In the latest years, spanish dermatologists have seen an increase of parasites infectious diseases. One of the commonest is scabies, most known as mange. In this article we will talk about some interesting facts related with the disease and what we should do if we think we suffer of it.

Mange is a parasitary skin disease provoked by a small parasite called sarcoptes scabie. It belong to the mites family and it lives in the skin making little paths on the surface, eating dead skin and laying eggs as it goes by. Contagion happens with a very direct contact with people affected, normally of sexual or familiar kind, although it can also be when we sleep in a bed recently used by a person with mange (something that can happen specially in hostels with a deficient sanitary control or by a friend). Like it is very well-known, the most peculiar clue that we have this bug living in our skin is the intense itch. But calm down, not every itching is because of mange. This itch is very typical, very hard, sometimes it even avoid sleeping because it even get worst at night and after shower. It is usually family (it affects all people living in the same house) and it normally does not concerns head, because the mite does not live here.

Lesions that it makes in our skin could differ from a person to another. Often they are almost invisibles. If we look carefully with a magnifying glass or if we have a very good sight, we will see small lines, sometimes in shape of S, between the fingers or in the wrists, that are the mite favourite places to live. Sometimes we can not find them because they can be erased by scratching. Some people can also notice a slight reddening in other parts of their body, or even small blemishs, specially in genital area or buttocks.

By any means, sometimes diagnosis is difficult, and it can go unnoticed for months by doctors, even by dermatology specialists, who are the ones most accostumed to it.

Treatment is somehow easy, but labourious. Permethrin lotion is preferred, like in case of louses, but we have to extend it very well all over the body, except for the head. We should have a lot of care to keep nails very short and to apply lotion between fingers and under nails because we can have some dead skin with mites in this area. We shoul apply lotion by night and leave it at least for 6 hours before wash it away the next day. If we are doing it right, we have already kill the mites, but sometimes living eggs can remain, so it is necessary to repeat the whole process after 7 days. Be carefull, it is important to make clear that we should not apply the treatment daily, because it is an insecticide and could damage the skin, so itch will be worst. Treatment should be taken for all people who lives in the same house and those persons who mantain intimate relationships, otherwise, we could have infections again.

The most difficult thing is to clean well the entire house, wash all sheets and clothes we have used in the latest weeks with very hot water or, in case of delicate garments, we could keep them for several weeks in airtight bags in order to kill all mites.

And lookout, itch and blemishs could last some weeks more before vanish entirely, even if we made the treatment right. This is so because itch is nothing but a defense of our body, a way to try to erase this small parasites that live in our skin, so it takes a while in disappearing. In fact with people who do not move a lot, or with a little awereness, like babies or old people with dementia, or other neuronal lesions, we can have a very aggressive type of mange, with thousand of miles living in the skin. In these cases contagion is much easier and it could be a real plague, specially in old people’s home.

I hope I enlightened a little this thorny topic. And do not mind, if after reading the article you feel like scratching your body, it does not mean that you have a sarcoptes family living in it.

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