Scabies Treatment Online
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Scabies Treatment Online
By Medical Editor:
Dr. Francesco-Maria Serino, MD, PhD
September, 2024
Summary
Scabies is a skin condition caused by tiny mites that burrow into the skin, leading to intense itching and a rash. It’s spread through prolonged skin contact and is common in places like homes, schools, and care facilities.
The mites, particularly the females, lay eggs under the skin, which triggers an allergic reaction and severe itching, especially at night. Scabies often affects areas like the fingers, wrists, elbows, waist, and genitals, with symptoms including small, wavy lines on the skin where the mites burrow. In children, it may also appear on the hands, feet, and face.
Treatment usually involves a prescription cream like permethrin, applied to the whole body. For more severe cases, or when creams don’t work, oral medication like ivermectin may be used. While antihistamines and corticosteroid creams help relieve itching, they don’t kill the mites. If a bacterial infection develops, antibiotics may be needed.
To prevent reinfestation, wash clothing, bedding, and towels in hot water, as the mites can’t survive long without human contact. Scabies is treatable, but acting quickly can help stop it from spreading.
What is scabies?
Scabies is a skin infestation caused by the Sarcoptes scabiei mite. These tiny mites burrow into the upper layer of the skin, leading to intense itching, often worse at night. A common symptom of scabies is a scabies rash, which appears as small, red bumps or lines (burrows) on the skin. These are typically found between the fingers, wrists, elbows, and other areas like the waist, areolae, or genitalia.
The term “scabies bites” is often used to describe the itchy rash or burrows caused by the mites, although the mites themselves do not technically bite the skin. Instead, they burrow and cause irritation.
Types of scabies
There are two main forms of scabies:
- Classic scabies, which involves fewer mites (typically 10-15), and presents with widespread itching and a rash.
- Crusted scabies (also known as Norwegian scabies), which is more severe and occurs primarily in individuals with weakened immune systems. This form involves a much heavier mite infestation and leads to thick crusts of skin filled with thousands or even millions of mites.
Scabies outbreaks are often spread through direct, prolonged skin contact with an infected person, such as within households or among sexual partners.
What causes scabies?
Scabies is caused by an infestation of the skin by the Sarcoptes scabiei mite, a tiny, eight-legged parasite. These scabies mites are microscopic and burrow into the outer layer of the skin, where they lay eggs and produce waste, triggering an allergic reaction. This results in intense itching and a characteristic rash.
How Scabies Mites Infest
- Mite Infestation: The female mite burrows into the skin, creating tunnels where she lays 2-3 eggs per day. After mating, the males die, and the females continue to burrow.
- Eggs and Larvae: The eggs hatch within a few days, and the larvae mature through several stages within the skin.
- Burrowing Mites: The burrowing process causes damage to the skin, leading to the characteristic scabies rash and intense itching.
Transmission of Scabies
- Direct skin-to-skin contact is the most common way scabies is transmitted, especially in close quarters like families, nursing homes, and schools. Prolonged contact, such as holding hands or sexual activity, increases the risk of transmission.
- Fomite transmission, or transmission via infested items like bedding or clothing, is rare in classic scabies but more likely in severe forms like crusted scabies, which involves a larger number of mites.
The infestation can affect anyone regardless of age or socioeconomic status, especially in crowded environments that promote close contact, leading to scabies outbreaks.
Scabies outbreaks typically occur in settings with close physical contact, such as households or institutional settings like nursing homes. Transmission happens through prolonged skin-to-skin contact, making outbreaks common in crowded environments.
Scabies mites can live outside the human body for about 24 to 36 hours under normal conditions, but they can survive even longer in cooler and more humid environments.
By recognizing these mite infestation symptoms, particularly the scabies rash and early scabies burrows, it becomes easier to diagnose and manage the condition
Scabies Symptoms
Scabies is a skin infestation caused by tiny burrowing mites known as Sarcoptes scabiei. These mites trigger a variety of symptoms due to the body’s allergic reaction to the mites, their eggs, and their waste products.
