scabies

scabies or scabies is a contagious skin infection that can usually be treated without complications with appropriate lotions. There are various ways to prevent scabies from developing, which are explained in detail here.

What is scabies?

The scabies is a skin disease caused by the so-called itch mite (Sarcoptes scabiei). In technical language, the scabies is also called scabies designated. Typical symptoms of scabies are scaly or crusty skin that is interspersed with nodules.

The symptoms of scabies are often associated with severe itching. Changes in the skin caused by scabies often show up on the wrists, armpits or genital area in adults. Affected children may also have skin changes on the face or on the palms of the hands and feet.

People around the world are affected by scabies, but the number of people infected varies depending on time and region: While the disease hardly occurred in Germany in the 1950s, the number of people infected with scabies has been increasing again since the 1960s.

causes

The cause of the occurrence of scabies is a corresponding infection with the itch mite. The female animals of these parasites are primarily responsible for the clinical picture.

In the course of scabies, female itch mites cause small holes in the horny layer of the skin in which they lay their eggs. Itch mites feed on skin and lymph cells and thus damage the skin. This damage causes the body's immune system to become active, causing some symptoms of scabies (such as itching).

The scabies is contagious and can be transmitted through physical contact. Since such transmission is possible through sexual intercourse, among other things, scabies is a sexually transmitted disease and one of the sexually transmitted diseases.

Many people usually associate scabies with dirty and unhygienic living conditions. Indeed, this may be a cause of the itch mite spreading. However, itch mites are also found in schools, hospitals, retirement homes and kindergartens, i.e. in places where many people bump into each other every day. Similar to lice, these bodies are ideal for the rapid spread of scabies.

Symptoms, ailments & signs

The symptoms of scabies show up in most cases within two to six weeks. Then there are inflammatory reactions of the skin and severe itching. Particularly warm areas with thin epidermis are primarily affected. These include, for example, the spaces between the fingers and toes, the armpit area, the navel region, the nipple region and the genital region. The back and head are seldom or never attacked by the scabies.

The affected areas are reddened and nodules sometimes form. These nodules are very small and delicate. In children, vesicles are more likely to appear than nodules, and scabies can also affect their heads. The itching increases with increasing heat. The warmth of the bed in particular leads to severe itching.

Scratching the itchy areas results in flaking and cornification of the skin. The complexion of the skin can therefore be severely damaged. In some patients, the mite tunnels can be seen with the naked eye. Sometimes individual mites can also be seen.

Bark scabies, which rarely occurs, has other effects on the skin. So the itching is weak here or does not appear. The keratinization and scaling of the skin is particularly pronounced on the hands and feet and most of the body is reddened.

Diagnosis & course

A diagnosis of the disease scabies is initially possible based on the typical skin changes. These can be shown especially with the help of a reflected light microscope. If this diagnosis of scabies still needs to be confirmed, another possibility is the so-called ink method:

Diluted ink can make the drilled tunnels of the itch mite visible on a skin nodule. In addition, an existing skin nodule can be removed to diagnose scabies and then examined for itch mites.

In most cases, with adequate treatment of the scabies, a positive course of the disease can be expected. In some cases, itchiness may persist beyond successful treatment. Scabies can lead to complications due to poor personal hygiene, among other things: germs can penetrate the injured skin and cause, for example, rose sores or blood poisoning.

Complications

A bacterial inflammation in the area of ​​the damaged skin is the most common complication of scabies.The bacterial colonization is often streptococci or staphylococci, which, as secondary diseases, can trigger sore sores (erysipelas) or swelling of the lymph nodes (lymphadenopathy) associated with fever and chills. If the germs spread further via the lymph vessels, they can become inflamed (lymphangitis).

If the infection is left untreated, in the worst case the pathogens in the lymphatic system penetrate the bloodstream and lead to life-threatening blood poisoning (sepsis). Rheumatic fever and a special type of kidney infection called glomerulonephritis can also be caused by strep throat. All of these infections usually respond well to antibiotics, so rapid treatment can usually avoid severe sequelae of scabies.

In some cases the skin is overly sensitive to the anti-mite agent used for therapy, cracked areas of the skin and reddening indicate eczema caused by dehydration. A rare complication of scabies is persistent itching after treatment has been completed, which is due to overactivation of nerve cells: These report a stimulus to the brain long after the trigger has been eliminated.

When should you go to the doctor?

Scabies is a disease with a high risk of infection. So that the infection does not spread to other people and does not spread further on your own body, a doctor should be consulted at the first signs. If the person concerned suffers from skin abnormalities, these should always be clarified by a doctor. Inflammation of the skin is a warning that should be followed up. The hands, the spaces between the fingers, the armpits and the genital area are particularly at risk for scabies. If there are changes in the skin texture on these parts of the body, a visit to a doctor is advisable. A doctor should also be consulted in the event of itching or open wounds.

