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SCABIES

The very name evokes bad habits and poor personal hygiene in many people! Nothing can be far from the truth. It does not respect any class or society and can affect anyone.  A form of scabies, affecting very clean people is aptly called ‘gentleman scabies’.  The good news is it can be treated very effectively.  So relax!

 It is caused by a 0.3 – 0.4 mm mite, this mite creates havoc with peoples life causing intense itching at night.  It is spread by close physical contact and contrary to popular belief cannot be obtained by sitting on public toilet seats!

Once they reach the skin they burrow slowly and form more mites from the eggs laid in the burrow.  The number of mites in any person is usually around ten unless it’s the rare form of Norwegian Scabies.

 The first time around it may take 4-12 weeks for the rash to appear while in subsequent infections (meaning if you have had it before) it can take only 48 – 72 hours

.  The rash is seen in the armpits, breasts, nipples, elbows, wrists, web spaces of hands, genitals, soles.  Reddish itchy raised lumps predominated but burrows are typical.

 Burrows are seen as a spidery thread like mark on the skin with a dark dot representing a mite at one end.  A hand lens may be useful if you want to go hunting for these.  It can get infected and secondary eczema may develop.

Treatment

Many effective treatments are available

The following steps are important

1. Apply the lotion/cream to ALL AREAS below the neck
2. Leave it on for recommended period by doctor
3. If you wash hands then reapply it to the areas
4. Do not forget under nails, toe spaces, bottom and other body folds.
5. Repeat treatment after one week (some doctors consider one treatment sufficient)
6. Ordinary washing takes care of mites in bed clothes and clothing.  No steam washes or extra precautions needed.

I have been treated but I still itch!

Itching following scabies can be present for a few weeks.  Do not reapply the treatment, use simple lotions like calamine lotion available at any chemists.

NORWEGIAN SCABIES

This is a special type of scabies which is uncommon, seen in individuals in residential homes, mentally depressed, immunosuppressed this is seen as thick scaly areas on palms soles including web spaces.  Contrary to the ordinary scabies this is not very itchy.  The number of mites can exceed 1,00,000.  A dermatologist should be able to identify and treat such patients.

Treatment

1.      Repeated application of antiscabetic lotion/cream may be required.

2.      Systemic medications may also be needed