What Are The First Signs of Scabies?

Although scabies sounds like a disease from the middle ages, there have been more and more cases recently. Why that is, and what you should know about the infection.

The word alone. “Scabbers.” One associates with long gone times, lack of hygiene and a life under poorest conditions – certainly not the daycare center or the school around the corner. But anyone who has children or knows parents knows that, in addition to warnings about gastrointestinal infections and lice infestation, “We have scabies” is increasingly being displayed on the door.

What’s with the scabies? You’ll know it when you see it

In fact, the number of cases of the strongly itchy skin disease, also called scabies, has been clearly increasing in this country in the last years. According to the Barmer health insurance company, prescriptions of scabies medication increased by 40 to 130 percent between 2016 and 2017, depending on the federal state. “Scabies is an infectious disease caused by the scabies mite,” explains Dr. Ute Siemann-Harms, senior physician at the Department of Dermatology and Venereology at the University Hospital Hamburg-Eppendorf.

The mites dig into the uppermost horny layer of the skin and lay their eggs in ducts. “The severe itching is caused by developing an allergy to the mite’s excrement.” Then red, sometimes scabby pustules and nodules form – usually on parts of the body with thin skin and/or skin-to-skin contact, because this is how the mites change their human habitat. Affected areas include those between the fingers, in the armpits, around the chest, in the anal and genital areas. Experienced dermatologists usually recognize the scabies by their characteristic skin lesions. “They often look comma-shaped, like small scratches”, says Ute Siemann-Harms. Pronounced itching is also typical.

How is the disease transmitted? What to do in case of a diagnosis?

Fortunately, shaking hands or short hugs are harmless. “Infection only occurs with close physical contact over several minutes,” says Ute Siemann-Harms. “That’s why whole families are often affected.” There is also an increased risk of an outbreak in communal facilities such as daycare centers or nursing homes, where people are cuddled or have frequent skin contact.

Once the diagnosis has been made, all those who live closely with the affected person will receive anti-mite treatment on the same day. The difficult part: every millimeter of skin surface down the chin must be thoroughly creamed with a mite-killing ointment and left to work for eight to ten hours. “Often, however, only the itching and visibly affected areas are treated,” says the dermatologist. In the meantime, tablets that block the mites’ metabolism have also been approved. But since side effects such as liver dysfunction can occur, treatment is primarily local.

Further measures: Wash bed linen, towels, clothing and cuddly toys at a temperature of at least 50 degrees Celsius or pack them in plastic for three days and cut the fingernails as mites can also collect underneath.

And why are there more and more scabies infections now?

Some see a connection with migration – people would bring the parasites with them from their home countries. “There have been repeated outbreaks in recent decades But where people live together in a confined space, whether in a retirement home or refugee accommodation, an infection is naturally more likely to spread,” explains Ute Siemann-Harms. She also suspects that many affected people do not have the disease detected and treated for a long time because they experience a mild course. “In addition, itching only occurs six weeks after the infection. Unless you have been ill before. During this time you may have infected others.” And: Doctors sometimes confuse the lesions with allergic eczema – and prescribe the wrong drugs.

Anyone who notices itching or burning skin, comma-shaped scratches, pustules or nodules on warm parts of the body, either on themselves or on family members, should seek medical help as soon as possible. And a small consolation is at least this: Usually a single treatment is enough to get rid of the unpleasant parasites.