Scabies, just like head lice, is not a disease or an infection, it is an infestation. We talk about scabies infestation just like we talk about lice infestation. What is scabies? They are tiny mites that are located in the outer layers of our skin. The skin reacts to this infestation, and as the mites burrow and lay eggs inside the skin, this leads to very severe itching and rash symptoms.

Here are a few pictures of scabies:

Scabies rash on the abdomen

Pimple like rash between fingers

Scabies infestation on a hand before treatment

Credit: Center for Disease Control and Prevention

Other good scabies pictures can be found here:

• Scabies slideshow from WebMD: http://www.webmd.com/skin-problems-and-treatments/ss/slideshow-scabies-overview

• Scabies slideshow from EmedicineHealth: http://www.emedicinehealth.com/scabies/article_em.htm

Professional head lice removal services are a growing industry mainly because head lice are showing increasing resistance to traditional OTC head lice treatments. In some areas resistant head lice are common and parents may have to treat their children for head numerous times before the lice are gone. Their children may also get lice again and again from their school- or sports mates. A head lice removal service can be handy when parents don’t have time to sit for several hours combing out lice.

Types of Head Lice Removal Services

Head lice removal services are often found in higher socio-economic neighborhoods and can be divided into two types:

• Head lice removal salons – these businesses operate like hair salons, with the difference that they don’t cut hair, but specialize exclusively in removing lice and nits.

• Head lice removal home services – these businesses are less common and they do home visits to help people get rid of head lice in the comfort of their own homes. Sometimes a head lice removal salon will also do home visits.

Who Uses Head Lice Removal Services?

For certain people it has more advantages to consider using a professional head lice removal service. Consider using a professional service if you:

• Have tried different OTC products several times without success.

• Are allergic to any of the ingredients in OTC head lice products. Most salons use treatments free of chemicals and pesticides.

• Feel overwhelmed with the idea of treating the head lice infestation by yourself.

• Are pregnant, breastfeeding or if you have asthma or other diseases. People with asthma or other diseases often show a reaction to the ingredients in OTC head lice shampoos and lotions.

What Can a Head Lice Removal Service Do?

The specific treatment regime differs from lice removal service to lice removal service but generally a head lice removal salon will include one or more of the following procedures:

• Treatment with a specific head lice product. This differs from salon to salon and the exact ingredients are kept secret to keep a competitive edge.

• Specialized combing sessions by trained nit pickers.

• A treatment with a device called the LouseBusterTM. This device makes use of hot air to kill lice and nits. There is a small risk of burning the scalp and the device must be used by a trained operator. It is suitable for use from four years of age.

• A rinse with a special herbal shampoo that inhibits the hatching of lice eggs.

Not all salons offer all of the above services and at most salons the procedures are tailor made for the customer based on the following factors: length of hair, age of the customer, level of infestation and persistence of the lice. Some services guarantee to get rid of the lice in only one visit, while others require a follow-up visit within seven to ten days.

Apart from these services, some head lice removal services also sell anti-lice hair- and laundry products.

What Are The Disadvantages of Head Lice Removal Services?

The main disadvantage of making use of professional head lice removal services is the cost. One family reported on spending up to $500 at a head lice removal salon to get rid of a head lice infestation. However, it is also true that families who are getting rid of lice at home regularly spend more than $500 on lice products, without really managing to eliminate lice.

Since head lice removal services are a new industry, they are not regulated by a governing body like hairstylists and cosmetologists are. Therefore, there is a risk that some salons may use unapproved products or methods. It is often best to ask the school nurse or medical practitioner in your area to recommend a head lice removal service instead of visiting one without references.

What Are The Costs of Head Lice Removal Services?

The cost structure of head lice removal salons differ widely. A common price for salons to ask is $45 per half hour or $90 per hour. The amount of visits, length of hair, and length of time per visit and severity of the infestation will determine the total amount necessary to get rid of head lice. Health insurance may cover a part of the treatment costs.

A good head lice removal service will help parents get rid of head lice efficiently. Making use of such a service can lessen the anxiety and shame associated with head lice infestation.

Head lice infestation is not a dangerous condition but it causes high anxiety among parents, children and in schools. School aged children are at greatest risk to contract head lice. Managing head lice in schools is very important because it is in the school setting that head lice is most likely to be transferred.

