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Scabies: What it is, what it is not, and how to treat it


 Definition

Scabies is a communicable skin infection caused by the ‘itch mite’ Sarcoptes scabiei. Scabies is classified as a parasitic infection by an arthropod.  In some peer reviewed literature scabies is discussed alongside sexually transmitted infections despite infection being more common among the elderly and infirm who are no longer sexually active. There are two types of scabies infection: Norwegian or crusted scabies and what is commonly termed ‘classical’ scabies. Both infections are caused by the same mite, Sarcoptes scabiei. The only distinction between the two varieties of scabies is that the Norwegian type is more aggressive and difficult to eradicate. Scabies can affect anyone of any social class. Common sites for infection are the groin, hands, feet, elbows, buttocks, underneath breasts and wrists. Scabies eggs hatch within three to four days. Scabies mites live for around 30 days and only females burrow under the skin. Males stay on the surface to mate with females and die after mating.

Symptoms  and verbal description

Scabies presents vesicular or raised and elevated blisters on the skin, with a rash that is often symmetrical. Intense itching almost always accompanies the infection, particularly at night. In the elderly, scabies often appears on the face, ears and scalp. The scabies rash does not present itself identically in each individual and visual depictions may vary a great deal. In individuals who have not been previously infected, symptoms present themselves on average two or three weeks after the initial infestation or contact. For those who have previously been infected, symptoms typically appear within one week.

Causes of scabies and transmission

Scabies is caused when an infected animal or individual comes into contact with another and rubs against them vigorously. Handshakes and hugging are not thought to be intense enough contacts to facilitate transmission of the infection. Exposure must be prolonged thru direct rubbing of skin to skin contact such as sexual intercourse. Blisters and the co-occurring rash are an allergic reaction to the introduction of the mites eggs and fecal matter into the layers of the dermis, not the presence of the mites themselves.

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Comorbid factors/or illness that develop from scabies

Bacterial infection also termed impetigo is the most commonly seen comorbid or related illness resulting from scabies infection.

Who is most at risk for contracting scabies?

Anyone taking intimate care of others who already have the infection and those whom are bedridden or who move thru the living spaces of infected individuals regularly have a higher risk. This typically involves health care workers in residential homes and hospitals.  Older people, those who are HIV positive, anyone with a weakened immune system, infants, those with Downs Syndrome and those receiving any kind of corticosteroid treatment are at a higher risk for contracting scabies than the general population.

Conventional/Allopathic standard treatment

Allopathic treatment for scabies is based on various forms of insecticide, as the scabies mite is classified as an arthropod. Typically, when one family member is diagnosed, the entire family should be treated, even if they do not present symptoms at the time.

Permethrin 5% dermal cream is a common treatment prescribed for scabies in the UK.

Malathion 0.5% liquid is a treatment applied to the body for 24 hours and must NOT be washed off for that length of time, making it more of a hassle than other treatment options.

Ivermectin is an oral treatment that is typically prescribed if there is resistance to topical treatments.

Alcoholic preparations are not recommended because they are painful if applied to broken skin.

Complementary therapies such as tea tree oil are not recommended because there is no evidence that they are effective from the viewpoint of allopathic medical professionals who caution that reliance on treatments such as tea tree oil may inadvertently facilitate the spreading and lingering of the infestation.

Alternative Treatment Options

Supplements are a gentle alternative to some of the more aggressive allopathic treatment options. Tiger Balm and even Bengay may alleviate the intense itching but additional treatment options will be needed to clear up the condition completely. Dr. Andrew Weil recommends a one percent permethrin cream rinse brand named Nix. Neem is an additional option that is found online and in many natural health stores but consumers should be certain that they are picking up Neem for medicinal and not cosmetic use. The FDA does state that Neem is safe for public consumption and advocates claim that it disrupts hormonal processes that cause the mites to die off.  As a caution about children and permethrin, this substance can exaccerbate asthma so parents should be advised before trying this option. To combat the high stress level that results from the intense itching, guided meditation, breathing exercises and even hypnotherapy may help alleviate tension.

Additional treatments may include a bath in Borax, Hydrogen peroxide and highly diluted bleach. Borax is a common household cleaner and is a natural insecticide. Hydrogen peroxide is an anti-bacterial agent that may eliminate co-morbid skin irritations.

Zinc is an easily obtainable ingredient that can be taken both orally and turned into a paste to combat the itching that accompanies scabies. Several zinc tablets crushed and mixed with water can be applied to the rash and left on for 30 minutes and then rinsed off.

Diet is another arena that may warrant some attention for those dealing with scabies infections. As this condition assaults those with weakened immune systems, a healthy diet rich in fruits and vegetables and natural juices is recommended.

How to clean the home to get rid of scabies mites

Use a standard detergent or even a stronger cleaner if you are able to wash all clothing, towels and bedding that have been used in the past three days. Machine dry all items on high heat and dry clean any additional items necessary. After vacuuming the home, throw away the vacuum bag to prevent any mites from escaping and re-entering the home. Remember that scabies mites can not survive away from a human body for more than three days. If necessary, any additional items you may consider contaminated can be sealed in a plastic bag and placed in a garage for a few weeks.

No matter what choice a consumer makes for their own health and wellbeing, consulting a medical professional or naturopath about available treatment options and researching their effectiveness is highly recommended in today’s health care marketplace. Numerous websites that provide access to peer reviewed medical studies free of charge do exist. SpaEvidence.com is one such website that offers links to a variety of databases that professionals and consumers can consult to answer their questions and sate their curiosity about the efficacy of natural health alternatives.

REFERENCES

Olley, M. What you need to know about scabies infections. Nursing and Residential Care, 13.

Weil, A. (2014, May 14). Condition Care Guide. Treating Scabies. Retrieved May 18, 2014, from http://www.drweil.com/drw/u/ART03166/Scabies.html

Simple and All-Natural Home Treatments for Scabies. (2013, August 11). . Retrieved May 18, 2014, from http://lerablog.org/health/simple-and-all-natural-home-treatments-for-scabies/

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