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Body lice or scabies is a skin infection caused by a small mite (Sarcoptes scabiei). Intense itching all over the body is usually the most common symptom, with the itching more likely at night or after bathing.
The itching and rash of scabies can sometimes be mistaken for dermatitis or other skin conditions. Scabies is usually confirmed by finding the mite burrows in the skin, which are more commonly seen in the finger webs and wrists, although they may also be found in the genital area, breasts, palms of hands, or soles of feet. The mite burrows may be up to 1 cm long, but are often obscured by scratching.
The mites and their waste droppings trigger an allergic reaction which causes the intense itching. The itching is widespread and not confined to the areas where the mite burrows are found. This allergic reaction may take up to 6 weeks to develop. During this period before symptoms appear, the risk of transferring the mite to others is high and can easily happen through direct contact (e.g. hugging, holding hands and sexual contact).
The mite can infect anyone, and outbreaks are common in residential villages for the elderly, hospitals and child daycare centres.
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- if the itch is severe or extensive
- if you are not sure what skin condition you have
- if treatment is required for a child under 2 years
- if there is crusting or pus from scratching
- if the itch and scratching is localised in one specific area
- if you also suffer from dermatitis or other skin conditions
- if the symptoms have persisted or come back despite treatment (note that the itch can persist for several weeks after treatment)
- if you also have heart or lung problems, diabetes or another medical condition
- if you are pregnant or breastfeeding
- treatment is with a scabicide (insecticide) product which kills the mites
- treat all close personal contacts with the scabicide, regardless of whether they are itchy or not, since it may take up to 6 weeks for the itch to develop
- ensure the scabicide is applied to the whole body from the chin down in people aged over 2 years
- clean and dry skin prior to applying the scabicide
- use a soft brush to apply the scabicide under fingernails
- leave on for the recommended time for that product and reapply after washing hands
- a second application may be given after at least 7 days if there are no signs of the original lesions healing or if new mite burrows have appeared
- skin irritation is common with the use of scabicide products
- oral antihistamines or topical crotamiton may be helpful for the itch, which may persist for 4 to 6 weeks after treatment
- wash in hot water any bedding, clothing or soft toys that the infected person has had contact with. Alternatively, seal objects in a plastic bag for 2 weeks
- clean carpets and furniture with a vacuum cleaner following treatment
- some products are subsidised in cost if obtained with a doctor’s prescription
e.g. permethrin (Lyclear, Quellada Scabies Treatment)
- apply to clean, dry skin from the neck down to the soles of the feet
- apply overnight and leave on for 8 to 10 hours
- wash off with warm, soapy water
- 2 treatments 1 week apart are recommended
- avoid contact with the mouth and eyes
e.g. benzyl benzoate (Ascabiol, Benzemul 25%)
- test the product on the skin first to check for excessive stinging; if this occurs the product must be diluted (always dilute for use in children)
- apply from the chin down and wash off after 24 hours
- repeat treatment after 5 days
e.g. crotamiton (Eurax)
- best used to treat the itch which persists after treatment rather than treat the infection (just apply to the affected areas)
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Last Reviewed: 18/04/2016
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