To effectively manage head lice in schools, it is important that the school and parents work together as a team where each take responsibility for certain tasks.

The School’s Responsibilities In Managing Head Lice

Head lice are not an environmental problem but a personal health problem. This is because head lice need a human host to live on and therefore individual children get the infestation and not the school classroom. Head lice school policies differ widely from school to school and state to state. In general, it is the school’s responsibility to have the following head lice management strategies in place to prevent infested children from transferring head lice to other children.

• Each school should have a head lice school policy in place that describes procedures that will be followed to identify head lice, notify parents, minimize transfer of head lice and how and when to do follow-up after treatment.

• To train teachers and other school personnel in identifying and managing head lice.

• To maintain confidentiality when head lice is identified and to notify parents in a sensitive manner.

• To provide practical advice for parents of infested families and maintain a sympathetic attitude.

• To make the head lice school policy known to all parents.

• To make an informed decision whether children with live lice and nits should be allowed to attend school. The American Academy of Pediatrics recommends that no child should be forced to stay home because of live lice or nits, but in reality many school policies require that children with at least a few live lice are not send to school.

• If a school adopts a no-lice or no-nit policy, clear guidelines should be available as to when the child will be allowed to attend school again; for example, after one treatment or when the school nurse is satisfied that there are no nits or lice left.

• Extra help should be given to children with chronic or prolonged infestation, to minimize the number of days they are absent from school.

The Parent’s Responsibility In Managing Head Lice

It is ultimately the parents’ own responsibility to take control of head lice in their children. To make it easier to manage head lice in schools, parents may carry out the following procedures:

• Check their children’s hair for head lice on a weekly basis.

• Treat an infested child as soon as possible after lice have been identified.

• Inspect household members regularly.

• Notify the school and the parents of close friends if they have identified head lice in their children, to make sure that if the lice were transmitted, treatment can start as soon as possible.

• Notify the school of the treatment procedures you have followed so that your child can attend school if the school has a no-lice or no-nit policy in place.

•  Make sure that children with long hair attend school with hair tied back.

• Be willing to attend head lice information sessions or meetings organized by the school.

Tips For Preventing The Spread of Head Lice In Schools

Head lice are transmitted through close person-to-person contact. Head lice cannot fly, but only crawl and can also be transmitted through sharing personal belongings like brushes, combs, helmets and hats. The following measures can be put in place to avoid getting head lice in the classroom:

• Desks should be spaced apart so children are not sitting shoulder to shoulder.

• Children with long hair should be encouraged to tie it back.

• Have separate pegs for coats and hats. Children shouldn’t hang coats and hats on top of those of other children or pile them on top of each other.

• Ensure ample space between children in lines or when working together as groups.

• Minimize shared use of headgear such as earphones, helmets and clothing (such as concert costumes). Hand-vacuum these items between users.

• Make sure that the health curriculum of all pupils contains information about head lice and how it is identified, transferred and treated.

Managing head lice in schools is the responsibility of both the school and the parents. If both parties cooperate the spread of head lice in schools can be minimized.

According to the American Academy of Pediatrics the ideal head lice treatment product should be free of harmful chemicals, inexpensive, available without a prescription and easy to use. Many of the different head lice treatment products available fulfill these criteria. Head lice treatments containing pyrethrin or those with permethrin are most commonly used and usually sold as a shampoo, cream rinse, mouse or a lotion.

In some areas the head lice populations show resistance to certain types of treatments. If uncertain about what type of head lice treatment product you should buy, consult the school nurse or medical doctor.

Beware Of Common Head Lice Treatment Mistakes

Although OTC head lice treatments are considered safe to use, it is important to follow the instructions on the label or information leaflet closely. Here are some important things to avoid when applying head lice products:

• Never cover hair undergoing the treatment with a towel or bag.
• It’s not safe to use OTC head lice treatments in infants under two months of age or during pregnancy or breastfeeding.
• It’s not safe to use lice treatments more often than recommended on the package. In general, it is considered to be safe to reapply it after nine days.
• Don’t use OTC lice products on other parts of the body or face and never on skin with open sores or scratches.
• Never combine two different head lice treatment products during the same application.

