies, upto seven doses of ivermectin is recommended to ensure the cure and eradication of scabies mites.
Prevention of Scabies
- When a person gets affected by scabies, he/she should be immediately diagnosed and treated by the doctor as quickly as possible.
- Besides the patient, other family members should also be given the scabies treated to avoid further infestation.
- Family members and other person must avoid skin-to-skin contact with the affectant.
- The belongings of the patient like clothing, bedding, and bath linens should be machine washed using hot water and dried using the hot drier cycle.
- Clothing and other items that cannot be washed should be stored in a closed plastic bag for atleast one week.
- Furniture, mattresses, carpets, curtains, etc. that cannot be washed should be vacuumed regularly.