Overview
Scabies is a highly contagious skin infestation caused by the Sarcoptes scabiei mite. It leads to intense itching, rashes, and skin irritation. In Korea, while scabies is less common in the general population due to improved hygiene and living standards, outbreaks still occur, particularly in group settings like elderly care homes, dormitories, and hospitals. Early diagnosis and treatment are key to preventing spread.
What is Scabies?
Scabies is caused by tiny parasitic mites that burrow into the upper layer of the skin to live and lay eggs. The body reacts to the presence of the mites, their eggs, and waste, triggering an allergic response characterized by severe itching and rash.
Scabies spreads through prolonged skin-to-skin contact, often among family members, sexual partners, or in crowded living conditions. It is not a reflection of poor hygiene but rather a result of close personal contact.
Symptoms
- Intense itching, especially at night
- Small red bumps or blisters
- Thin, irregular burrow tracks (lines) on the skin
- Sores caused by scratching
- Thick crusts in severe cases (crusted or Norwegian scabies)
Common sites:
- Between fingers
- Wrists and elbows
- Waist and buttocks
- Genital area
- Under breasts
- Ankles and feet (in infants)
Causes
Scabies is caused by direct infestation with the Sarcoptes scabiei mite. Female mites burrow into the skin to lay eggs, and the larvae spread across the body. Transmission occurs through:
- Prolonged skin contact with an infested person
- Sharing clothes, bedding, or towels
- Close living conditions (e.g., dormitories, hospitals, care facilities)
Risk Factors
- Close physical contact with an infested individual
- Crowded living conditions
- Nursing home or hospital residency
- Immunocompromised individuals
- Infants and the elderly
- Sexual activity with an infected partner
Complications
- Secondary bacterial infections (e.g., impetigo) due to scratching
- Crusted scabies (a severe form with thousands of mites)
- Post-scabies dermatitis or prolonged itching
- Social stigma or sleep disturbances
Prevention
- Avoid prolonged contact with infested individuals
- Wash clothes, bedding, and towels in hot water
- Vacuum furniture and carpets during outbreaks
- Isolate personal items of infected individuals
- Treat all close contacts simultaneously, even if asymptomatic
- Monitor care facilities regularly for symptoms
Treatment Options in Korea
South Korea provides highly effective dermatological care for scabies, with fast diagnostic tools and access to modern medications. Clinics, dermatology centers, and major hospitals are well-equipped for treatment and prevention management.
1. Medical Treatment
- Topical scabicides like permethrin 5% cream (first-line treatment)
- Oral ivermectin for crusted or resistant scabies
- Sulfur ointment or crotamiton cream (alternative agents)
- Application of creams over the entire body (excluding face, unless directed)
- Repeat treatment after 7–10 days to kill newly hatched mites
2. Treatment of Household and Contacts
- Simultaneous treatment of family members and close contacts
- Thorough washing of clothes and linens in hot water and drying at high heat
- Items that can’t be washed may be sealed in plastic bags for at least 72 hours
3. Follow-Up Care
- Itching may persist for weeks even after mites are killed (post-scabies itch)
- Antihistamines or topical steroids to relieve itching
- Skin moisturizers for healing irritated areas
- Follow-up appointment to ensure treatment success and prevent reinfestation
4. Infection Control in Facilities
- In hospitals and care homes, Korea’s infection control protocols include isolation of affected patients, routine surveillance, and staff education to prevent outbreaks