Step-by-step Guide to Appling an OTC Head Lice Treatment

• Choose a OTC head lice treatment product
• Then you need to determine how much of the head lice treatment product you will need. In general, if your child’s hair is longer than shoulder-length or you are treating more than one child, you may need more than one bottle to finish the first treatment.
• Always consult the instruction leaflet in the package before starting the treatment.
• Make sure that the ingredients include either permethrin or pyrethrin and piperonyl butoxide.
• Permethrin creams should be applied to wet hair. Wet hair also inhibits the mobility of the lice and helps to saturate them with the cream.
• Products containing pyrethrin and piperonyl butoxide should be applied to dry hair.
• If you are using a permethrin based product, wash the hair, but don’t use conditioner. Conditioner lessens the effectiveness of the lice treatment.


• Towel dry the hair. It should be damp, but not dripping wet.
• Wear old clothes or drape an old towel around your child’s shoulders.
• Keep an old washcloth handy to hold over your child’s face so the cream can’t get in his eyes.
• Although not absolutely necessary, you can wear rubber gloves to protect your hands, especially if you have cuts or bruises on your hands.
• Squirt the cream or shampoo onto your hands and massage it into the scalp, from the roots to the ends. The scalp and hair should be completely covered.
• Make sure that you apply enough cream to the hairline on the back of the neck and the area around the ears. Lice are fond of attaching themselves in these areas.
• It is common to see head lice falling off the head while the treatment is going on.
• Set the alarm for ten minutes after you have applied the product to the whole head.
• After ten minutes, you can rinse or wash the hair depending on which product you are using.
• Once you are done, change your clothes as well as your child’s and wash all clothes, towels and washcloths on the hot cycle in the washing machine.
• Nit combs are often sold as part of OTC head lice products. Some experts feel that comb-outs after a head lice treatment is unnecessary, while others argue that it will help get rid of the remaining nits. Most parents will probably choose to go ahead and do a thorough comb-out right after the application.

What If the Lice Treatment Doesn’t Work?

Lice treatments usually don’t kill all the lice at once. It is a good idea to do a thorough comb through with a nit comb twelve hours after applying the product. Lice treatments usually kill 70-80% of the nits and this combing session will help remove it. If you notice a few slow moving lice during this time, they are probably dying and it is not an indication that the treatment hasn’t work.

OTC head lice products are considered a safe and effective way to deal with head lice infestation and it is important to follow the instructions of different products carefully.

Head lice have been a nuisance to people for centuries. Fortunately, with the right head lice home treatment techniques, it is possible to get rid of it. Head lice are parasitic insects the size of a sesame seed. They live on the scalp of humans and feed on tiny bits of blood. Their activities may cause itching and irritation on the scalp. Head lice are most common in children between the ages of three and twelve.

There is a small risk that lice can be transmitted through the belongings of an infected child. It is therefore important to follow the right procedure for a more effective lice home treatment. Before you start treating your home from top to bottom, it is important to remember  the following facts about the life cycle of head lice:

• Their eggs are attached to hair, no further than 1cm away from the scalp, because they need body heat to incubate;
• When removed from the scalp, their eggs cannot hatch at room temperature.
• Adults cannot survive without a source of blood for more than 48 hours.
• They can’t jump or fly and are usually transmitted through crawling during direct head to head contact.

The following techniques can be helpful to get rid of head lice in your home:

• Identify People At Risk To Be Infested With Head Lice

Head lice can be transmitted through close personal contact. If a child in the household has head lice, it is important to examine the hair of those in close personal contact with the infested child carefully for lice. Any sign of live lice or nits within 1 cm of the scalp should be treated. Children who share a bed or combs, brushes or towels should be examined closely.

• Wash Items Infested With Head Lice

Head lice can’t survive off the scalp for more than 48 hours. If a head lice infestation is discovered and treated, it is important to wash all items that have been in contact with the child for the last 48 hours. Pillows, sheets, pajamas, towels, clothes all need to be washed and changed daily until the head lice are gone. Wash contaminated items in the hot washing cycle and dry in a dryer with the heat setting turned on.

Make sure to wash personal hair care items such as combs, brushes and hair bands in hot water everyday to eliminate head lice.

