How To Treat Scabies During Pregnancy?

Scabies is an itchy skin condition caused by a skin-burrowing mite, Sarcoptes scabiei. The mite is an eight-legged creature smaller than a pinhead. Scabies in pregnancy accounts for 2% to 6% of skin conditions during pregnancy. However, the infection is not known to cause adverse pregnancy and fetal outcomes. (1) (2).

The scabies infection can occur in all age groups and predominantly in children. People with ordinary scabies have around 12 mites, and those with crusted scabies have 1000s of mites (3) (4) (5). This post discusses the causes, symptoms, diagnosis, and treatment management for scabies when pregnant.

How Do Scabies Mites Grow On The Skin Of An Infected Person?

Scabies spreads through prolonged skin-to-skin contact and sexual intercourse. It may also spread through towels or bedding because the mites survive for 24 to 36 hours outside the host (6).

When a person is infected with scabies mites, an impregnated female mite burrows deep in the person’s outer skin layer (stratum corneum) and lays eggs. These eggs take three to five days to hatch. They grow into adult mites in around one to three weeks. The new female mites again mate with the males and lay eggs, thus continuing the life cycle.

An infected person starts showing the signs of the infection (persistent itching) two to six weeks after the infestation. The itching worsens at night because the female mites become more active (7).

What Are The Symptoms And Complications Of Scabies In Pregnancy?

The common symptoms of scabies are (6) (8) (9):

• Intense itching that gets worse at night and with a hot shower
• Burrows on the skin (especially between the fingers and folds of armpits and groin)
• Thread-like red bumpy rash on the skin (body’s allergic reaction to the mites)
• Clear, fluid-filled lesions
• Inflammatory scabies nodules may develop around the breast in females with nodular scabies
• Thick crust develops all over the body in case of crusted scabies (uncommon scabies) (10)

Sometimes, scabies leads to other complications as follows (9) (11):

• Scratching the scabies rash may lead to infections, such as impetigo (skin sores).
• Scabies worsens previous skin diseases, such as eczema or psoriasis.
• If not treated on time, crusted scabies may lead to death due to secondary sepsis.
• Scabies-related infection may also increase the risk of having kidney diseases and rheumatic heart disease.

How Is Scabies Diagnosed During Pregnancy?

A healthcare provider may diagnose scabies by (2) (6):

• Examining the rash and other symptoms.
• Identifying the burrows on the skin.
• Removing skin scraping and looking for mites and eggs under a microscope.

How Is Scabies Treated During Pregnancy?

It is important to treat scabies on time to prevent secondary infections. Remember the following points before going for the treatment (12):

• Since scabies is contagious, ensure everyone in the family who is infected is treated.
• Topical agents would work for some pregnant women. Since the mites could spread all over the body, applying the medicines to every body part, regardless of itching helps.
• Apply topical medicines before bedtime to leave them on the body for around 12 hours before washing off.
• Do not take a bath before the treatment.
• Wash towels and bedding to get rid of the mites and eggs.

Most commonly recommended medications that you should use only after consulting a doctor include (2) (7):

1. Benzyl benzoate 25% lotion may be applied for three consecutive days and washed off.
2. Crotamiton 10% may be applied for three to five consecutive days and washed off.
3. Malathion 0.5% lotion may be applied for 24 hours before washing it off.
4. Permethrin 5% cream treats scabies by killing the mites and eggs. However, there are no studies to confirm its safety during pregnancy. Evidence shows that it does not risk the growing baby because of its poor absorption after topical application. The cream is applied for 12 hours and then washed off. You may repeat the treatment after a week.
5. Mild to moderate corticosteroids such as Hydrocortisone acetate 1% cream may be used for a short duration to treat the itching.
6. Oral Ivermectin can treat scabies when a single dose of 200mcg/kg body weight is taken with a meal. It might work for treating crusted scabies. However, its safety during pregnancy is not yet confirmed, and there are concerns about its usage (13).
7. Antihistamines such as Cetrizine or Clemastine might help relieve itching.

How To Treat Scabies Naturally During Pregnancy?

Some natural treatments for scabies are (14):

1. Applying neem oil or a paste of neem leaves and turmeric on the affected area may relieve from the infection.
2. Apply a paste of turmeric and lemon juice on the affected area, leave it for some time, and rinse off. This remedy might soothe the rashes.
3. Apply aloe vera gel on the affected areas, leave it for half an hour, and wash it off.
4. Put a few drops of lavender oil in your bathwater. Repeat this treatment for two to three weeks to notice the results.
5. Sandalwood is good to treat scabies because of its anti-inflammatory and antimicrobial properties. Apply it to soothe the affected area.
6. Tea tree oil has acaricidal, antibacterial, anti-inflammatory, and antipruritic properties. Therefore, it may be an effective treatment for scabies (15).

What Is The Prognosis Of Scabies?

Scabies is curable with effective treatment options. The itching and eczema accompanying the condition can resolve with time and restore healthy skin. However, you should stay away from infected people because there are high chances of recurrence if you live in an endemic area (3).

Scabies during pregnancy does not affect the growing fetus. However, it causes a lot of discomfort to the mother due to itching and burning. If you notice any symptoms of scabies, consult your healthcare provider. Timely treatment will help prevent secondary infections and stay comfortable during your pregnancy.

References

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