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Leandro Martínez: «The itch of scabies is incorrigible; No matter how much you scratch, it continues to itch.

The director of the dermatology clinical management unit at the Carlos Haya Regional Hospital, Leandro Martínez, details the causes, symptoms and treatments of scabies, an annoying and contagious skin disease that is back in the news due to the outbreak declared in a residence of elderly people from Benalmádena.

What causes scabies?

–It is caused by a mite that lodges in the superficial layers of the skin and moves and reproduces; there are males and females.

What are your symptoms?

–Itching, especially at night. When we sleep and the body is still, the mite begins to act. This activity causes an incorrigible, very annoying itch. By scratching, patients themselves cause injuries and develop grooves and erosions on the skin. It is common for those infected with scabies to arrive at the consultation with wounds and erosions.

Can it go away on its own or is treatment always necessary?

–Scabies should not have complications because there is a fundamental treatment: permethrin. It is a five percent concentration that is applied in adults from the neck to the tips of the feet and left to act for at least seven or eight hours, which is why we recommend that patients put it on at night, after showering, with the clean skin. The next day you have to remove it. This same treatment must be repeated after six or seven days, precisely to intervene in the reproductive cycle of the mite and for the eggs to hatch. With few exceptions, scabies disappear with these two topical solutions.

What are the consequences of scabies when it is not treated correctly for months?

–The itching is so annoying that it is rare that it is not diagnosed before, but sometimes patients arrive who have been suffering from it for a long time. There are usually no complications, although it has been described that prolonged scabies can cause kidney damage, although I am not aware of any such case. Living with scabies for two or three months is complicated, because the itching wakes you up at night not once or twice, but quite a few times. As we have said, it is an incorrigible itch: even if you scratch, it continues to itch.

I suppose that continuous scratching can cause wounds and injuries, with the risk of infection.

–Scratching injuries generate a loss of the skin surface, which protects us from the outside world. These wounds can become infected and complicated, of course. The skin becomes dehydrated as well. There are not many more consequences, but it is not little; When treated, patients feel tremendous relief.

Are we facing one of the most contagious diseases?

–It is very contagious and people who live nearby are easily contagious. The mite can live for a few hours in sheets, clothing or furniture, but the most common infection is caused by skin contact.

Is the lack of hygiene related to the appearance of the mite?

–When transmitted between people, someone with very adequate hygiene can become infected if they come into contact with someone infected. We must banish the idea that it only appears in places with poverty, although it is usually found in places where there is confinement, from small houses where many people live to residences or prisons.

And can it promote transmission?

–I can have correct hygiene, but if I come into contact with someone with scabies, they will transmit it to me no matter how clean they are. The only possible treatment, I insist, is with permethrin. Lately, studies have appeared that suggest that a type of oil can serve as prevention, but for the moment it only disappears with a miticide.

Is intense contact necessary to transmit the mite?

–It is very difficult for there to be contagion with a handshake, although any small wound or erosion can facilitate the penetration of the mite. If the skin barrier is altered due to dehydration or any other problem, the transmission of the disease will also be easier.