The nightmare of recent days: Ways to protect yourself from scabies

Clinical Microbiology Specialist Dr. Dilek Leyla Mamçu provided information about the scabies disease, which has been on the agenda recently, and ways to protect against it.

Stating that scabies is a highly itchy and contagious skin disease caused by a mite invisible to the naked eye, Infectious Diseases and Clinical Microbiology Specialist Dr. Dilek Leyla Mamçu said, “Scabies is common all over the world and can be seen in people of all races and social classes. Nursing homes, daycare centers, prisons, and overcrowded communities with inadequate hygiene conditions are places where scabies outbreaks can occur.”

HOW IS SCABIES TRANSMITTED?

Expressing that the disease is usually transmitted through direct, prolonged skin contact (at least 15-20 minutes) with a person who has scabies, Mamçu stated, “It also spreads easily to sexual partners and household members. It can also be spread indirectly by sharing items such as clothing, towels, or bedding used by a person with scabies. Transmission is easier in collective areas such as schools, barracks, and nursing homes, especially among those with weak immune systems, children, and the elderly.”

It can take 4-8 weeks for symptoms to appear the first time

Emphasizing that the most important symptom of scabies is severe nighttime itching, Mamçu continued as follows:

“While itching is primarily seen between the fingers, on the inner surface of the wrists, wrists, armpits, elbows, and groin, it can be seen all over the body. Sometimes scratching these rashes can cause secondary bacterial infections on the skin. The most distinct finding of the disease is the gray-white, 1-10 mm long tunnels between the fingers where the mite lives.

If a person has never had scabies before, it can take 4-8 weeks for symptoms to appear. In a person who has had scabies before, symptoms can usually appear much sooner (1-4 days) after contact. A person infected with scabies can spread the disease even if they do not yet have symptoms.”

HOW IS SCABIES DIAGNOSED?

Explaining that while a definitive diagnosis of scabies requires the identification of the mite, mite eggs, or mite feces (scybala) through dermoscopy or microscopic examination of skin scrapings, these tests are not always possible to perform, Mamçu said, “For this reason, in daily practice, diagnosis is usually based on the observation of rashes and tunnels (burrows) with a characteristic appearance and distribution.”

HOW IS IT TREATED?

Noting that scabies treatment is carried out with creams, lotions, or tablets that kill the Scabies mite and its eggs, Mamçu provided the following information: “Creams containing 5 percent permethrin are applied twice with a one-week interval; additional doses can be given if necessary. Adults, children older than 2 months, pregnant women, and nursing mothers can be treated with permethrin. Permethrin must remain on the skin for 8-14 hours before washing.”

Stating that in resistant cases, in conditions where bathing facilities are not available, and in people with impaired immune systems, two doses of oral medication tablets taken one week apart are quite effective, Mamçu stated that this tablet, which is also available in our country, should not be used in small children and pregnant women.

POINTS TO CONSIDER IN SCABIES TREATMENT

Expressing that the treatment varies according to the person's age and the state of their immune system, Mamçu continued:

“Although different drugs can be used in treatment, there are some rules that must be followed regardless of which drug is used: Treating all family members sharing the same living environment at the same time, even if they do not have active complaints at that moment, is one of the most important points affecting the success of the treatment. Those living in the same house within the last 6 weeks, those with prolonged skin contact, and sexual contacts must be treated.

A good bath and scrubbing are essential before applying the topical (applied to the body) lotion. This will facilitate the contact of the medication with the parasite settled just under the skin. Care should be taken to apply the cream or lotion used to the entire body surface. The medication should be left on the body for the duration recommended by the manufacturer.

ITEMS THAT CANNOT BE WASHED SHOULD BE KEPT IN A BAG FOR 7 DAYS

Clean clothes should be worn after treatment. All clothes, laundry, and bedding used in the last 1 week must be washed at at least 60 degrees, dried in a hot air dryer or in the open air, or ironed. Although scabies mites can live on human skin for 1-2 months, they cannot survive in the external environment for more than 2-3 days. Keeping items that cannot be washed in a sealed bag for an average of seven days will be sufficient.

Especially for patients with crusted scabies, household items such as furniture and carpets should be vacuumed and cleaned. It should not be forgotten that itching and disease symptoms may continue for 2-6 weeks even after successful treatment. If itching continues for longer than 2-6 weeks after treatment, or if new tunnels or rashes appear, re-treatment is required.”