Let's learn about scabies. Here's how to get rid of this annoying itch!

Have you or someone in your family ever had an unbearable itch with small blisters on their body? If this itching is worse, especially at night, it could be scabies. Although many people are embarrassed to talk about it, scabies is a condition that can affect anyone. Today, we will talk about this in simple terms.

What is Scabies?

Simply put, scabies is a disease caused by a small pest that comes to our skin. The cause of this is a small mite called `(Sarcoptes scabiei)` . These mites are so small that they are not even the tip of a pin. They are almost invisible to the naked eye. These little mites burrow into the top layer of our skin and live there, eat, and lay eggs. Imagine, this is what happens inside our skin! So, our skin reacts to this mite and its waste products. That reaction is what we see as a rash that comes with severe itching .

This disease called cholera can be easily transmitted from one person to another. It spreads quickly, especially among people who are huddled together and in close contact (for example, people living in the same house, young children in schools, people living in dormitories). That is why, if one member of the family develops cholera, a doctor will examine everyone else and, if necessary, treat them all at once.

Yeast infections are a worldwide problem. They are most common in tropical countries, especially in areas with poor sanitation. However, they can affect anyone, regardless of age, race, or economic status. No matter how clean you are or how good your hygiene, you can still get yeast infections. So don't think, "Oh, I must be dirty." Doctors treat them with medicated creams or oral medications.

Are there different types of thieves?

Yes, in addition to the classic scabies we usually see, there are several other types. The two main types are:

• Crusted Scabies / Norwegian Scabies: This type of scabies often occurs in people with a weak immune system. For example, people with diseases like HIV, people taking cancer medications, or the elderly. This is when crusted areas form over a large area of ​​the skin. While there are only 10 to 15 mites in a typical scabies case, in this case, there can be millions of mites ! This is why it is a bit more severe, and the risk of spreading it to others is much higher.
• Nodular Scabies: This type is most common in young children. It appears as red, raised nodules, especially on the genitals, groin, and armpits. Sometimes, these nodules can persist for a long time after all the mites have died.

How common is measles?

In fact, ringworm is more common than you might think. It is said that more than 400 million people worldwide develop ringworm every year . As mentioned earlier, it is most common in tropical countries with poor health facilities. However, in a country like Sri Lanka and in developed countries, it can occur anywhere and in anyone. Especially, in places where people spend a lot of time together, such as nursing homes, school dormitories, and prisons, there is a high chance of ringworm spreading. In our country, we see many cases of this spreading outside families or among children in schools.

What are the symptoms of a hangover?

The main and most annoying symptom of scabies is the intense itching. This itching is so severe that sometimes it prevents sleep. This itching is especially severe at night.

If you have never had scabies before, you may not experience symptoms (itching, rash) for up to six weeks after the mites have entered your body. However, if you have had scabies before, symptoms may appear within a few days. The rash may spread over your body over weeks or months.

In addition to itching, hives have several other symptoms:

• Severe itching: Itching that is severe, especially at night, and interferes with sleep.
• Sores or painful bumps: Constant scratching can cause skin damage, and sometimes these sores can become infected, causing redness, swelling, and even pus to form.
• Burrowing tracks or bumps: Sometimes, you can see small, raised lines that are the same color as your skin. These are the tunnels that the mites have dug under your skin. Sometimes they can look like small blisters.

When young children have a fever, they may itch all over their bodies. They may be cranky and very tired because they don't sleep well at night.

Where on the body are these parasitic mites most common?

These mites like to live in warm, creased areas of our skin, where there are folds . These are the places they most commonly nest:

• Between the toes (on the feet and hands)
• Thighs and genital area
• Wrists and knees
• Waist area
• Under the nails
• Under areas where you wear things like rings, watch bands, and bracelets
• Women's names are around the nipples.

In young children, warts can also be seen on the face, neck, scalp, palms, and soles of the feet.

Can we see this mite? What does the hori rash look like?

Actually, this wasp is very small. It's about the size of a pinhead. So it's very hard to see with the naked eye. It's a creamy white color. It's an animal with 8 legs and a round body. You can only see it clearly if you look at it through a microscope.

The rash (which appears like a rash on the skin) can appear in different colors depending on your skin tone. Some people may see it as red, some as brown, and others as gray. The rash can look like hives, insect bites, or pimples . Sometimes, the rash can appear as a continuous line across the skin. These are the paths that the mites have dug.

What causes ringworm? How is it spread?

The only reason for scabies is that the little mite (Sarcoptes scabiei) mentioned earlier enters our skin. These little mites burrow under the skin, live inside it, eat it, lay eggs, and excrete their waste there. Our skin reacts to these things. This is similar to how we get itchy and red skin when we are allergic to something.

Ringworm is spread from one person to another.

