Do Scabies Ever Go Away? Understanding and Eradicating the Itch
Do scabies ever go away? Yes, scabies can absolutely go away with appropriate treatment, but successful eradication requires diligent adherence to prescribed protocols and environmental decontamination. Without treatment, however, the infestation will persist and can worsen over time.
What Are Scabies and How Do They Spread?
Scabies is a highly contagious skin infestation caused by the Sarcoptes scabiei mite. These microscopic parasites burrow into the upper layer of the skin, where they live and lay eggs. The hallmark symptom is intense itching, especially at night, caused by the body’s allergic reaction to the mites, their feces, and their eggs.
The spread of scabies primarily occurs through prolonged, direct skin-to-skin contact with an infested person. While less common, scabies can also spread through contact with infested items such as clothing, bedding, or towels, particularly in the case of crusted scabies, a severe form of the infestation.
Recognizing the Signs and Symptoms
The primary symptom of scabies is intense itching, often worsening at night. Other common signs and symptoms include:
- A pimple-like rash
- Tiny blisters
- Scales or crusts on the skin
- Visible burrows, thin, raised, irregular lines on the skin (though these can be difficult to spot)
Common locations for scabies include:
- Between the fingers
- In the wrist folds
- Around the waistline
- On the elbows
- On the buttocks
- On the genitals
In infants and young children, scabies may also appear on the scalp, face, neck, palms of the hands, and soles of the feet.
Effective Treatment Options
The most common and effective treatment for scabies involves prescription medications called scabicides, which kill the mites and their eggs. These are typically applied as lotions or creams to the entire body from the neck down and left on for a specific period (usually 8-14 hours) before being washed off.
Commonly prescribed scabicides include:
- Permethrin cream (5%): Often the first-line treatment.
- Ivermectin: An oral medication, typically prescribed for those who can’t tolerate topical treatments or for crusted scabies.
It is crucial to follow your doctor’s instructions carefully regarding the application and duration of treatment. Often, a second application is necessary one to two weeks after the first to kill any newly hatched mites. Even after successful treatment, itching may persist for several weeks as the skin heals. Topical corticosteroids or antihistamines can help relieve this itching.
Environmental Decontamination: A Crucial Step
Successfully treating scabies involves not only treating the affected individual but also decontaminating their environment to prevent re-infestation. This includes:
- Washing all clothing, bedding, and towels used within the past three days in hot water and drying them on high heat.
- Dry cleaning items that cannot be washed.
- Sealing unwashable items in a plastic bag for at least 72 hours, as the mites cannot survive off the human body for that long.
- Vacuuming carpets and furniture thoroughly.
Common Mistakes to Avoid During Scabies Treatment
Several common mistakes can hinder successful scabies treatment:
- Not treating all household members and close contacts: Even if some individuals don’t show symptoms, they may be carriers.
- Not applying scabicide correctly: Failing to cover the entire body from the neck down or not leaving the medication on for the prescribed time.
- Not decontaminating the environment: Re-infestation is likely if mites remain on clothing or bedding.
- Stopping treatment too soon: Even if the itching subsides, it’s crucial to complete the full course of treatment.
- Scratching: While difficult to resist, scratching can lead to secondary bacterial infections, complicating the treatment process.
Understanding Crusted Scabies
Crusted scabies, also known as Norwegian scabies, is a severe form of scabies that primarily affects individuals with weakened immune systems, such as those with HIV/AIDS, the elderly, or those taking immunosuppressant medications. This form of scabies is characterized by thick crusts of skin containing thousands of mites. Crusted scabies is highly contagious and requires aggressive treatment, often involving a combination of topical and oral scabicides.
Prevention Strategies
Preventing scabies involves minimizing skin-to-skin contact with infested individuals and avoiding sharing personal items such as clothing, bedding, and towels. Maintaining good hygiene practices, such as frequent handwashing, can also help reduce the risk of infestation. Regular inspection of the skin for any signs of scabies is crucial, especially in settings where close contact is common, such as nursing homes or childcare facilities.
FAQs about Scabies
What is the difference between scabies and eczema?
Scabies and eczema can both cause itchy rashes, but they have different causes. Scabies is caused by a mite infestation, while eczema is a chronic inflammatory skin condition. Eczema is usually not contagious, whereas scabies is highly contagious. A doctor can diagnose the condition accurately.
How long does it take for scabies symptoms to appear after exposure?
The incubation period for scabies, the time between exposure and the onset of symptoms, can range from two to six weeks in individuals who have never had scabies before. In those who have had scabies previously, symptoms may appear much faster, typically within one to four days.
Can I get scabies from my pet?
No, human scabies mites cannot live on pets, and animal scabies mites cannot live on humans. The scabies mites that infest animals are a different species and cannot survive or reproduce on human skin.
Is it possible to have scabies without itching?
While intense itching is the hallmark symptom of scabies, it is possible to have a scabies infestation without experiencing significant itching, especially in individuals with weakened immune systems or those who have previously been exposed to scabies. This is more common with crusted scabies.
How long are scabies mites contagious?
Scabies mites are contagious as long as they are alive on the skin. With proper treatment using scabicides, the mites are typically killed within a few days. However, individuals remain contagious until they have completed the full course of treatment and the environment has been decontaminated.
Can I use over-the-counter remedies to treat scabies?
No, over-the-counter remedies are not effective in treating scabies. Scabies requires prescription scabicides to kill the mites and their eggs. Consult a doctor for diagnosis and treatment.
How do I know if my scabies treatment has been successful?
The primary indicator of successful scabies treatment is the resolution of itching and the disappearance of the rash. However, it’s important to note that itching may persist for several weeks after treatment as the skin heals. A follow-up appointment with your doctor is recommended to confirm eradication of the infestation.
Can scabies survive on surfaces for long periods?
Scabies mites can only survive off the human body for a limited time. Typically, they can survive for about 24 to 36 hours on surfaces at room temperature. This is why environmental decontamination is crucial for preventing re-infestation.
Why is the itching worse at night?
The itching associated with scabies tends to be worse at night due to several factors, including increased skin temperature, reduced distractions, and the mites’ increased activity during this time. Cortisol levels, which have anti-inflammatory properties, are also lower at night.
Do I need to see a doctor or can I treat scabies myself?
It is crucial to see a doctor if you suspect you have scabies. Self-treating with over-the-counter remedies is ineffective and can delay proper diagnosis and treatment. A doctor can confirm the diagnosis and prescribe appropriate scabicides.
Can I go to work or school if I have scabies?
You should stay home from work or school until you have completed your first treatment with a scabicide. This helps to prevent the spread of the infestation to others. Once you have started treatment and decontaminated your environment, you can typically return to your normal activities. Check with your doctor to confirm.
What happens if scabies is left untreated?
If scabies is left untreated, the infestation will persist and can worsen over time. The itching and rash can become more severe, leading to skin damage and secondary bacterial infections. In rare cases, untreated scabies can lead to more serious complications, particularly in individuals with weakened immune systems. Untreated scabies will not go away on its own.