Scabies

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Scabies is caused by a mite called Sarcoptes scabeii.  It is picked up from others with the condition and can be passed on to others.  It is particlularly common in children and in nursing homes.  Although it is generally regarded as a disease of overcrowding, it is certainly not restricted to any particular group of individuals or social class.  


Common sites of scabies involvement are:


  1. •between the fingers

  2. •the wrists

  3. •armpits

  4. •belt line

  5. •buttocks

  6. •genitalia



a scabies mite seen under the microscope



Scratch marks between the fingers are very typical



Burrows from scabies seen in the armpit



Treatment


Ascabiol

Quellada

Eurax

5% Sulphur ointment

Spregal

Ivermectin


Ascabiol


  1. Day 1:

  2. Bath

  3. Dry with rough towel

  4. Apply ascabiol from neck to toe

  5. Wait for 15 minutes for ascabiol to dry

  6. Re-apply ascabiol


  8. Day 2:

  9. No bath

  10. Apply ascabiol from neck to toe

  11. Wait for 15 minutes for ascabiol to dry

  12. Re-apply ascabiol


  14. Day 3: Bath

  15. Do no apply any more ascabiol

  16. Wash all linen, pyjamas, clothing etc in boiling water or washing machine. Hang all items in sunlight.

  17. Iron all items before using. Mattress to be left out in the sun.

  18. All family members and household contacts must be treated at the same time, whether scratching or not.

  19. Below the age of 1 year, ascabiol can be diluted 50% with water and applied in the above manner.


Quellada


  1. One application from neck to toe, after a bath. Repeat after 7 days.


Eurax Cream


  1. One application daily after a bath for 5 days. Ideal for children under 1 year as it is not associated with burning sometimes experienced with Ascabiol or Quellada.


5% Sulphur ointment


  1. One application daily after a bath for 2 weeks. May be applied on the face in kids but avoid the eyes.


Spregal 


  1. This spray is applied once after a bath.  It can be repeated after one week.  It's main advantage is the lack of irritation.  One can is usually enough to treat the family.


Ivermectin


  1. This medication has been used successfully for the treatment of resistant scabies.  It is given by injection.  Special arrangements need to be made with the Medicines Control Council to obtain this medication as it is not commercially available.