If the symptoms spread or if they intensify, a doctor's visit is necessary. If gangrene develops, pus develops or the skin feels burning, a doctor is needed. In severe cases, the affected person is at risk of blood poisoning. If the skin surface is flaky, dry, or crusty, a visit to a doctor is required to determine the cause. If lumps, swellings or small ulcers form, the changes in the skin must be assessed by a doctor. Reddening of the skin, inner restlessness or sensory disturbances should be presented to a doctor so that appropriate therapy can be initiated as soon as possible.

Treatment & Therapy

When a scabies-Disease is not accompanied by complications, successful treatment is usually possible through the use of locally applied lotions. The effects of such therapy against scabies are both in killing the mites and in preventing re-infection.

It can often be necessary to treat people from the private sphere of an affected person for scabies. This can also be useful for people who do not yet have any acute symptoms of scabies, as symptoms can sometimes only appear a long time after infection.

Active ingredients that are partially contained in ointments for the treatment of scabies are the substances permethrin (an artificially generated insecticide) or benzyl benzoate. Corresponding ointments usually require certain exposure times after they have been applied before they are then rinsed off again.

The duration of a treatment for scabies depends, among other things, on the severity of the disease and the remedy used. If the complications mentioned above occur in the course of scabies, these are treated with antibiotics, for example.

Outlook & forecast

The prognosis and outlook for a scabies disease depend on whether the patient is consistently completing the treatment and taking the appropriate precautionary measures. If left untreated, scabies can take a chronic course. Affected patients sometimes suffer from increasingly worsening symptoms for years. Increasingly larger areas of skin are then affected by the lesions.

This increases the risk of worsening general health. Because if pathogens get into the typical scratch wounds, purulent infections or even life-threatening sepsis can be the consequences. In rare cases, untreated scabies can heal on their own after a few years.

The prognosis of scabies disease is much better if the patient takes medication and follows hygiene recommendations. In this case, the scabies almost always heals without any problems, without those affected having to fear serious long-term consequences.

In contrast to some infectious diseases, the body does not develop any immunity after it has overcome scabies. In particular, after the illness has just been overcome, a renewed infestation can occur if, for example, people from the immediate environment are sick with scabies, often without noticing it.

prevention

That is to be prevented scabies for example, about avoiding close physical contact with people suffering from scabies. If you already have scabies, preventive treatment by private contact persons can prevent re-infection. In order to prevent a protracted course of scabies, in addition to correct use of the medication, regular living space and personal hygiene can also contribute, which makes it difficult for the scabies mites to reproduce.

Aftercare

Special aftercare is not an option after successful therapy. The patient is considered cured. Skin changes and itching may still be present for a short time. However, these can be treated with creams. If a patient wants to prevent re-infection, he must take preventive measures himself.

He is solely responsible for this. There is no direct medical support. However, doctors provide information about transmission routes. The most suitable measures include compliance with high hygiene standards. Especially in foreign accommodation you should take a critical look at the sleeping facilities and sanitary facilities. Infected people are to be avoided.

Re-infection should not be taken lightly in patients with weak immune systems and young children. In-patient treatment in the hospital is inevitable. These groups of people are at risk of complications such as blood poisoning or inflammation of the lymph nodes. The treatment period expands.

In rare cases, scabies can develop chronically. Then there is a need for long-term treatment. The medication is increased or changed, another cure with anti-mite ointments is started. Affected patients have to severely restrict their everyday life. Close contact with other people should be avoided. Laundry items and textiles must be adequately cleaned.

You can do that yourself

Anyone suffering from scabies should first observe a few hygiene measures. It is advisable to wash your bedding and clothing with hot water and to shower at least twice a day. In addition, close contacts should be informed about the disease in order to avoid infection.

Typical measures such as cold compresses against the itching, soothing ointments against the pain and cosmetic measures such as natural make-up against the redness help against the actual symptoms. If the scabies is not very advanced, various home remedies can help. Tea tree oil kills the parasites and supports the structure of the skin. Lavender oil helps against itching and redness of the skin, while aloe vera oil has an overall analgesic effect. Herbs such as sage, St. John's wort or peppermint, which are boiled and applied directly to the skin, are just as effective. Onion peels are a tried and tested home remedy - also boiled and applied to the itchy areas.

From homeopathy, the preparation Psorinum offers itself, which is supposed to kill the parasites and alleviate the pain. Sulfur is also said to have a soothing effect. The use of these agents is best discussed with the attending physician first.