• Vacuum High Risk Spots

Although a much larger than usual house cleaning effort is most likely not necessary for getting rid of head lice, it may be wise to thoroughly vacuum certain key areas. Furniture that might have been in contact with the head of the infested child, like a couch where they spend prolonged time and a car seat should be vacuumed. Be sure to focus on the area where the child rests his head. Vacuuming can be done daily until the head lice have disappeared.

• Seal Non-Washable Items

Any item that cannot be washed such as stuffed toys and hair accessories should be bagged and sealed for two weeks. During a two week period any nits on the items would have hatched and the nymphs would die without a source for feeding.

• Fumigant Sprays For Head Lice

The use of fumigant sprays designed to kill head lice is not recommended. These sprays are often sold with head lice shampoo for head lice home treatment. The chemicals in fumigant sprays do more damage than good, because it is toxic when inhaled or absorbed through the skin.

Can Head Lice Be Transmitted In A Swimming Pool?
Head lice are able to survive in chlorinated water for a period of time, but it is unlikely that an infestation would spread in this way. Scientific studies showed that head lice become immobile when submerged in water and therefore stay in place on the head of the affected child.

It is possible to apply a successful lice home treatment program without extraordinary measures. If you apply the procedures above, it is unlikely that any live head lice will remain in your home.

Home remedies for scabies have not proven to be very effective in the past. Various lotions, oils, herbs and vitamins have been suggested, but lack scientific proof as effective natural scabies treatments. In fact, some of the recommended scabies home remedies may make scabies symptoms worse. The only scabies home remedy available without a prescription that has scientific research supporting its effectiveness is Australian Tea Tree Oil.

Is Tea Tree Oil an Effective Natural Scabies Treatment?

Tea tree oil is the essential oil of the Australian tea tree. It is used in traditional Aboriginal medicine specifically for bruises, skin infections and insect bites. Scientific studies have shown that tea tree oil is able to heal bacterial, viral and yeast-type skin infections. Up to recently, there have been no studies determining the effectiveness of tea tree oil for a parasitic skin infection such as scabies.

In a recent Australian study, a young women with crusted scabies (Norwegian Scabies), was treated with tea tree oil and other prescribed medicines to determine its relative effectiveness. The study found that tea tree oil was effective in shortening mite survival times. With a 5% concentration of tea tree oil, the scabies mites were dead within three hours, whereas the prescribed medicines took up to three times as long. Tea tree oil may prove to be a valuable scabies natural treatment as resistance to prescribed scabies drugs increases.

Scabies Self Care at Home

Once scabies are diagnosed and the appropriate treatment prescribed, the following guidelines can be used to support the medical treatment at home:

• Consider treating all family members who had contact with the infested person, even if there is no sign of scabies because symptoms may take up to four weeks to appear. Discuss this with your medical practitioner.
• While the skin is still itchy – avoid scratching and keep open sores clean, especially in children.
• Use the medicine exactly as the doctor prescribed. Do not use it more often than recommended because it can cause a chemical irritation of the skin.
•  Cut the fingernails of all family members and clean under it properly to remove all mites or eggs that might have remained.

Non-Prescription Medicine for Scabies

All non-prescription medicine for scabies will only treat the symptoms of scabies, but will not kill the mites and their eggs. The following over the counter medicines may be useful in providing relief for the itching associated with scabies:

• Antihistamine creams can be applied directly onto the affected areas.
• Oral antihistamine (such as Benadryl) can provide relief from the allergic reaction to the activities of the scabies mites. It will not interfere with the diagnosis of scabies. It is not recommended to give oral antihistamine to children without consulting with a doctor. Oral antihistamines with a sedative effect may help with sleep problems due to itching.
• Be careful of using corticosteroid creams without a doctor’s prescriptions as these creams may make the scabies sores look different and make it harder for the doctor to diagnose scabies correctly.

How Can I Treat My Home After Scabies Infestation?

While scabies is treated medically, it is important to take specific steps to prevent re-infesting the home and family members.

The following can be done to rid the home from surviving scabies mites:

• Wash all clothing, towels, bed linens that have been used in the last three days.
• Use to hot washing cycle and do not air dry the clothes, towels and linen, but place it in the dryer on the hot setting.
• Extra cleaning efforts such as washing walls, furniture or a daily change of bedding are not necessary except if the person has Norwegian (crusted) scabies.
• Place non-washable objects such as soft toys, pillows and coats in seal plastic bags for at least seven days.
• Vacuum carpets, furniture, bedding, car interior and child car seats thoroughly. Discard the vacuum cleaner bag when finished.

