Care of Patient with Scabies

【Major Points】

Scabies is a contagious skin disease caused by mites, primarily transmitted through close contact.
Scabies infection causes intense itching and can be identified by the presence of small bumps, spots, tiny crusts, or areas of darkened skin.
Scabies is a curable condition that requires a combination of disinfection of the environment and clothing, as well as appropriate topical medication.
Scabies mites can survive outside the skin for about two weeks but will die in an environment with a temperature of 60°C (140°F) or higher.

What is scabies?

Scabies is a skin disease caused by tiny mites called scabies mites. These mites burrow into the human skin to live and reproduce.
Once the mites leave the host, they can only survive for a short period of time.
Scabies is a skin disease caused by mites that primarily infest the outer layer of human skin. It is more common in older individuals, those who are weakened, bedridden, or have poor hygiene habits.
Scabies is mainly transmitted through close contact with an infected individual. This can include sharing towels, bed sheets, blankets, underwear, and other personal items.
Scabies outbreaks are more common in healthcare facilities such as nursing homes, long-term care facilities, assisted living centers, and hospitals.

What are the symptoms of scabies?

After the scabies mites burrow into the skin, they trigger an inflammatory response, and the skin develops a rash in about 10 to 30 days. People who have had scabies before may experience symptoms earlier, within 1 to 4 days, upon reinfection.
The period between get infected and onset of symptoms is known as the incubation period, and during this time, the infection can still be transmitted to others.
Scabies infection causes intense itching, which tends to be more severe during the late evening and early morning hours. Itching may worsen when covered by bed sheets or during hot showers.
Common symptoms of scabies include small bumps, spots, tiny crusts, areas of darkened skin, flakiness, and burrow marks. These symptoms are often found in skin folds and creases such as between the fingers, palms, wrists, breasts, groin, genital area, elbows, and armpits. However, having these symptoms does not necessarily mean it is scabies, so if you experience these symptoms, it is important to seek medical attention from a dermatologist as soon as possible.

How is scabies treated?

Scabies is a curable condition, and it can be treated effectively by combining environmental and clothing disinfection with appropriate topical medication. Generally, treatment lasts for three days and shows positive results.
During the treatment period, it is recommended to take a daily bath using soap and gently cleanse the skin with a nylon soft brush. After bathing, apply the medication to the entire body from the neck down to the soles of the feet, paying special attention to skin folds and creases.
Common medications for scabies, application methods, and precautions are as followings.
- B.C Cream (10g): Before applying the medication, thoroughly wash the body, scrubbing the skin with a soft brush or towel. Then, apply the cream to the entire body from the neck down to the soles of the feet, especially in skin folds. Usage: Apply 1-2 times daily, and after a week, evaluate the effectiveness of the treatment with a dermatologist.
- Jaline lotion (Benzyl benzoate 250 mg/ml, 150ml): Apply once daily to the entire body from the neck down to the soles of the feet. Rinse off the lotion during the next day's shower and reapply after drying the body. The treatment course usually lasts for two to three days. This medication may cause irritation, and for use in children, it should be diluted 2-3 times as instructed by a doctor.
- Permethrin cream 5% (30g): Apply this cream in the same manner as mentioned above and leave it on for 8-14 hours before washing it off with soap. Repeat the treatment once or twice within one to two weeks, as instructed by a doctor.
- Ivermectin (200ug/kg): It can be taken orally as a single dose, and an additional dose may be necessary within 10 to 14 days if required. It is with adequate safety, but it is not recommended for pregnant women and children.

How to take care of yourself if you get scabies?

When scabies mites leave the skin, they typically die within two weeks. To take care of yourself, place the clothes, bed sheets, blankets, pillowcases, and other items that you have used in a sealed plastic bag. Keep them in the bag for two weeks, and the mites will naturally die off.
Scabies mites cannot survive in temperatures above 60℃ (140℉) for more than 5 minutes. You can heat your clothes and bed sheets by using a dryer or ironing them with a hot iron.
Scabies is usually transmitted through direct contact or by sharing bedding, blankets, and clothes. Therefore, it is important for those living with a person infected with scabies to practice proper isolation and avoid using the same bathing facilities.
Maintaining personal hygiene and cleanliness of the environment can help reduce the chance of scabies mites proliferating.
During the treatment period, it is advisable to isolate yourself and avoid contact with others to prevent the spread of scabies.

References

Lai, B. R. (2019). Scabies-How to Diagnose? How to Effectively Treat it? Journal of Healthcare Quality, 13(5), 76-79. http://doi.org/10.3966/199457952019091305015
Taiwanese Dermatological Association (2019, 05/14). Medications for Scabies. Cited from http://www.derma.org.tw/index.php?sort_no=1379727060&sort_s_no=1379760888%20&%20id=1500528490
Tsai, M. C., Chan, M. C., Lin, Y. C. (2020). Using team resource management to manage scabies in respiratory care patients. Infection Control Journal, 30(2), 83-92. http://doi.org/10.6526/ICJ.202004_30(2).0002

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