Scabies: significance, symptoms and treatment

Scabies is a parasitic skin disease. The pathogens, scabies mites, colonise the upper layer of the skin, causing itching and a characteristic rash on various parts of the body. As a rule, scabies is not dangerous and responds well to appropriate treatments. However, the illness is highly contagious.

It’s important to note that scabies has nothing to do with poor personal hygiene – it can affect anyone.

Scabies is transmitted through prolonged skin contact with an infected person, which allows the mites, tiny arachnids, to get onto the skin. However, the skin reactions are not caused by bites: with scabies, these mites dig tiny burrows into the skin and lay their eggs there.

Scabies is particularly common among children, as they often experience close physical contact in kindergartens and schools. The risk is also higher within families, among housemates and in nursing homes. Transmission through shared clothing, bed linen or furniture is rare, but possible.

Scabies often starts with severe itching, especially at night. And what about scabies’ typical appearance? A rash with red papules and lines caused by the mites’ burrows. Scabies mainly affects areas such as the spaces between the fingers, wrists, elbows, armpits, waist, genital region and buttocks. In babies and toddlers, symptoms of scabies also occur on the scalp, face, palms of the hands and soles of the feet.

Scabies discreta

With scabies discreta, symptoms are milder, making it harder to detect. Frequent washing or nourishing skincare smooth the affected areas, leaving the mites’ burrows less visible. While the rash is milder, the itchiness persists.

Scabies crustosa

Scabies crustosa mainly occurs in immunocompromised individuals and older people. This is a particularly extreme form of scabies that causes severe symptoms. Normally, the skin is covered with thick, sticky crusts and flakes, often found on the hands and feet, on the elbows, on the scalp or on larger areas of skin on the torso. Since the mite infestation is significantly worse than with ordinary scabies, the skin changes appear to be more intense. The itching is sometimes less pronounced, but remains a typical symptom.

It’s important to be aware that there is a very high risk of infection due to the large number of mites on the skin. Even a brief moment of skin contact, or contact with skin flakes or textiles, is often sufficient to transmit the disease. Treating this variant of scabies therefore requires exacting medical supervision and strict hygiene, both for those affected and anyone they come into contact with.

To diagnose scabies, doctors carefully examine the affected areas of skin, paying attention to tiny mite burrows, papules or crusts. If necessary, they may take a skin sample or examine the skin with a dermatoscope. Differential diagnosis plays an important role in suspected scabies cases, as similar skin reactions also occur with eczema, allergies or bacterial infections. If you suspect you have scabies or are unsure, seek medical support at an early stage: this will give you clarity about the cause of your issues and help you avoid infecting others.

Scabies is usually treated with prescription medication. At the same time, consistent hygiene is important to prevent people who are suffering from scabies from reinfecting themselves and to help protect others. This includes cleaning textiles and living areas, as mites can survive outside the skin for a short period of time.

The following steps will help you get rid of scabies in your home:

• Change clothes, bed linen and towels daily and wash them at a minimum of 60 °C.
• Place any unwashable textiles in an airtight container for 3 days.
• Thoroughly vacuum mattresses, upholstered furniture and carpets.
• Regularly clean surfaces that are touched frequently.

Tell your close contacts about the infection so that they can also be examined and treated if necessary. Take the illness seriously: professional treatment is required even if the rash is very mild or if you have a scabies infection that doesn’t itch. Without appropriate treatment, the infection will persist for a long time and the condition could become chronic.

Scabies medication

Effective treatment requires medications that completely eliminate the scabies mites and prevent reinfection. In Switzerland, prescription creams and tablets are used to treat scabies medicinally. External treatment with cream is considered standard, while tablets are primarily common for extreme forms such as scabies crustosa. The treatment is based on these two active substances:

• Permethrin: the active ingredient is found in scabies ointments and is suitable for treating the entire body. The cream is applied over a large area and remains on the skin for a predetermined period of time.
• Ivermectin: scabies tablets are often used if external treatment is insufficient or difficult. Medications containing ivermectin are usually taken once and re-administered after 7 to 14 days.

Clarify the exact use with your doctor and follow their advice. Avoid using additional lotions without prior consultation, as these may have an impact on the treatment.

Home remedies for scabies

Some home remedies relieve itching or soothe the skin. However, they are no substitute for treating the underlying cause: the mite infestation persists and the risk of infection continues. Without the right treatment, skin irritations and secondary infections can also occur more quickly – so it’s worth talking to a healthcare professional before trying out your own remedies for scabies to ensure that your treatment remains safe.

Good hygiene helps you to prevent scabies and reduce the risk of infection. Wash textiles regularly, make sure your skin is clean and avoid close contact with infected individuals until their treatment is complete. Contact your doctor when you first notice scabies symptoms; they will be able to provide reliable assistance.