The effects of scabies can be lessened and shortened by applying home treatment techniques and appropriate self care at home. Tea tree oil as a scabies home remedy or prescription drugs to cure scabies are effective ways to stop the disease.

Specialized treatment for scabies is available and can cure the disease. You should know that home remedies have not been scientifically proven to be effective for scabies treatment, and that over-the-counter medicines for head lice are not strong enough to kill scabies mites. Using over-the-counter medicines or home remedies for scabies treatment can make it more difficult for the doctor to diagnose scabies correctly.

Products used to kill scabies mites are called scabicides, and some may also kill mite eggs. For the treatment of scabies, the doctor may prescribe both skin cream treatments and oral medication.

Skin Cream Treatment for Scabies

It is important to follow the doctor’s prescriptions and instructions precisely for scabies treatment. The following skin creams are used to treat scabies and its symptoms:

• The medicine that is used most frequently to kill scabies mites is called 5% permethrin cream (like Elemite and Acticin). The 5% cream is much stronger than the over-the-counter permethrin which is used for head lice and that will not cure scabies. The 5% permethrin lotion is applied on clean, dry skin over the whole body from the neck down and is left on for at least 10 to 14 hours (usually overnight) and then rinsed off. Permethrin is considered safe for children from two months of age. In infants, the cream should be applied to the forehead, scalp and temples too. Only one application of the cream is often enough, but another application can be necessary if the symptoms continue after 2 to 4 weeks.

• If for any reason permethrin cream does not kill the scabies mites, other, generally less effective creams with more side effects are available for use. These include: Lindane 1%, Malathion lotion, Crotamiton lotion and sulfur-based lotions.

• Antihistamine creams or a cortisone cream may be prescribed to control itching, but will not cure scabies. It will only relieve the symptoms. It is important to follow the doctor’s prescription exactly, as some cortisone creams may make the itching worse.

Oral Medication Treatment for Scabies

There are a few oral medication treatment options available for the treatment of scabies and its symptoms:

• Ivermectin pills have been used to treat scabies, but it is not FDA approved for this use. Ivermectin for scabies is not considered safe to use in pregnant women and children younger than five. Ivermectin is mostly used in cases where the scabies infestation is severe (like Norwegian scabies or in crowded living conditions) or where permethrin creams were unsuccessful in killing scabies mites.

• Oral antihistamines or cortisone may also be prescribed to lessen the itching associated with scabies. Antihistamines with a sedative side effect can be useful at night to help with sleeping when itching is severe.

• Oral antibiotics may be prescribed if secondary infection of the scabies rash is present due to scratching.

It is important to remember that although the itching may lessen in one to two days, it can be present for up to two weeks after the mites have been killed. If the symptoms have not cleared up after two weeks, another round of treatment may be necessary. It is generally not necessary to treat other family members until they show signs of scabies themselves, but in special cases a doctor may prescribe treatment for all those who have come into contact with the infected person.

How Can I Prevent Scabies?

It is hard to keep scabies from spreading. Try to avoid prolonged physical contact such as hugging and holding hands with someone who is being treated for scabies. Scabies mites can live for 2 to 3 days without a host and it is possible that they can live in the clothes or bedding of an infected person while the treatment is going on.

To prevent re-infestation it is recommended that all clothes and bedding be washed in hot water and dried in a dryer with the setting on hot to kill any mites. Stuffed animals and other items that cannot be washed should be sealed in a plastic bag and left for seven days. It’s not necessary to use pesticide sprays or fogs for scabies mites because they are not effective and can be harmful to the skin or poisonous if inhaled.

Remember that scabies treatment is effective if the prescription and instructions of the medicines are followed closely and if steps are taken to prevent re-infestation.

The two main scabies symptoms are itching and a pimple-like rash on the skin. The itching can be severe and is usually worse at night or after a hot bath. The scabies rash starts as small itchy bumps, blisters or puss-filled bumps that can break when it is scratched.

Short, s-shaped lines may also be visible on the skin where the female mite burrows under the skin, but burrows may be easy to overlook. Occasionally the actual mite can be seen as a tiny black dot at the end of the curvy burrow. Not every bump represents a mite and in most cases there are only 10 to 15 life mites active on the skin.

