This is a very contagious and itchy skin condition, caused by tiny mites called Sarcoptes scabiei, which dig their way under, into the superficial skin layer

The transmission is from person to person. It needs close contact for a long period. Simple handshakes for example will not pass on the mites. Sharing the beddings and clothing with a person having scabies may contract the infestation although the chance is not very high

Some animals also have scabies caused by a different kind of mites. This can be passed onto humans through contact. When this happens, it is a lot more itchy than the human category.

The mites dig a tunnel into the skin and live there. Female mites lay eggs there, which will hatch after 2 to 4 days. The young mites will mature after a few days, leave the tunnel and dig a new tunnel elsewhere on the skin.

The eggs and excreta of the mites in the tunnels cause an irritation or allergy reaction, which is very itchy and there are some tiny red pimples. The first time sufferers will get these symptoms after they get sensitised in a few weeks, whereas repeated sufferers will have these very quickly in a few days.

Signs

The main problem is the intense itch, which intensifies after a hot shower and during sleep. It spreads very quickly to different parts of the body from the initial site. The common areas affected most are the finger webs, wrists, underarms, buttocks, groins, elbows, and breasts. Except in babies, the face and the scalp are not usually affected.

The sufferer may scratch hysterically and there are lots of deep scratch marks. There may be secondary bacterial infection.

The tunnels are seen as short burrows on the skin, and are most noticeable on the palms and soles because of the thick skin. Sometimes there are small blisters along the burrows.

Treatments

Lotions containing Gamma benzene hexachloride, Benzyl benzoate, or Malathion can be applied on the whole body surface below the face. In order to kill the mites effectively, it is left for 12 hours before washing off. Used beddings, clothing and towels need to be disinfected.

Even after all the mites are killed off, the itch will not subside very quickly because there are still the excreta of the mites. The itch may slowly disappear after 2 to 4 weeks, and this does not mean treatment failure.

Anti-histamines such as Chlorpheniramine or Hydroxyzine will help to reduce the itch and promote sleep because of the drowsiness they cause. Calamine lotion will also help to relieve the itch.

It is important to treat the whole family household and those who have had close contact with the index sufferer, otherwise there is a chance of cross transmission again and the infestation will recur.