Itching can last for up to two weeks after successful treatment and does not necessarily indicate that the treatment failed. Repeat examination by a doctor in two weeks is recommended if there is persistent itching after treatment or in other cases when indicated by the physician.

It is difficult to prevent scabies. If a person is known to have scabies, they should not have close skin-to-skin contact with others until they have been treated. If one member of a household has scabies, all other household members, sexual partners, and close contacts should be treated simultaneously.

In the hospital, staff should use gloves and gowns when treating patients who have a suspicious rash and itching.

Scabies is caused by a microscopic (<1 mm) mite called Sarcoptes scabiei var. hominis. The scabies mite causes symptoms when it digs a little tunnel below the skin (referred to as a burrow) and causes a type of allergic reaction. If the person has never been exposed to scabies before, he or she may not show symptoms until four to six weeks after the initial infestation. Individuals who have been exposed in the past usually show symptoms within a few days.

Scabies is almost always spread by protracted skin-to-skin contact with a person who carries the mite. Less commonly, scabies infestation can happen through the sharing of clothes and bedding. Theoretically, you can get scabies from touching something that the mite is on, but that is not a major mode of transmission.

Since the symptoms of scabies seem superficially similar to that of eczema or hives, the only way of ensuring clear diagnosis is by taking a skin scraping for examination under a microscope to check for the presence of mites, mite eggs or mite faeces which is termed scybala - this can confirm the diagnosis.

Sometimes, the chances of a correct diagnosis goes wrong when the skin or biopsy sample is negative for mites, but the patient could be a carrier of the parasite, and could well be manifesting the symptoms of scabies.

Since the number of mites present on the body of the person could be as little as 10 – 12 mites, the diagnosis could be missed or inaccurate.

Crusted or Norwegian scabies, which is a different type of scabies, can host large colonies of mites and is highly contagious.

The onset of disease is different for a person who is infested with scabies for the first time and for that of a person who is having a subsequent relapse of the disease.

For the first time infected patient of scabies, symptoms can manifest after a long gestation period of 6 weeks, and for a person who has contracted scabies multiple times, the symptoms will appear in a few days.

Bathing, washing or soaking.

*borax
*enzyme cleaners
*lice shampoo
*sulfur

Do not treat scabies with:

*hard soaps
*home remedies
*kerosene
*laundry detergent

Consult a dermatologist before using steroids or any other creams.

Cautions of scabies and its help factor

Call your doctor if your child shows signs of:

*fever
*pus drainage
*red streaks on the skin
*red, swollen, warm areas
*skin infection


Help Factors

*A sauna
*Keep fingernails cut short and apply mitts or socks to infants' hands at bedtime to cut down on scratching.

Currently three main types of solutions are used for scabies. All are applied to the whole body except the head and neck, and all whole family should be treated.

*Permethrin
*Benzyl benzoate emulsion
*Malathion
*Sulfur
*For young children with scabies

Method

*Apply a thin layer of cream from the neck down avoiding the face and scalp before going to bed
*The cream should be applied between the fingers and toes and beneath the tips of the fingernails (the eggs may be under the nails due to scratching)
*Wash off with soap and water 8-12 hours later