Scabies and bed bugs

Family Health Diary

Just visible to the naked eyes, the pregnant female itch mite Sarcoptes Scabiei burrows a tunnel into the skin of her human host before laying her eggs in a line along the dug out burrow… and then, herself, dying. Within six days her larvae have hatched and made their way to congregate around the hair follicles, becoming fully grown within 14 days of hatching, and beginning the cycle all over again. Within two weeks of the arrival of the very first scaby, the disease may be fully developed.

Scabies is highly contagious and often makes its way through a whole family in a short period of time. The parasite is transmitted by direct body-to-body contact with an infected person. Anything from holding hands, to a cuddle or sex can allow transmission. Transmission through clothing, sheets or towels is also possible but not common.

Scabies causes severe and intense itching (usually of the legs and trunk) which is often at its worse during the night when you are trying to sleep. A diagnosis often involves finding the initial burrows, which appear as tiny wavy dark lines anywhere from 3-10 millimetres in length, with a tiny papule at the open end. However the burrows may be difficult to see once they are masked by the generalised redness and swelling caused by constant scratching. The burrows are most likely to be seen in the webs between fingers, on the wrist, armpits, buttocks, penis, insteps and the back of the heels. Scabies can be misdiagnosed as dermatitis or eczema as it may present as a generalised rash with red, very itchy bumps on the limbs and trunk. Itchy bumps or nodules in the armpits, groin or along the shaft of the penis are suggestive of scabies. Itching can continue for 2–3 weeks even after a successful treatment. Scratching readily leads to complications such as dermatititis, urticaria, eczema or secondary bacterial infections, so resist the temptation at all costs, and keep fingernails short and clean.


Permethrin 5% insecticidal lotion is the standard treatment which can successfully treat scabies. The lotion is left on for 8-12 hours. Apply lotion to a clean body, from the chin downwards, and leave overnight for at least 8 hours, before thoroughly washing off in the morning. Hot wash all clothes, bedding, and towels used by the infected person in the two days prior to treatment. Dry in a hot drier. In some people a second treatment may be required 7-10 days after the first.

Don’t let the bed bugs bite

Cimicidae or “bed bugs” as we commonly know them, are small wingless insects that sustain themselves by feeding on the blood of warm-blooded animals… including humans! At only a quarter of an inch long when fully grown, and with no wings with which to fly, bed bugs still manage to make a real nuisance of themselves if they make it into your home. These are the archetypal super bug, with the ability to live for 500 days without food!

Globally bed bugs are enjoying a resurgence, especially in halls of residence, hotels and apartment blocks. They love to live in any little dark crevices they can find, such as the folds of curtains; where your sheets and blankets tuck into the mattress, or even behind pictures on the wall. At night while you’re sleeping they come out of their hiding places and enjoy painlessly drinking your blood, by puncturing your skin and feeding for 3-15 minutes until they are bloated. While the actual blood-sucking activity is painless, the allergic response and inflammation which often follows can be extremely unpleasant, with intense itching and swelling of the skin. Antihistamines and corticosteroid ointment may be needed to ease itching and swelling. Bed bug bites often resemble mosquito bites and, as a result, the presence of bed bugs is often overlooked. While they can carry disease, there is no evidence that bed bugs actually transmit diseases to humans.

Once you have a bed bug infestation, getting rid of them can be challenging and requires a multifaceted approach including cleaning the affected rooms, eliminating “junk” and spaces for the bed bugs to hide, and insecticidal treatments. Prevent an infestation in the first place by keeping your room clean and tidy with a minimum of clutter and junk; vacuum clean regularly; wash clothes and bedding regularly and monitor for eggs and castaway skins.

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