The most common areas on the body where the symptoms of scabies occur:

• The webs between the fingers;
• The wrists;
• The skin folds at the elbows or knees;
• The armpits;
• The shoulder blades;
• The area around or under the breasts (in women);
• The area around the bellybutton and
• The area around the buttocks.

The head, face and neck are usually not infected, except sometimes in babies or very small children.

It may be difficult to distinguish scratch marks from the burrows of the mites, as scratching usually destroys the burrows. Scratching may cause secondary infection in the scabies skin rash. The signs of secondary infection include redness, swelling, pus and pain in the area where the rash occurs.

What Do Scabies Feel Like?

Itching is the most distinctive characteristic of scabies. The itching starts off as subtle but then gradually becomes more intense until it is so severe that even sleeping may become difficult. The itch can prevent a person from falling asleep and even wake one up in the middle of the night. It is the relentless quality of the itching caused by scabies that distinguishes it from other itchy skin problems such as eczema or hives. The itching associated with these conditions usually comes and goes and does not have the same intense quality of the scabies itch.

How Do I know I Have Scabies?

The diagnosis for scabies is usually based upon the symptoms (intense itching and the presence of a rash) and the history of contact with other people who have signs of scabies. Some other skin diseases may look like scabies, for example allergic drug reactions, contact dermatitis and shingles. It is important to gain a diagnosis from a medical practitioner if:

• Anyone in the family suddenly develops severe night time itching that does not go away within three to four days;
• There are any signs of a secondary skin infection (fever, pus, red streaks protruding away from the skin rash, pain or tenderness.)
• If the symptoms haven’t disappeared two to four weeks after treatment.

If uncertain about the diagnosis, the doctor may do a skin scraping to confirm that the scabies mites are present. For this procedure, the doctor will place a small amount of oil or saline on the rash and will then scrape the upper layer of skin with a scalpel. Alternatively, if the doctor can see a tiny black dot at the end of a burrow, he may try to lift the mite out with a needle.

The material collected is viewed under a microscope to see if any mites or eggs are present. It may be very hard to find a mite or eggs, so even if the result of this test is negative and the doctor still strongly suspects scabies infestation he will prescribe treatment for it.

Scabies cannot be treated with over the counter medicine. It is important to go to a doctor as soon as scabies is suspected because the longer the infestation continues the more likely it is that it will be spread to other people.

Is Scabies The Same in Children And in Adults?

Children are more likely to get a scabies rash on their heads, faces and feet. Scratching marks are frequently also more pronounced in children than in adults. In small infants, the diagnosis of scabies may be delayed because they cannot say what the itching feels like. The rash in infants and children can also appear to be more reddened with larger blisters.

Even though the scabies symptoms may differ slightly, the treatment for scabies in adults and children is the same.

You’re probably familiar with head lice and body lice, but you may not have heard a lot about scabies, scabies mites, crusted scabies or Norwegian scabies. So what is scabies actually? How do you get scabies? Is it contagious? Here is what you should know about this skin condition.

Scabies infestation is one of the reasons a person may experience severe skin itching coupled with a rash. Scabies is a distinct skin condition caused by a parasitic mite (Sarcoptes scabiei var. hominis) and should not be confused with head lice or body lice. Lice are parasitic insects feeding on human blood, while mites feed on the outer layer of skin.

Scabies is a very common skin problem, affecting around 300 million people worldwide. It spreads mainly through skin to skin contact and occurs in all communities, regardless of age, gender, race, social class or personal hygiene habits. Scabies infestation is more common in areas with crowded living conditions such as nursing homes, hospitals, prisons, college dorms and childcare centers.

What Are Scabies Mites?

The mites that cause scabies are eight legged-microscopic parasites related to the spider family. They are grayish white, are less than 0.5 mm long and can seem like a tiny black dot to the naked human eye. A female mite makes tunnels (burrows) into the skin and lays her eggs. These burrows can sometimes be seen on the skin as short s-shaped lines. The female continues to burrow until she dies, in most cases after a month or two.

Within three to ten days the eggs hatch and start maturing. The mature mites travel back to the surface of the skin where they mate and repeat the cycle of tunneling and laying more eggs. Infected people usually have 10 to 15 active mites on their skin.  It is the females’ burrowing movements that cause an allergic reaction and the intense itching associated with scabies, sometimes called ‘the seven year itch’.