Early scabies symptoms
Early scabies symptoms often begin with intense itching, particularly at night. This is usually followed by a scabies rash, which consists of small, red bumps or blisters that may be mistaken for scabies flea bites. The itching can develop within 3-6 weeks for a first infestation, or as soon as 1-3 days in individuals with a previous infestation.
Scabies Rash and Burrows
One of the most distinguishing features of scabies is the scabies burrows. These appear as small, thin, wavy lines on the skin, often gray or skin-colored. These burrowing mites create tunnels in the upper layer of the skin where they lay eggs. Common areas for these burrows include between the fingers, on the wrists, and the scabies on hands and feet areas.
Did you know that...
One lesser-known fact about scabies: while animals like dogs and cats can get scabies, the species that infest them (causing sarcoptic mange) are different from those affecting humans. These animal mites can't reproduce on human skin, and the resulting irritation resolves after contact with the infected animal stops.
Classic vs. Crusted Scabies
- Classic scabies typically affects areas like the webs of the fingers, wrists, elbows, waist, and buttocks. In children and infants, scabies on the face, hands, and feet is more common.
- Crusted scabies is a more severe form, particularly affecting immunocompromised individuals. It leads to thick, crusted areas of skin teeming with thousands of scabies mites. This variant might not cause as much itching, but the scaling and crusting are more intense.
Scabies vs. Eczema
While both scabies and eczema cause itching and skin irritation, they are different conditions. Scabies involves burrowing mites, while eczema is an inflammatory skin condition without mites. Scabies burrows and the intense itching at night can help differentiate it from eczema.
Complications: Scabies and Impetigo
In severe cases, scabies impetigo can occur due to secondary bacterial infections, especially when the skin is broken from excessive scratching. This can lead to crusty, yellow sores.
Identifying Scabies Burrows
To identify scabies burrows, look for small, serpentine tracks on the skin, especially in the common sites like the fingers, wrists, and feet. These tracks may be accompanied by small red bumps or vesicles.
Scabies treatment
Scabies is treatable, but acting quickly can help stop it from spreading.
To treat scabies, the primary approach involves using prescription topical medications that kill the mites. Here are the key steps in scabies treatment:
Permethrin cream: This is the most commonly prescribed topical treatment. A 5% permethrin cream is applied all over the body, from the neck down, and left on for 8-14 hours before washing off. This kills both the mites and their eggs. It’s usually recommended to repeat the treatment after one week to ensure all mites are eradicated .
Ivermectin: For more severe cases, such as crusted scabies or when topical treatments are not effective, oral ivermectin is prescribed. Ivermectin is taken in two doses, typically one week apart, and it works by killing the mites from within the body .
Ivermectin is generally safe for treating scabies, but there are a few risks to be aware of:
Common Side Effects: People might experience mild issues like headaches, dizziness, feeling tired, or an upset stomach. These symptoms usually go away on their own.
Serious Reactions: In rare cases, ivermectin can cause more serious problems, like a condition called DRESS syndrome, which leads to severe skin rashes and other symptoms. There have also been reports of confusion or trouble with balance, especially in people with a history of neurological issues.
Not for Everyone: Ivermectin isn’t recommended for pregnant women or young children (under 15 kg) because it hasn’t been studied enough to know if it’s safe for them.
Overall, it’s usually well-tolerated, but it’s important to weigh the pros and cons, especially for those in more vulnerable groups.
Treating Scabies and Impetigo: If the scabies infestation leads to a secondary infection like impetigo, an antibiotic treatment is required in addition to the standard scabies therapy. Impetigo, often caused by bacteria like Staphylococcus or Streptococcus, needs antibiotics to prevent complications .
Relief of symptoms: Antihistamines or corticosteroid creams may be used to relieve itching and inflammation, although these don’t cure scabies. The itching may persist for several weeks even after the mites are killed.
