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When microscopic mites known as Sarcoptes scabiei burrow into human skin and lay eggs, they produce itchy bumps or blisters known as scabies. Scabies is treatable with a variety of topical medications that work to kill the mites; however, the condition spreads very easily, increasing the likelihood of complications among some people 1.
Itching and Scratching
Scabies begins as tiny bumps on the skin; however, persistent scratching of these itchy bumps can cause them to turn into bigger sores covering a larger surface area of the skin. According to the Cleveland Clinic, the intense itchiness can be especially bothersome at night 3. Those with scabies are often unable to sleep and spend their nights scratching the itchy sores. The sensation of itchiness often spreads across the entire body. Consequently, infected individuals may develop fatigue and moodiness due to lack of sleep. Sleep deprivation may also lead to problems concentrating on work or school during the daytime.
- Scabies begins as tiny bumps on the skin; however, persistent scratching of these itchy bumps can cause them to turn into bigger sores covering a larger surface area of the skin.
Norwegian (Crusted) Scabies
Signs That Scabies Is Going Away
Very severe cases of scabies called Norwegian, or crusted, scabies can occur in people whose immune systems are compromised, such as those with human immunodeficiency virus (HIV) or leukemia, as well as in people with physical or mental disabilities--for example, Down syndrome, dementia, spinal cord injury or paralysis. According to the Centers for Disease control, because of their depressed nervous systems, immune functioning and/or mental status, these people may not experience the usual itchiness associated with scabies 2. They will, however, develop crusty, scaly sores covering the skin. They may have millions of mites on their skin, leading to highly contagious, widespread infection over large areas of the body. Treatment of crusted scabies can be much more difficult as topical creams typically used to treat scabies may not successful penetrate the thickened, crusty skin.
- Very severe cases of scabies called Norwegian, or crusted, scabies can occur in people whose immune systems are compromised, such as those with human immunodeficiency virus (HIV) or leukemia, as well as in people with physical or mental disabilities--for example, Down syndrome, dementia, spinal cord injury or paralysis.
- According to the Centers for Disease control, because of their depressed nervous systems, immune functioning and/or mental status, these people may not experience the usual itchiness associated with scabies 2.
According to the Mayo Clinic, persistent scratching of scabies bites can create open sores on the skin that are vulnerable to penetration by bacteria 13. Secondary bacterial infections caused by these breaks in the skin are a known complication of scabies. One type of infection commonly caused by staphylococcus aureus or group A streptococcus bacteria is impetigo--a skin condition characterized by red, blistering and oozing sores that eventually crust over and turn yellowish-brown in color. While often these sores are painless and filled with fluid, they can become pus-filled, ulcerated and very painful. The Centers for Disease Control adds that, while impetigo is usually a superficial infection, it can spread, leading to an inflammation of the kidneys known as glomerulonephritis 2.
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- Mayo Clinic: Scabies Complications
- Centers for Disease Control: Scabies
- Cleveland Clinic: Scabies
- Micali G, Lacarrubba F, Verzì AE, Chosidow O, Schwartz RA. Scabies: Advances in Noninvasive Diagnosis. PLoS Negl Trop Dis. 2016;10(6):e0004691. doi:10.1371/journal.pntd.0004691
- Chandler DJ, Fuller LC. A Review of Scabies: An Infestation More than Skin Deep. Dermatology (Basel). 2019;235(2):79-90. doi:10.1159/000495290
- Su WJ, Fang S, Chen AJ, Shan K. A case of crusted scabies combined with bullous scabies. Exp Ther Med. 2015;10(4):1533-1535. doi:10.3892/etm.2015.2668
- Crusted scabies. Genetic and Rare Diseases Information Center. Published June 17, 2019.
- Mccarthy JS, Kemp DJ, Walton SF, Currie BJ. Scabies: more than just an irritation. Postgrad Med J. 2004;80(945):382-7. doi:10.1136/pgmj.2003.014563
- Centers for Disease Control and Prevention (CDC). "Scabies—Resource for Health Professionals." Atlanta, Georgia; updated March 21, 2017.
- Stiff KM, Cohen PR. Scabies Surrepticius: Scabies Masquerading as Pityriasis Rosea. Cureus. 2017 Dec 19;9(12):e1961. doi: 10.7759/cureus.1961.
Based in New York City, Tricia Mangan began her writing career in 2001. She has co-authored a National Cancer Institute report and a number of research articles that have appeared in medical journals. Tricia holds a Master of Arts in clinical psychology from Stony Brook University and boasts diverse clinical, research and teaching experience.