• Direct skin-to-skin contact: This is the easiest way to get shingles. It can spread very quickly when you touch someone who has shingles, sleep with them, or have sex. It can also spread when young children play together, or when parents hold their children.
• Through shared clothing, bedding, and towels: This is less common, but if someone else uses bedding, clothes, or towels that have been used by an infested person, the infection can also spread. Although the mites cannot survive for long outside of human skin, they can become active again within a few days if they come into contact with someone else's skin.

Can we get rabies from animals in our home?

No. The type of mange that your dog or cat gets (called ``mange'') cannot live on humans. So you can't get mange from them. The mange mites that cause mange in humans only live on human skin.

Who is most at risk of developing hoarseness?

As mentioned earlier, ringworm is a disease that can affect anyone. It is not caused by poor hygiene. However, some people are more likely to develop ringworm than others. These include:

• People who live in crowded, overcrowded conditions: For example, places like dormitories, refugee camps, and prisons where many people share the same room.
• Babies and young children: Young children are often touching and hugging their caregivers, friends, family, and classmates, so they can easily become infected.
• Elderly people: Especially those in nursing homes.
• Healthcare workers: Healthcare workers who care for patients who come for treatment without knowing they have the virus can also become infected.
• Sexually active people: Due to close contact.
• People with weak immune systems can even develop severe conditions like `(Crusted Scabies)`.

Can theft cause other complications?

Yes, if lice are not treated properly or are ignored, some complications can occur.

• Painful skin lesions: Frequent scratching can cause skin lesions, which can allow germs like bacteria to enter and cause serious secondary bacterial infections. The areas can then become red, swollen, and pus can collect.
• Septicemia: Some severe skin infections can cause bacteria to enter the bloodstream, leading to a dangerous condition called septicemia. This can be life-threatening.
• Heart disease and kidney disease: Some studies have shown that long-term scabies, especially crusted scabies, may be linked to some heart and kidney diseases. This is because of the ongoing inflammation and infection.

Therefore, it's not a good idea to dismiss a sore throat as "just an itch."

How do you know for sure if there is a thief? (Diagnosis)

If you suspect that you or your child has ringworm, be sure to see a healthcare provider. In most cases, a doctor can tell if you have ringworm by looking at your skin and listening to your symptoms. Especially if you can find things like burrow tracks, it's more likely that it's ringworm.

Sometimes, if the doctor wants to be more certain, he or she will take a small sample of skin (a skin scraping) and examine it. This is done like this: They apply a little oil, such as mineral oil, to the area where the rash is and use a very fine scalpel to scrape off a small amount of the top layer of skin. It doesn't hurt. The sample is then examined under a microscope to see if there are mites or their eggs. If they are found, it is 100% certain that it is scabies.

How to cure hori? (Treatment)

To cure scabies, you must use medication prescribed by a doctor. This will not just cure it. The main goal of the treatment is to kill the mites. However, itching can persist for several weeks even after the mites are dead. This is because our skin reacts to the mites' body parts and waste products as long as they are under the skin.

There are two types of medication that the doctor can give you:

1. Skin creams, lotions or ointments:

Doctors often prescribe this type of medicine. This medicine should be applied to the entire body from the neck down . It should be applied thoroughly to the palms of the hands, soles of the feet, and between the fingers. For young children, they are sometimes told to apply it to the face and scalp (but be careful not to apply it around the eyes and mouth).

You should use this as directed by your doctor, or as directed on the medicine packet. Typically, this cream should be left on the skin for 8 to 14 hours. Most often, it is applied at night before going to bed and washed off in the morning.

Some of the most common types of creams are:

• `(Permethrin cream)`
• `(Crotamiton cream or lotion)`
• `(Benzyl benzoate lotion)` (This is widely used in Sri Lanka)
• Sulfur ointment (This is also sometimes given, especially to young children and pregnant women)

2. Oral medications:

Sometimes, especially for those with severe conditions like `(Crusted Scabies)`, or those who have difficulty applying creams, the doctor may prescribe oral medication.

• The most common medication for this is a pill called `(Ivermectin). This can be given as a single dose, followed by another dose in a week or two. However, this medication is not given to children weighing less than 15 kilograms (35 pounds), pregnant women, or nursing mothers.

The most important thing: When treating lice, everyone you live with (family members) and all your sexual partners should be treated at the same time. Otherwise, even if you are healthy, you can still be infected by others. Since someone can still have the mites on their body even if they don't have symptoms, it's important to treat everyone in close contact.

Other adjuvant therapies:

To reduce itching, the doctor may prescribe medications such as `(Antihistamines)`. Sometimes, if the itching has caused an infection, `(Antibiotics)` may also be prescribed. You may also be prescribed ointments such as `(Steroid creams)` for areas that are red and swollen.

How quickly will I recover after treatment?

