Paul Donohue: Your Health

Scabies spreads from person to person

Dear Dr. Donohue: We have an outbreak of scabies in our area. Will you explain how one gets them? Is it by shaking hands or from pushing a grocery cart in the supermarket? How does one get rid of them?

D.S.

Dear D.S.: Scabies fills people with dread and disgust because they think it comes from poor personal hygiene. It doesn't. It happens to the very rich, the very poor, the very persnickety, the somewhat hygienically laid-back, the elderly and the young -- in short, to anyone. The scabies organism is a mite, a tiny insect. It's so small that you really need a magnifying glass to see it.

It's the female mite that causes all the trouble. She passes from infected person to uninfected through normal, daily person-to-person contact, like shaking hands. Off the human body, the mite lives for only 48 hours, so it's possible but not highly probable to catch a mite from inanimate objects.

Once on the skin, the female mite burrows a tunnel beneath the skin to lay her eggs. The tunnel looks like a white or red thread below the skin. Larvae hatch in two to three days, and in two weeks they are adults capable of producing offspring.

Itching from scabies can be fierce. It comes from the infection and from an allergic reaction to the mite and its waste products. The finger webs (the skin between fingers), the backs of the hands, the wrists, elbows, underarms, buttocks and genitalia are the places where the mite most often makes its home.

Treatment with permethrin is effective. Directions have to be followed carefully. Oral ivermectin also works well. All family members should be treated. Antihistamines and lotions like Calamine control the itch. The itch often lasts for four weeks after the mite has been eradicated. It is not a sign of a need for retreatment.

Laundering bedding and clothes in the hot cycle of the washing machine and dryer gets rid of the scabies mite.

Your health Write to Dr. Paul Donohue at P.O. Box 536475, Orlando, FL 32853-6475.