Scabies mites – the scabies in Germany

One of the contagious skin diseases is the so-called scabies, which is also known medically as scabies. Scabies is caused by scabies mites, the rash is then transmitted from one person to another through close skin contact. First, female mites penetrate the upper layer of skin and lay their eggs just below the surface of the skin. After a few weeks, the eggs themselves and the mite faeces cause an allergic skin reaction, a rash develops and is accompanied by severe itching.

The dross is rather rare in Central Europe

The scabies only occurs in humans, trigger of the scabies mite, which can reach a size of up to 0.5 millimetres. After mating has taken place, the males die, the females then devote themselves to laying eggs under the skin. They remain in the dug corridors for up to six weeks and lay a few more eggs every day. After only a few days, the larvae hatch, and after 14 days they are sexually mature themselves.

However, mites do not usually reproduce very strongly, because many of the parasites are destroyed by scratching, personal hygiene and the work of the immune system. If a doctor makes the diagnosis, more than 20 parasites are seldom found, but even few of the arachnids lead to sometimes severe symptoms. Large areas of the skin can be covered with eczema, the skin becomes inflamed and a tormenting itch develops. Since the itch mites can only survive for a maximum of 48 hours without a host, very close skin contact with infected persons is necessary for transmission. While people in developing countries still often suffer from an infestation, scabies is rather the exception in our country.

Important: scratch mites are found in mattresses, towels, linen and much more. These mites should also be killed. A mite spray can help well here.

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Symptoms that may indicate scabies

Probably the most conspicuous symptom of scabies is the extreme itching, which is described as unbearable by most people affected. Especially when it is warm, the itching becomes very strong, for example when you lie in bed at night. Some people also have very thin, reddish stripes on their skin, which are the mite ducts under the skin surface. In some cases there are also black dots at the end of these, which are the mites themselves.

Not all skin areas are equally preferred by the itch mites. They especially love areas where the skin is relatively thin and the body temperature may be slightly higher. In these places the females can easily drill into the skin. For this reason, the rashes occur mainly on the palms of the hands and soles of the feet, around the navel, between fingers and toes, on the ankles and wrists, under the armpits, on the chest or in the anal and genital areas.

Symptoms do not appear immediately after an infestation, it takes a few weeks until the organism has formed the corresponding antibodies. Although eczema with nodules, blisters or papules is spread over the entire body in many patients, this does not mean that all skin areas are also colonised by mites.

Frequently, rashes are also found on the calves, buttocks, trunk or the inner sides of the thighs, even if no mites can be found here. However, eczema on the shoulder blades, neck and head is almost never present. Scratching can hardly be avoided with such severe itching, bacteria can then easily penetrate, so that inflammations and a yellowish crust form

Itch mites are not so easy to detect

In most cases, affected people go to the doctor because skin rashes show up with extreme itching. The doctor will first have a detailed conversation with the patient to get to the bottom of the possible causes. He will want to find out whether the typical skin areas are affected and whether the itching increases with heat. Afterwards he will examine the skin to get first hints of an infestation with itchy mites.

The mite ducts can often be seen with the naked eye, and thanks to a dermoscope the mites are also easy to spot. In order to be able to make a reliable diagnosis, the dermatologist must scratch the skin slightly with a scalpel, directly above one of the mite ducts. The female mites either stick directly to the scalpel or are removed with the help of an adhesive strip, then the parasite is examined under a microscope.

However, since mites are only present in small quantities, the examination often only finds eggs, egg shells or even faeces, but even this is sufficient for detection. Sometimes skin areas are so extremely scratched that no mite ducts are visible. In this case, the physician must take a skin sample with a scalpel to be able to make a microscopic evaluation.

The treatment of scabies

If the diagnosis of scabies is indeed established, a drug treatment must be administered to completely destroy the parasites. Permethrin is one of the proven active ingredients in the fight against scabies mites. Permethrin is applied to the skin as a cream, only mucous membranes and face are omitted. This treatment is initially carried out only once, the cream has to work for about twelve hours, then you can take a shower. To make sure that all mites are really dead, this procedure is repeated after one or two weeks.

Treatment with benzyl benzoate can also be initiated, also in the form of a cream. The patient has to apply it three days in a row, twice a day on the whole body, up to the head. There are also tablets with the active ingredient ivermectin available, but so far this drug has not been officially approved in Germany for the treatment of scabies, the patient’s consent is required for this.

Scabies mites don’t like sulphur either. A good sulphur soap has a supporting effect against the mites.

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If there is an infection with itch mites, it is important that not only the skin is treated, but also the environment of the affected person is considered. Bed linen and clothing must be changed regularly and washed at 60 degrees to kill the parasites. If clothes cannot be washed at these temperatures, they must be left for three days, the mites will die off by themselves. Even if other household members do not show any symptoms, they should be treated at the same time as a precaution.

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