Scabies
Scabies is a common skin infection caused by microscopic mites that burrow under the skin. As the mites burrow, lay eggs and hatch, their actions cause an allergic reaction, resulting in a characteristic rash and itching. Scabies rash resembles red blisters or pimples with wavy lines. The rash typically appears in the warmer areas of the body, such as the inside of the elbows and wrists, armpits, waist, between fingers and toes and in the backs of the knees. The intense itching worsens with time and is especially irritating at night.
Scabies is highly contagious. The mites spread from sharing clothing, towels or bedding, or other close skin-to-skin contact with an infected person. Scabies spreads quickly through a home or facility such as a daycare center or nursing home.
Treatment
Scabies does not clear without a thorough two-step treatment process. The first step is killing the mites. Permethrin cream (5 percent) is the usual treatment. The cream should be applied from the neck down (scabies do not affect the face), and it must be left on for eight to 14 hours before being rinsed off. An oral treatment (ivermectin) is also available, and it is more convenient than the cream, but it has more side effects without being more effective than the cream.
The second step is to thoroughly clean the environment. All bedding and clothing must be washed or dry cleaned, and upholstery and carpets must be thoroughly vacuumed. Additionally, every member of the household should also be treated, as well as others who have had close contact with the infected person.
Antihistamines
The intense itching may continue up to four weeks . Antihistamines such as diphenhydramine (Benadryl) are helpful in relieving the itching. However, antihistamines may also mask symptoms of a reinfection. Although permethrin is effective, it does not work in 5 percent of cases. Also, improperly applied treatment or an inadequately cleaned household may result in a reinfection. If antihistamines are used and reinfection occurs, the returning itch may go unnoticed. Therefore, doctors recommend that antihistamines not be used for a week after treatment to ensure the treatment worked and there is no reinfection. Cool baths and calamine lotion may provide relief while antihistamines are stopped.
Secondary Infection
Scratching the scabies rash may lead to a bacterial infection. Broken skin may become infected with staphylococcus, causing impetigo. Secondary infections are treated with antibiotics.
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