Scabies

​​Scabies is a very itchy skin problem, that commonly affects the hands, wrists and fingers. It can affect the elbows, armpits, nipples and buttocks. In males, the genitals are often affected. The itch is worse at night.

Fig.1 Scabies affecting the trunk

​​This condition is caused by the scabies mite, which is a small parasite that burrows into the skin of infected patients. It is usually transmitted by close person-to-person contact, and by sharing the same bed or clothings, especially among children and people with poor hygiene. The whole family can be affected as scabies is quite infectious.

The mite can be killed rapidly by the use of an effective medication eg. Benzyl benzoate emulsion or malathion or permethrin. Attention should be paid to the specific instruction on how the medication should be applied.

​​You may still itch for some days to weeks,after correct treatment. This is because of the development of a hypersensitive reaction of your body to the dead mite. Your doctor would prescribe anti-histamine tablets and steroid creams to stop the itch. DO NOT APPLY the anti-scabies medication repeatedly, and excessively unless advised by your doctor, as you can develop a more severe dermatitis.

​​These include benzyl benzoate emulsion (for three days), malathion (Derbac) (one day), crotamiton (Eurax) lotion or cream (five days). For infants and young children, it is preferable to use crotamiton, or permethrin.

First Evening:
Immediately after a shower, apply the lotion to the whole body from neck downwards, even to the unaffected areas. Do not forget the soles, armpits, genitals and other body folds. Do not apply on the face. Do not wash away the lotion until the next evening. Re-apply the lotion on the hands each time you wash them.

Second and Third Evenings:
Repeat the above treatment in the same manner. To eradicate any mites in the family, all worn clothing should be washed in hot water and then sunned. Bed linen, pillow case, pillows, mattresses should be dusted and sunned.

​​Any family member with itch, or those with close body contact, or share the same bed or linen with the patient, whether affected or not, should have the same treatment at the same time. Your doctor would usually supply sufficient medicine for all of them.​