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Scabies

Plainly speaking, scabies is a communicable skin infection attributable to the mite Sarcoptes scabiei and is distinguished by extreme itching, swelling, tenderness and development of cysts and boils. Scabies is caused in humans owing to invasion of the skin by the human itch mite (scientific name, Sarcoptes scabiei var. hominis). These minuscule scabies mites make tiny holes in the upper skin strata, especially the in the soft skin areas, for instance, the armpits, wrists, genitals, buttocks as well as the spaces between the toes and fingers. Entering the skin layer, these microscopic organisms inhibit the areas and multiply by laying eggs.

Severe itching and skin rash akin to pimples are the most common symptoms of scabies. This type of rash is marked by tiny reddish bulges, which soon become arid and flaking. The condition may be extremely itchy for many, particularly at night. In addition, children enduring scabies may also develop minute, slight pale gray or pink lines on their skin. These are actually the tunnels burrowed by the human itch mite.

Scabies is a global problem and has an effect on people belonging to all races as well as social classes. In crowded conditions, scabies has the aptitude to multiply and spread very speedily, especially where there is frequent and intimate body contact. It may be noted that establishments like prisons, nursing homes and extended care facilities are generally the common places where scabies outbreak occurs.

It may be noted here that scabies is an extremely infectious condition and it transmits by means of skin-to-skin contact or due to contact with infected clothes, towels and sheets. In addition, people may also develop scabies from their contact with infected animals. In case your child catches scabies, it is important that every member of the family is examined to find if any of them too have been infected by the human itch mite.

Generally, scabies can be cured quite successfully at home. However, call your physician for immediate help if the swelling and tenderness continues even a week after contracting scabies and treatment or if the condition of the patient deteriorates or if you notice new bumps developing.

Crusted scabies (Norwegian scabies)

The crusted scabies, also known as the Norwegian scabies, is an exceptional type of the disease. Interestingly enough, it has been found that majority of the individuals who develop scabies once, usually do not develop Norwegian scabies.

Precisely speaking, the Norwegian scabies is a more serious type of scabies as it occurs with hyper-infestation or over-stimulated infection of scabies mites. In other words, it denotes that in this case actually several thousands or even millions of scabies mites cause extreme flaking/ peeling of the skin. As there are such a great number of mites and since the skin is peeling off, it becomes extremely infectious. The rash developed in the case of Norwegian scabies is somewhat coated and has an appearance akin psoriasis. Norwegian scabies has the potential to turn out to be extremely far-reaching and if the condition is serious, it can also result in development of secondary bacterial infections of the skin.

It may be noted that generally crusted scabies develops in individuals who are immuno-compromised. In other words, this condition affects people having a poor immune system most easily. Such type of people include those having HIV/ AIDS or people who are undergoing chemotherapy and feeble people, especially the aged and those who are sick with other medical conditions. Even people who are malnourished face the risk of developing crusted or Norwegian scabies. In addition, people who endure learning problems - those who are unable to comprehend things usually or react to itching, or individuals having nerve problems - those who are not sensitive to the itching feeling, are also susceptible to Norwegian scabies.

Apart from close body contact, crusted or Norwegian scabies can be transmitted or spread easily by means of contact with infected bedding, towels and upholstery. Moreover, the mites have the aptitude to survive for several days, almost up to a week, in the case of crusted scabies. What is worse is that people like laundry personnel or cleaners, who are nominally exposed, also face the risk of developing crusted scabies and they require insecticide therapy in case they are engaged in any establishment where there is an outbreak of the disease. When crusted scabies outbreaks in any organization where there are several susceptible people, such as a nursing home, it really becomes a challenging task to eradicate the disease. In such a situation, it is essential for all the residents as well as the staff of the nursing home or any other institution where there is an outbreak of crusted scabies to undergo treatment.

The good news is that even when a healthy individual with a normal immune system comes in bodily contact with any patient enduring crusted scabies, he or she would be generally affected by the scabies mite and only develop ‘normal' scabies and not crusted scabies.

On the other hand, it might be next to impossible to completely cure HIV/ AIDS patients infected with crusted scabies. In this case, even if the disease is cured for the time being, recurrences of crusted scabies are very widespread.

How do you get scabies?

Scabies is an extremely contagious disease and it spreads very rapidly. There are a number of ways by which an individual may develop this medical condition. The most common mode of transmission of scabies is direct or close skin-to-skin touch. In most conditions, the human itch mite, which is responsible for scabies, is able to live on the body of its host for around 24 hours to 36 hours. The disease spreads mainly by intimate person-to-person contact, especially skin-to-skin direct contact. Although it is rare, but many people may even develop scabies by merely shaking hands with infected people, hanging their coat beside someone's who has already developed the disease and even by sharing towels and sheets which might have human itch mites on them in the previous night.