Fomite control: To prevent reinfestation, all bedding, clothing, and towels used by the affected person should be washed in hot water and dried on high heat. Items that cannot be washed should be sealed in plastic bags for at least 72 hours, as mites cannot survive more than 2-3 days without human contact .
While it’s certainly not possible to get rid of scabies in 24 hours, applying treatments like permethrin or taking ivermectin under medical supervision can start killing mites immediately. However, full recovery and relief from symptoms typically take a few days to weeks .
Common scabies medications
Permethrin
topical cream
Ivermectin
tablets
How can Doctorsa help with scabies treatment online?
If you’re searching for scabies treatment online, the good news is that it’s easier than ever to get help. With Doctorsa, you can consult with a licensed doctor and receive a diagnosis from the comfort of your Hotel or Bed and Breakfast. No need to rush to a clinic trying to find a doctor who understands you by pure luck or wait in long lines—everything can be done virtually.
During your online consultation for scabies treatment, the doctor will ask about your symptoms, like severe itching, rashes, or burrows on the skin. They may also inquire if you’ve been in contact with someone who has scabies since it’s highly contagious. Even though the doctor can’t perform a physical exam, they can often diagnose scabies based on your description, and you can even send photos to help them assess your condition.
Once diagnosed, your doctor will provide you with the appropriate scabies treatment online, such as a topical cream like permethrin or oral medication like ivermectin. These medications are effective in killing the mites that cause scabies. You can have your prescription filled at your nearest pharmacy, or in some cases, get it delivered to your home—making the process super convenient.
Keep in mind that while the mites start to die right away, it may take a few days to weeks for the itching and irritation to completely go away. Doctorsa also offer 7-day free chat with your provider to ensure your treatment is effective and to answer any questions.
Getting scabies treatment online is a fast and convenient way to manage this condition without commuting in a foreign city, offering expert care and quick access to the medications you need.
References
Lake SJ, Kaldor JM, Hardy M, et al. Mass Drug Administration for the Control of Scabies: A
Systematic Review and Meta-analysis. Clin Infect Dis 2022; 75:959.
Salavastru CM, Chosidow O, Boffa MJ, et al. European guideline for the management of
scabies. J Eur Acad Dermatol Venereol 2017; 31:1248.
Veraldi S, De Micheli P, Schianchi R, Pontini P. A new treatment regimen with permethrin in
scabies. G Ital Dermatol Venereol 2018; 153:491.
Coyne PE, Addiss DG. Deaths associated with ivermectin for scabies. Lancet 1997; 350:215.
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Your questions answered
How does a person get scabies?
Scabies is caused by tiny mites called *Sarcoptes scabiei*, which burrow into the skin. People typically get scabies through direct, prolonged skin-to-skin contact with someone who already has the infestation. It can also spread by sharing personal items like clothing, towels, or bedding, although this is less common.
Close contact, such as living with someone who has scabies or sexual contact, increases the risk of catching it. Scabies can spread more easily in places like nursing homes, daycares, or crowded living conditions, where close personal interaction is frequent.
The mites can live on the skin for several days, which is why treating both the person with scabies and their close contacts is important to prevent re-infestation.
Is scabies an STD?
Scabies isn’t classified as a traditional sexually transmitted disease (STD), but it can spread through close physical contact, including sexual activity. The scabies mites, Sarcoptes scabiei, are primarily transmitted by prolonged skin-to-skin contact, which is why scabies outbreaks can occur in places like households, dormitories, or nursing homes. While sexual contact can lead to transmission, scabies can also spread through sharing bedding, towels, or clothing, making it more than just an STD.
How long does scabies take to go away?
Scabies usually takes about 1 to 2 weeks to go away after treatment, though itching and irritation can persist for up to 4 weeks. The scabies mites are killed quickly with treatment, but your skin may still react to the dead mites and their waste, causing continued itching.
