Definition

Scabies is a contagious skin condition caused by the mite Sarcoptes scabiei. The mite tunnels into the skin and can cause severe itching. Itching is felt especially at night due to the mites' more active activity. Scabies are spread by skin-to-skin contact with another person who has scabies or indirectly through objects contaminated by the mites.

Scabies can live on the human body for 1 to 2 months. Scabies usually occur in densely populated areas, public service facilities, prisons, or boarding schools. Healthy adults most often get these mites through sexual contact with an infected person. You can’t get scabies from pets.

The worldwide incidence of scabies is estimated at 200 million cases each year. Therefore, in 2009, the World Health Organization declared scabies a significant health problem in several developing countries and a neglected skin disease.

Causes

The mite that causes scabies is Sarcoptes scabiei var. Hominis. This mite resides in the dermal and epidermal layers of humans. The infestation begins with the female mite burrowing within the stratum corneum of its host where it lays its eggs. The eggs eventually become adult mites and this cycle repeats itself if not treated appropriately so that a person experiences symptoms of scabies, especially severe itching at night.

Risk factor

Recognition of several risk factors plays an important role in preventing and treating scabies. Everyone can be at risk of developing scabies. However, some risk factors determine whether or not you will develop scabies in the future.

Some of the risk factors include:

• Close contact with a person suspected of having scabies
• Frequent exchange of personal toiletries such as towels or clothes
• Sleeping together with an infected person

Symptoms

Recognition of several risk factors plays an important role in preventing and treating scabies. Everyone can be at risk of developing scabies. However, some risk factors determine whether or not you will develop scabies in the future.

Some of the risk factors include:

• Close contact with a person suspected of having scabies
• Frequent exchange of personal toiletries such as towels or clothes
• Sleeping together with an infected person

Diagnosis

The diagnosis of scabies is a clinical diagnosis, meaning that the doctor can determine the diagnosis through a specialized medical interview and physical examination, generally through the appearance of the typical appearance of scabies-infected area and the typical location where scabies are most commonly found. The physical examination that can be found in scabies usually involves red pustules that feel very itchy. In addition, tunnel mites can be seen.

It's best to let your doctor know if you or your family have had scabies in the past. Information such as when the symptoms first appeared will also help the doctor diagnose and determine the best treatment for the patient.

Some supporting examinations that can help determine the diagnosis of scabies include dermoscopy. Dermoscopy is possible to observe the burrow structure in scabies, also known as the "jetliner trail". If the diagnosis is ambiguous, a skin biopsy can be used to confirm the diagnosis.

There are diagnostic criteria to determine whether someone has scabies or not. Some of them are very severe itching, especially at night, there is a group of people experience the same complaints, visible mite tunnels in the area infected with scabies, and the discovery of one or more live mites. A diagnosis can be made if two of the four criteria are present.

Management

Scabies require comprehensive treatment. Available medications usually kill the mites and relieve itching. Ointments are usually applied at night when the mites are most active. A doctor will probably instruct you to apply the medication all over the body from the neck down. The medication can be washed off the following morning. You may be asked to repeat the same 7 days later to ensure the mites are gone.

Some common medications used to treat scabies include:

• 5% permethrin cream
• 25% benzyl benzoate lotion
• 10% sulfur ointment
• 10% crotamiton cream
• 1% lindane lotion

Medications can be given to relieve the itching caused by scabies. These drugs include anti-histamine drugs such as CTM.

Complications

Possible complications of scabies include secondary bacterial infections, such as impetigo, which results from repeated scratching due to itching caused by mites.

Another complication that can arise is crustal scabies, which usually occur in a group of people who are at high risks, such as people with weakened immunity or chronic health conditions (e.g., HIV or chronic leukemia), someone with severe illness, or elderly patients. Crustal scabies, also known as Norwegian scabies, present as thick crusts on the skin and cover large areas of the body. This type of scabies is highly contagious and very difficult to treat.

Prevention

After identifying your risk factors, the next step is to take preventative measures to avoid scabies infection. Here are some steps you can take:

• Avoid close contact with someone who has been diagnosed with scabies
• Avoid wearing clothes or toiletries that have been used by someone who has scabies
• Avoid sleeping together with someone suspected of having scabies
• Wash clothes or tools that have been contaminated with hot water or boiling water and dry them with a dryer at a high temperature for at least 10 - 30 minutes
• Don't forget to apply or take your medication as directed by your doctor

It is important to take the necessary steps to prevent scabies infection. If you have not yet seen a doctor, it is recommended that you do so immediately. Doing this can detect any underlying condition or disease that may increase your risk of getting a scabies infection. This will help you start treatment as early as possible and prevent complications or worsening of the condition.

When to see a doctor?

If you are experiencing symptoms similar to scabies, are trying to treat scabies on your own but not getting better, or have been in close contact with someone who has been diagnosed with scabies, it would be best to consult a dermatologist. The doctor will conduct a medical interview, a physical examination, and some supporting tests to identify the exact diagnosis and recommend the appropriate treatment.

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