Ever wondered why some itches get worse at night and seem to spread through the household? Sarcoptes scabiei is the tiny mite behind scabies. It burrows into the skin, lays eggs, and causes intense, persistent itching. The good news: scabies is treatable and preventable if you act fast and treat everyone exposed.
The classic signs are relentless itching (worse at night) and thin, wavy burrows in the skin. Common spots: between fingers, wrists, elbows, waistline, buttocks, and the genital area. Babies and elderly people can have rashes on the face, neck and scalp too. If you see small red bumps or crusted patches with thick scaling, that could be crusted (Norwegian) scabies — a severe form that needs urgent care.
Doctors usually diagnose scabies by exam and history. They may look for burrows or take a skin scraping to find mites or eggs under a microscope. Don’t wait if symptoms match and a close contact has scabies — early treatment stops spread.
First-line treatment for typical scabies is topical permethrin 5% cream. Apply to all skin from the neck down (or head to toe in children), leave on overnight (8–14 hours), then wash off. Most guidelines recommend repeating once after 7–14 days. Oral ivermectin (single dose of 200 mcg/kg, often repeated after 1–2 weeks) is an effective alternative, especially for outbreaks or when topical treatment fails. Ivermectin is not for young children or pregnant women, so talk to a doctor.
For crusted scabies, treatment is more aggressive: multiple doses of ivermectin plus topical scabicides and close follow-up. Secondary bacterial infections need antibiotics.
Treat household members and close contacts at the same time, even if they don’t itch yet. Wash clothing, bedding, and towels used in the last 3 days in hot water (≥60°C) and dry on high heat. Items that can’t be washed should be sealed in plastic for 72 hours — mites die without human skin contact. Clean surfaces and avoid close skin-to-skin contact until treatment is complete.
To ease itching while mites die, use antihistamines for sleep, and short courses of topical steroid creams for inflamed skin. Itching can continue for 2–4 weeks after successful treatment — that’s a normal immune reaction, not treatment failure.
See a doctor right away if someone is very young, pregnant, immunocompromised, or if rash gets worse despite treatment. Crusted scabies, spreading in care homes, or signs of bacterial skin infection are reasons to get urgent medical help.
Act quickly, treat everyone exposed, and follow cleaning steps. That’s how you stop Sarcoptes scabiei from turning one case into many.
May, 6 2023
In today's blog post, I want to discuss the crucial role of public health initiatives in controlling Sarcoptes scabiei outbreaks, also known as scabies. These initiatives are vital in raising awareness, promoting early diagnosis, and implementing effective treatment plans to curb the spread of this highly contagious skin condition. Public health campaigns also play a key role in educating communities about preventive measures and reducing the stigma associated with scabies. Additionally, collaboration between healthcare providers, governments, and communities is essential to ensure accessible and affordable treatment options for everyone affected. In summary, public health initiatives are crucial in managing and controlling scabies outbreaks and ensuring the overall well-being of our communities.