Most treatments, like permethrin cream or oral ivermectin, require a second application after 1 to 2 weeks to ensure all mites, including any newly hatched eggs, are eradicated. If symptoms last longer than 4 weeks, it’s a good idea to follow up with a doctor, as this could indicate reinfestation or treatment failure.
What happens if scabies is left untreated?
If scabies is left untreated, the infestation will continue to worsen over time. The mites will keep multiplying, leading to intense itching, skin irritation, and more widespread rashes. Scratching the itchy areas can break the skin, increasing the risk of secondary bacterial infections, such as impetigo or, in more severe cases, cellulitis.
In some cases, untreated scabies can develop into crusted scabies (also known as Norwegian scabies), a much more severe form that leads to thick, crusted skin filled with mites. This form is highly contagious and more difficult to treat, often requiring both topical and oral medications.
Leaving scabies untreated also increases the risk of spreading it to others through close contact or shared items like bedding and clothing.
Can scabies live in a mattress?
Yes, scabies mites can live in a mattress, but they can’t survive for long once they are off the human body. Scabies mites need a human host to survive, as they feed on the skin. Typically, they can live for about 2-3 days on surfaces like mattresses, bedding, or clothing. However, during that time, they may still be contagious, so it’s important to take steps to prevent reinfestation.
If you or someone in your household has scabies, it’s crucial to clean your bedding, clothes, and other fabrics that may have come into contact with the mites. Washing items in hot water and drying them on high heat will kill any lingering mites. For items that can’t be washed, sealing them in a plastic bag for at least 72 hours can help, as the mites won’t survive without a host for that long.
Vacuuming your mattress and furniture can also be helpful, but most importantly, make sure everyone in the household gets treated at the same time to avoid passing scabies back and forth.
How does scabies treatment online with Doctorsa work?
Open the intake form and choose one of the following options:
- Urgent Care: For immediate treatment of your Bacterial Vaginosis via virtual care.
- Set Up an Appointment: To schedule a same-day or future appointment.
- Prescription Refill: Use this option if you have lost or forgotten your medication.
Next, select how you would like to receive appointment offers from doctors.
We recommend using WhatsApp as it is faster and more reliable. You will quickly receive various visit options. Choose the one that suits you best and proceed to online payment.
Video visits are browser-based, so no apps are needed. Simply click the link you receive to start your video visit in your browser.
After the consultation, expect to receive an invoice and an e-prescription via email. You can show or print the e-prescription to purchase medication at the pharmacy of your choice.
How do I get a prescription from an online doctor?
Following the consultation, the doctor will either email the e-prescription to you or send it via WhatsApp. You can then either print it out or show it directly to the pharmacist when purchasing the medication.
It’s important to understand that doctors must responsibly evaluate each case individually. They can’t simply prescribe medication solely based on a patient’s request or a recommendation from another doctor without confirming that it’s suitable for the patient’s specific condition.
How much does it cost?
The total cost may differ based on the providers. Each one competes for your request, offering a fair price tailored to your needs. On average, an online doctor visit costs 25 Euros. Prices for in-person appointments, specialists, and lab work vary by city. You can send a request to learn more—there’s no commitment to book, and you can select your provider.
Please note that the visit fee doesn’t cover medication expenses, but common antibiotics are quite affordable in Europe. The cost of antibiotic treatment typically ranges from 5 to 15 euros approximately.
Are doctors available on weekends?
Yes, whenever you submit your request it is instantly received by the doctors active at that time. Whether it’s late at night, on a Sunday morning, or on New Year’s Eve, there’s always someone on the other side who’s ready to see you. When you receive an option for an appointment, there’s a person behind it (a doctor) who’s read your request and is willing to assist you.
Can I contact the doctor for follow-up questions after the consultation?
You can message your physician with follow-up questions at no additional cost for up to 7 days after the video visit.