• Rash (skin blisters/eczema): The red, blister-like rash on the skin should subside about four weeks after starting treatment.
• When do mites die?: After using a skin cream or a pill once, the mites die.
• When will the itching stop?: This is a question that many people have. Even if all the mites are dead, it can take two to four weeks for the itching to stop completely. For some people, it can take a little longer. The reason for this is that, as mentioned earlier, our skin reacts to the dead mites and their waste products as long as they are under the skin. So, don't worry, "Oh, I'm still itching even after taking the medicine, I don't know if the disease is getting better or not." This is normal.

Will Hori just get better? Is this a difficult disease to cure?

No, scabies never just goes away. It can only be treated with prescription medication. If you don't get treatment, you will continue to spread the disease to others. Also, scratching can damage the skin and increase the risk of developing a serious skin infection.

Scabies is a treatable disease, but sometimes it can be difficult to completely cure it. Especially the severe types like `(Crusted Scabies)` are difficult to cure. Also, sometimes after taking the medicine once, you may need to get another treatment (repeat treatment). This is done to kill any remaining mites. Therefore, it is very important to take the treatment exactly as the doctor says, and to get the whole family treated.

What is the future for someone who has been a thief? (Outlook)

Ringworm is a frustrating and uncomfortable condition that can last for several weeks. However, medications prescribed by a doctor can kill the mites and reduce symptoms. It can take up to two months for the skin to heal completely.

If your symptoms do not improve after taking the medicine, or if the rash is still there after four weeks, see your doctor again. You may need to have another treatment.

Also, you should wash all your bedding, clothes, and towels thoroughly in hot water and dry them thoroughly. Sweep and clean your floors as well. Although mites cannot survive on these surfaces for more than a few days, it is important to get rid of any mites that may be on your body.

If my child has a concussion, how soon can they return to school?

In most cases, your child can return to school as soon as treatment begins. If you are an adult, you can also return to work after treatment begins. However, it is best to check with your doctor to be sure.

Can someone be a thief more than once?

Yes, it is definitely possible. If you have close contact with someone who has shingles, you can get shingles again at any time. Just because you've had shingles before and recovered doesn't mean you can't get shingles again.

How to prevent the spread and development of ringworm?

How can I prevent myself from infecting others?

If you find out you have shingles, do these things to prevent spreading it to others:

• Wash all bedding, towels, and clothing thoroughly in hot water and dry them well (preferably in a dryer). Place items that cannot be washed (e.g., large toys, large pillows) in a large garbage bag, tie it tightly, and store it in a garage or basement for about 7 days. Mites cannot survive for more than a few days without human skin. Then, you can take the items out and clean them by hand.
• Have your family members and other close contacts tested for the virus. If necessary, they should also receive treatment.
• After you find out you have a seizure, limit your close contact with others for a while.

Can you prevent the formation of warts? (Prevention)

There is no specific vaccine to prevent scabies. The only way to prevent getting scabies is to avoid people or places with known scabies outbreaks. The disease spreads very easily between people who live in the same house or share the same room. Therefore, if someone has scabies, it is best to avoid close contact with them until they are properly treated.

When do I need to see a doctor again?

After you know you have thrush and start treatment, see your doctor again if any of the following happens:

• If symptoms or skin problems persist after about a month.
• If you see signs of a bacterial infection, such as red, swollen, or pus-filled skin, these infections can lead to more serious problems.
• If you experience a bothersome side effect, whether due to medication or illness.

What questions should you ask the doctor?

When you find out you have a hernia, you may have many questions. That's normal. You can ask your doctor questions like these:

• Do people who live with me also need to receive treatment?
• Can I go back to work/school after starting medication?
• Can I still spread the disease?
• Can I become a thief again?
• What side effects can be expected from the medication?
• When will my symptoms get better?

A few more small questions...

• Do we feel the mites when they are on our body?

No. These mites are very small, and they burrow under the skin. So we don't feel them on our bodies. We only feel the itching and burning that they cause on the skin.

• Can bedbugs live in mattresses?

Mites can live temporarily on or inside a mattress. However, they absolutely need human skin to survive. They can live on furniture, clothing, and any surface for a short time, but if they don't find human skin within a few days, they will die.

• Do dirty bed sheets cause lice?

No. Dirty bed linen does not cause scabies. This is because this disease has nothing to do with cleanliness or hygiene. However, someone who has scabies can spread scabies to another person through bedding used by someone who has scabies. Therefore, it is always good to stay clean, but do not assume that scabies are caused by dirt.

Final Take-Home Message

If you have a skin rash that is so itchy that it keeps you up at night, you should definitely see a doctor. It could be scabies. Scabies is a contagious disease caused by a tiny mite. It is important for you and anyone else you come into close contact with to get treatment right away.

If you have any skin rash that just won't go away and is bothering you, see a doctor. Like other red, itchy rashes, hives are completely treatable with medication. So, don't be embarrassed or afraid, seek medical advice right away. Then you can get rid of this annoying itch quickly.

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