How Do You Get Scabies? Is Scabies Contagious?

Scabies is transmitted through close, prolonged skin-to-skin contact. The mites cannot jump or fly but can only crawl and therefore skin-to-skin contact must be long enough to give the mite an opportunity to get from one host to the other.

It is possible for parents and children to infect one another with the mites during the normal course of family life. You should know that scabies is highly contagious. However, scabies cannot be transmitted through a brief hand shake or storing clothes next to someone’s who is infected.

Picture: CDC – Alexander J. da Silva, PhD/Melanie Moser

What is Norwegian Scabies?

Norwegian (crusted) scabies is a severe form of scabies and was first encountered and described in Norway. It occurs in people with weakened immune systems when scabies mites colonize and infect large areas of skin causing large, crusty red patches that eventually has a wart-like appearance. The elderly, people who are mentally or physically disabled and those with AIDS are at risk to develop Norwegian scabies. The lesions can occur on the hands, feet, elbows and scalp but it may spread over the whole body if left untreated. It is interesting that almost no itching is present in people with Norwegian scabies.

Large colonies of mites are present (usually over two million) causing persons with Norwegian scabies to be much more contagious to others. Because of the large number of mites present, the disease spreads not only through skin-to-skin contact, but also through clothing, bedding and furniture. It should be treated swiftly and aggressively to prevent an outbreak of the disease.

Main Symptoms of Scabies

The main symptoms of scabies are intense itching and a rash on the skin. The itching may be severe and is usually worse at night. Sometimes small s-shaped lines are noticeable where female mites made their burrows in the skin. In children, the rash may be more pronounced due to scratching.

Treatment for Scabies

Scabies can be cured, even though it is highly contagious. There are five main treatment options for scabies and its symptoms:

•    Application of skin creams designed to kill mites;

•    Oral anti-parasite medication;

•    Oral antihistamine to lessen itching;

•    Cortisone cream or oral cortisone for severe itching;

•    Getting rid of scabies mites in the living environment of the affected person.

There are no over the counter medicine available to treat scabies. It is best to consult a medical practitioner if you suspect scabies infestation.

Head Lice or Dandruff?

When you receive a school notice about head lice, or when you want to check your child for lice, you don’t always know what lice eggs look like. How do lice eggs vs dandruff look? How can you tell the difference? When you look at your child’s head, you see some white flecks the size of a sesame seed: are they nits, or are they just dandruff or hair debris?

The main difference between head lice eggs and dandruff is that lice eggs are glued to the hair shaft; they are firmly attached to the hair, and are not easily removed. On the contrary, dandruff is not attached to the hair and can be easily brushed off.

• Dandruff is a common form of skin eczema, also called Seborrheic dermatitis. It is thought to be caused by an overproduction of oil by the skin, and it is called dandruff when it affects the scalp. Dandruff looks like thick, falky, white to yellowish localized patches of scale, and can occur together with red, irritated skin.

• Lice eggs are like white to yellowish dots on your hair, the size of a sesame seed. They are 0.8 millimeter long and 0.3 millimeter wide. What happens is that lice eggs have a grey or caramel color when they are laid by the female louse, and they turn yellowish to white when they are empty. So, the color is not always the same, and that’s why it should not be your only criteria when looking for head lice eggs.

Nits can indeed be very difficult to see. After they hatch, the shell of the egg can remain in the hair for several months, because as said above, it is firmly attached to it. In this case, it will be whitish. Of course, empty nits can be easily confused with dandruff when you only look at the color. But try to brush them off, and if it sticks, it means you are dealing with lice eggs.

Dandruff is usually located all over the scalp, while lice eggs are usually primarily located behind the ears and in the neck area, as this is where female lice prefer to lay their eggs. But if your child is severely infested, you’ll also find nits all over the head.

Another important point is that live lice eggs will be located within one centimeter from the scalp, even less (usually half a centimeter). If you find nits further away from the scalp, they will either be dead or anyway not viable, so you don’t have to worry about them hatching.

Remember that the only solid criteria to tell if you have lice eggs or dandruff is to brush the hair with your hand: lice eggs will stick, dandruff will be brushed off.