Do Scabies Infest the Scalp: Understanding Scabies and Scalp Involvement
Do Scabies Go On Scalp? Yes, scabies can infest the scalp, especially in infants, young children, the elderly, and immunocompromised individuals; however, it’s less common in healthy adults.
Scabies, a highly contagious skin infestation caused by the microscopic mite Sarcoptes scabiei, is typically associated with intensely itchy skin, often worse at night. While scabies commonly affects areas like the hands, wrists, elbows, and genitals, understanding its potential to affect the scalp is crucial for accurate diagnosis and effective treatment. This article will delve into the complexities of scabies, focusing on its presence on the scalp, its symptoms, diagnosis, treatment, and preventative measures.
What is Scabies?
Scabies is an infestation of the skin caused by the human itch mite, Sarcoptes scabiei var. hominis. These mites burrow into the upper layer of the skin, where they live and lay eggs. The burrowing activity and the subsequent immune response trigger intense itching.
The contagious nature of scabies means it spreads easily through prolonged, skin-to-skin contact with an infected person. Less commonly, it can spread through sharing infested items like clothing, bedding, or towels, particularly in the case of crusted scabies.
The Relationship Between Scabies and Scalp
While the scalp isn’t the typical primary site of scabies infestation in healthy adults, understanding its potential involvement is essential. Do Scabies Go On Scalp? Yes, they can, particularly in specific populations.
- Infants and Young Children: In this age group, scabies is more likely to affect the entire body, including the scalp, face, and neck.
- Elderly and Immunocompromised Individuals: These groups often have weakened immune systems, making them more susceptible to more widespread infestations, including the scalp.
- Crusted Scabies (Norwegian Scabies): This severe form of scabies involves a massive mite burden and can lead to widespread involvement, including the scalp, with thick, crusty lesions.
Symptoms of Scabies on the Scalp
The symptoms of scabies on the scalp are similar to those seen on other parts of the body, but they can sometimes be confused with other conditions like seborrheic dermatitis or psoriasis.
- Intense Itching: The hallmark symptom of scabies, particularly worse at night.
- Small, Raised Bumps or Blisters: These can be difficult to see among hair follicles.
- Scalp Lesions: Scratched areas may become inflamed and infected.
- Crusting: In crusted scabies, thick, scaly crusts may form on the scalp.
- Hair Loss: In severe, untreated cases, hair loss may occur due to scratching and inflammation.
Diagnosing Scabies on the Scalp
Diagnosing scabies on the scalp can be challenging, as the lesions can be subtle and hidden by hair. A dermatologist’s examination is crucial.
- Visual Examination: A doctor will look for characteristic burrows, bumps, and signs of scratching.
- Skin Scraping: A sample of skin is scraped from a suspected burrow and examined under a microscope to identify mites, eggs, or fecal matter. This is the gold standard for diagnosis.
- Dermoscopy: Using a dermatoscope, a magnifying lens with a light source, can help visualize burrows that might be missed with the naked eye.
Treating Scabies on the Scalp
Treatment for scabies on the scalp involves the same medications used for scabies on other parts of the body.
- Topical Scabicides: Permethrin cream (5%) is often the first-line treatment. It’s applied to the entire body from the neck down, including the scalp, and left on for 8-14 hours before being washed off. Multiple applications are usually necessary.
- Oral Ivermectin: This medication is often used for crusted scabies or when topical treatments fail. It’s typically administered in two doses, a week apart.
- Treating Secondary Infections: If scratching has led to a bacterial infection, antibiotics may be necessary.
- Treating All Close Contacts: It’s essential to treat all household members and close contacts simultaneously, even if they don’t have symptoms, to prevent reinfestation.
Preventing Scabies
Preventing scabies involves practicing good hygiene and avoiding close contact with infected individuals.
- Avoid Skin-to-Skin Contact: Limit contact with people known to have scabies.
- Wash Clothing and Bedding: Wash clothing, bedding, and towels in hot water and dry them on high heat. Items that can’t be washed should be dry-cleaned or sealed in a plastic bag for at least 72 hours.
- Vacuum Regularly: Vacuum carpets and furniture to remove any mites.
- Avoid Sharing Personal Items: Do not share clothing, towels, or bedding with others.
Summary Table of Scabies Treatments
| Treatment | Application/Dosage | Notes |
|---|---|---|
| Permethrin 5% | Entire body, neck down, including scalp | Leave on for 8-14 hours, rinse. Repeat in 1-2 weeks. |
| Oral Ivermectin | Dosage based on weight. | Typically two doses, one week apart. Used for severe cases or when topical treatments fail. Consult a doctor for correct dosage. |
Frequently Asked Questions (FAQs)
Can you have scabies on your scalp without having it anywhere else?
It’s uncommon but possible. In some cases, the infestation may initially be localized to the scalp, especially in young children. However, it’s crucial to examine the entire body to rule out involvement in other areas.
How can I tell if it’s scabies and not just an itchy scalp?
The key difference is the intense itching, particularly at night. Scabies often presents with small, raised bumps or blisters, and there may be visible burrows. However, a definitive diagnosis requires a skin scraping examined under a microscope.
Is scabies on the scalp more difficult to treat?
Treating scabies on the scalp can be challenging due to the difficulty of applying topical medications effectively through the hair. Ensure the entire scalp is thoroughly covered with the prescribed cream.
What should I do if I suspect I have scabies on my scalp?
See a dermatologist or healthcare provider immediately. They can properly diagnose the condition and prescribe appropriate treatment. Early diagnosis and treatment are crucial to prevent the spread of scabies.
Can scabies cause hair loss?
While not a direct cause, severe scratching and inflammation associated with scabies can lead to hair follicle damage and hair loss. Treating the scabies and preventing further scratching are essential to minimize hair loss.
How long does it take for scabies on the scalp to go away with treatment?
Symptoms usually improve within a few days of starting treatment, but it may take several weeks for the infestation to completely resolve. Complete eradication requires diligent adherence to the prescribed treatment regimen.
Can I use over-the-counter treatments for scabies on the scalp?
No. Over-the-counter treatments are generally not effective against scabies. Prescription scabicides are necessary to kill the mites and eggs.
Is it possible to get scabies from a dog or cat?
Humans cannot contract animal scabies. However, they can contract a different form of the mite. This type will not burrow into the skin to live and will be short lived compared to the form humans transmit to each other.
What are the risk factors for getting scabies on the scalp?
Risk factors include close contact with infected individuals, living in crowded conditions, having a weakened immune system, and being an infant or young child.
Can you see scabies mites with the naked eye?
Scabies mites are very small, typically less than 0.5 mm in length. They are generally difficult to see without magnification.
What should I do if the itching persists after treatment?
Itching can persist for several weeks after successful treatment due to an allergic reaction to dead mites and their waste products. Antihistamines and topical corticosteroids can help relieve the itching. If itching continues, consult your doctor.
Can scabies affect eyebrows or eyelashes?
While less common, scabies can affect the eyebrows and eyelashes, particularly in severe cases. It is important to apply medication carefully in these areas, avoiding contact with the eyes.
In conclusion, while the question “Do Scabies Go On Scalp?” is definitively answered with a “yes,” it is important to understand that scalp involvement is more prevalent in specific populations. Early diagnosis and appropriate treatment are crucial for resolving the infestation and preventing its spread.