In addition, scabies can also be transmitted by means of sexual physical contact. In effect, it has been found that transmission of the disease through sexual contact is most widespread among young people who are sexually active. This particular aspect has made many consider scabies to be a type of sexually transmitted disease (STD). Nevertheless, even other types of physical contact, such as a mother hugging her children, are also enough for the human itch mites to spread rapidly and infest other healthy people. In due course, even friends and relatives may also develop the disease in this manner. This disease is seldom transmitted among children from their schools, as the situation in the schools does not allow physical contact for long enough for the human itch mites to spread and transmit the disease.

Incidentally, aged people as well as those who are feeble and residing in nursing homes or other related establishments are likely to develop scabies even without displaying visually noticeable signs of the disease. In such instances, there may be far-reaching outbreaks of the disease among patients as well as the healthcare providers. Although such instances are striking, luckily they are quite rare.

What are scabies symptoms and signs?

Generally, the signs and symptoms of scabies are visually noticeable. When any individual catches scabies, his/ her skin produces rash comprising minute red bumps and eruptions that effects particular areas of the body, especially where the skin is soft. Scabies may develop on the wrists, armpits, the space between the fingers, around the waist and umbilicus, at the back of the elbows, the knees, in the region of the nipples, the auxiliary folds, in the genital areas, at the side and back of the feet as well as the buttocks. The bumps, medically called papules, might enclose blood crusts. However, it is useful to be aware that not all bumps are bugs. In the majority of instances where healthy people develop scabies, their body does not host any more than 10 to 15 live human itch mites, although they may have several hundred pimples and papules.

Skin rash produced due to scabies is generally noticeable on the face, head, neck, palms and soles of the feet among the infants and very young children. However, they are not so visible in older children and adults.

When scabies is described in textbooks, they always talk about ‘tunnels' and/ or ‘burrows'. In effect, they are actually miniscule projections akin to thread that vary in length from 2 mm to 15 mm. These ‘burrows' or ‘tunnels' look like slight gray, brown or reddish lines in the areas affected by the mites. In fact, it is very difficult to see these ‘burrows' with the naked eye. Many people usually mistake straight scratch marks to be ‘burrows'. These linear scratch marks are usually larger and striking and emerge in people having an itchy skin. It may be noted that the burrows are actually destroyed when people scratch the itching area.

Prevention

As discussed earlier, direct skin-to-skin contact, such as holding hands, and even sharing the clothing and upholstery, towels and sheets of people infested with scabies are some of the most common ways by which the human itch mite transmits the disease. This is all the more true because the human itch mites, responsible for scabies, are able to survive for around two to three days in the clothing, bedding and even dust.

In the event of any member of your family developing scabies or being treated for the disease, it is important that every member of the household also be treated for the disease. Washing all clothing, towels and sheets in hot water helps to kill the mites and, thereby, prevents the spread of the disease. In case you have stuffed animals at home, keep them sealed in plastic bags for at least three days for the human itch mites responsible for causing scabies do not have the aptitude to survive for too long without coming in contact with the human skin. In addition, you should vacuum clean every room in the house and once the cleaning is over, discard the cleaner bag.

Although scabies is an extremely contagious disease, most children who have developed it are able to get back to school a day after their treatment is completed.

Supplements and herbs

Generally, scabies can be treated at home and there are numerous herbs that can not only alleviate the symptoms of the disease, but also cure it completely. For instance, the tea tree oil (botanical name, Melaleuca alternifolia) is a potent herbal sanitizer/ antiseptic and painting the affected area with concentrated tea tree oil two times every day will help to stop the spread of the mites as well as the disease.

Another herb, balsam of Peru possesses strong anti-parasitic attributes and, hence, it is helpful in eradicating human itch mites and curing scabies. This balsam may be applied topically on the affected areas either in concentrated form or diluted with almond, olive or sesame oil to treat the patient affected by scabies. In addition, comfrey root too is an effective salve that can be applied on the affected areas. For best results, apply this ointment thrice every day.

Ointments prepared with calendula and goldenseal too are effective in treating scabies. These are also commercially available. Using calendula salve to treat scabies helps to heal as well as comfort the affected skin. On the other hand, the goldenseal ointment is useful in curing the infection by the human itch mites. For best results apply the mixture of the two ointments topically on the affected skin areas thrice every day.

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