Scabies is a skin infestation caused by microscopic mites (Sarcoptes scabiei) that burrow into the top layer of human skin. These mites live, feed, and lay eggs within the skin, causing an allergic reaction. This common condition affects anyone, regardless of hygiene, and can appear on almost any body part, including sensitive areas like the genitals.
Manifestations on Genital Areas
On genital areas, scabies presents with distinct symptoms, most notably intense itching, often worse at night. This itching results from the body’s allergic reaction to mites, eggs, and waste. The skin may develop a rash characterized by small, red bumps, pimple-like lesions, or tiny blisters.
Burrows are a specific sign of scabies: thin, irregular lines created by female mites just beneath the skin’s surface. These burrows can be grayish-white or skin-colored and may be difficult to spot, as an infested person may only harbor 10-15 mites. In the genital region, scabies can also cause small, reddish-brown, itchy lumps or nodules. For a first-time infestation, symptoms might not appear for four to six weeks after exposure.
Transmission and Diagnosis
Scabies primarily spreads through direct, prolonged skin-to-skin contact. Sexual contact is a common method for genital spread due to close and extended skin contact. Non-sexual close contact, like sharing a bed or living in the same household, can also facilitate transmission. Brief contact, like a handshake or contact with inanimate objects such as toilet seats, is generally unlikely to transmit scabies.
Healthcare providers diagnose scabies by visually examining the skin for characteristic rash and burrows. To confirm, a doctor may take a skin scraping from an affected area, especially a burrow. This sample is then examined under a microscope to identify mites, eggs, or fecal matter, confirming the infestation.
Treatment and Prevention
Scabies is treatable with prescription medications called scabicides, which eradicate the mites. Common topical treatments include permethrin cream; oral ivermectin may be prescribed for severe cases or when topical treatments are not suitable.
Treatment typically involves applying cream to all body areas from the neck down, including hands, feet, and the genital region. A second application is often required about one week later to kill newly hatched mites.
To prevent re-infestation and spread, all close contacts of an infested individual must be treated simultaneously, even if asymptomatic. Prevention measures include washing all clothing, bedding, and towels used by infested individuals in hot water (at least 122°F or 50°C) and drying them on a hot cycle. Unwashable items can be sealed in a plastic bag for at least 72 hours, or up to a week, to starve the mites. Vacuuming carpets and upholstered furniture can also help reduce the mite population.