SCABIES - HOW TO IDENTIFY AND TREAT

Scabies is one of the commonest skin parasite infestations in tropical regions. It is one of the diseases of public health importance, yet it is not receiving the adequate attention that it needs. This made the World Health Organisation to now classify scabies as one of the neglected tropical diseases (NTDs).

By Mohammad2018 - Own work, CC BY-SA 4.0, Wikimedia

Scabies is a skin infestation caused by the parasite called Sarcoptes scabiei. It occurs globally but it is endemic in hot tropical regions, especially in resource-poor settings. The average incidence is about 1 in 10 children in these regions. So it is very common.

The transmission of scabies is mostly by a person to personal contact, contact with clothes, bedding, etc of an infested person. Therefore, it occurs and spreads commonly to people who live in clusters and households.

A typical example of this is the incidence of scabies outbreak that happened in my school dormitory years back. We just returned from a long vacation to school and weeks later, it was noticed that everyone started developing characteristic rashes and itching.

Our school principal then invited a team of medical experts that checked the students and discovered that it was scabies. That was my first time hearing about this condition. We were all given topical medications to rub as well as some tablets. The entire dormitory was then fumigated and all the beddings and clothes were properly washed. That promptly addressed the challenge.

The way the parasite used to spread, it may just be that one of the students got it from his/her home during vacation. Immediately it got to even one person, the spread is always easy. Therefore, in treating scabies, the treatment should always be extended to other members of the family or those who share the same bedding or clothes.

By Gzzz - Own work, CC BY-SA 4.0, Wikimedia

HOW DOES SCABIES OCCUR
The parasite that causes scabies is a mite that attaches to the surface of the skin of the individual. It then burrows into the skin where the female mite lays the egg and hatches them after some days to release more adult mites.

The proteins and feces from these mites under the skin then trigger the body's immune response which then causes rashes and itching.

SYMPTOMS OF SCABIES
Scabies commonly present with rashes, itching, and vesicles. The rashes are very characteristic and occur commonly in between the fingers, armpits, at the wrists, under the breast for females, in between the thighs, and on the genitals.

So if you notice, the rashes and vesicles have a special affinity for the areas of the body where skin appose together. There is also intense itching which some persons describe to be 'sweet' while scratching it. This makes some persons scratch more and more and then develop injuries and wounds on the skin due to intense itching.

This open injury on the skin surface can be a source of bacterial infection, which can lead to the entrance of microorganisms into the blood (septicemia), septic shock, multi-organ failure, or even death. This is the extreme of it, but most times, the prognosis is good because it can easily be treated before all these complications set in.

TREATMENT OF SCABIES
Scabies infestation responds well to medications. But it should be noticed early and properly treated before it results in complications.

The common drug used to treat scabies is benzyl benzoate lotion. It is usually robbed all over the body from the neck down to the feet except the face. This is done for 3 nights. The lotion may have a stinging sensation but it effectively treats the condition and in 3 days, there will be a great improvement.

Oral Ivermectin is also very important and should be available to households. It is a very effective drug in treating scabies. However, it should not be used by young children and pregnant mothers. For them, benzyl benzoate lotion and others will serve. Other medications include 5% permethrin, malathion, antihistamines, etc.

By Bundesministerium für Finanzen, CC BY 2.0, Wikimedia

The treatment of scabies cannot be complete without washing the infested clothes, bedding, and surfaces. As I stated earlier, the parasite that causes scabies is a mite, just like the lice.

If you treat scabies on your body while the mites are still on the bedding and clothes, it cannot work. This is where many people get the treatment wrong. This is because when you lie down on that bed sheet, the mite will still crawl to your body, burrow into the skin and still cause further itching and rashes.

So, the first day you start the medication, ensure to adequately wash all your beddings and clothes you recently came in contact with. You wash them with warm water and dry them under the sun or iron them. Then you can still fumigate the room and around the bed space and corners of the room. Other members of the household in close contact also need to be treated. By this, the treatment of scabies will be adequate and comprehensive.

Prevention of scabies can be achieved through personal hygiene, good housing, and avoidance of overcrowding.

In conclusion, scabies is a very common parasite infestation in the tropics. It occurs in all age groups, especially in children and resource-poor settings where people live together in crowded places like school hostels, IDP camps, etc.

The transmission is by a person to person contact with an infested person and their clothes and beddings. It can also be gotten through sexual contact with an infested person due to prolonged skin-to-skin contact.

The clinical features are very easy to know which are itching, rashes and vesicles, especially in the areas of the body where skin appose together.

Treatment is simple with benzyl benzoate lotion, oral Ivermectin, etc.

Early detection and prompt treatment are key as the prognosis is always the best when noticed and quickly treated.

Thanks so much for reading.

For references and further reading, please visit;

World Health Organisation

Centres for Disease Control

American Academy of Dermatology Association

National Health Service

Kids Health