Aloe Benifits
Infection

Scabies

Scabies is a common infestation with a small mite that lives in the upper surface of the skin. The mites are passed from person to person. The scabies rash varies, but typically itches so much that people feel that they have never had anything like it before. There are often patches of eczema, and the tell-tale marks of small pustules and tracks around the wrists and in the finger webs. In children under 18 months of age, pustules are sometimes also seen on the soles of the feet.

Treatment is available over the counter at your chemists. The pharmacist will discuss the products with you, and they all come with written instructions within the packaging as to how to use them. However, diagnosis is sometimes difficult and, given the upheaval of treatment, you may want to confirm the diagnosis with your GP. This is particularly the case for children and babies, where treatment advice can be slightly different.

All products are creams or liquids which are applied to the whole body below the ears and chin. Although it is necessary to wash all clothing and bed linen used 24 hours before treatment, it is seldom advised to do more than this. Important aspects of treatment include:

  • Apply the treatment thoroughly to all body sites below the chin and ears. This includes between the buttocks and toes and around the genitals. If you are not thorough, mites may spread back over the body.
  • Treat everyone in the household. Not all household members will be itching, but this is not a certain guide as to whether they are infested. Some people will not itch and it is common not to itch in the early stages of infestation.
  • Close family contacts who are itching and members of their household may also need treating.
  • When treating more than one person for one outbreak, all people should be treated at the same time – otherwise the in-festation can spread back on to a treated person before the un-treated one applies the cream.
  • The itch may persist for months after treatment, although it usually gradually diminishes during that time. Some products will recommend applying the treatment again after 7 to 14 days.

Scabies is a mite infestation of the skin, causing an intensely itchy rash.

Impetigo

Impetigo is a bacterial skin infection that is most common in young children. Typically, a few patches appear first on the face. They are often itchy and may have blisters and yellow crusts. Impetigo can spread quickly to other sites because scratching carries bacteria on the fingernails and breaks the skin surface, promoting infection. It also spreads between children. It is usually thought best to keep a child with impetigo home from school until the outbreak is fully under control.

Impetigo may develop as a complication of eczema. It can also develop in children who have no particular history of eczema, yet who develop patches of eczema beneath the infected crusts. This does not mean that they will go on to get eczema elsewhere, but probably means that they have a tendency to get irritant dermatitis.

For small areas of infection, treatment can be with an antibiotic ointment. Several are available on prescription. Those bought over the counter from the chemist are seldom sufficient. The ointment is best applied to the infected skin after the crusts have been removed. This can be combined with the use of an antiseptic washing agent or simply with soap and water. When infection is beyond one or two small patches, it may be necessary to take antibiotics by mouth.

Routine precautions in a family would be for children not to sleep in the same bed and for an infected child to have a separate wash cloth and towel. It may help prevent infection of school friends if children are kept at home until the crusts have settled and treatment is well established.

Impetigo usually settles within 7 to 10 days of effective treatment. There may be residual pink marks on the skin for several weeks after, but they eventually fade. If infections are recurrent, it is sometimes helpful to take swabs from family members and from the nose of the infected person, to see if there is a source of bacteria that accounts for the repeated infection. This is done by the GP or practice nurse.

Impetigo is caused by bacteria entering broken skin, giving rise to blistering and crusting of the skin.

Fungal infection

Fungal infection, such as ringworm, can easily be confused with eczema on any part of the skin. It may resemble gravitational eczema or seborrhoeic eczema. Fungal infec-tion is particularly common on the feet, where it usually causes irritation between the toes (athlete’s foot). Sometimes it may be helpful to take a skin scraping to rule out fungal skin infection before proceeding with eczema treat-ments. Skin scrapings are best done by someone with specific training in this technique. It might be your GP or practice nurse.

KEY POINTS
  • The epidermis is the top layer of the skin and where most damage is seen in eczema
  • Solvents such as excess water and soap are damaging to the epidermis
  • Scratching and rubbing contribute to the ‘itch–scratch cycle’, making eczema worse
  • When eczema oozes and leaves crust on the skin, it is often associated with bacterial infection
  • Rashes that come on suddenly may well be infection, or a reaction to infection
  • If a new rash affects several household members at the same time, it is more likely to be infection than eczema and all household members may need treatment depending on the diagnosis
  • Psoriasis can look like eczema but is rare in children and often has a silvery scale; it is more likely than eczema to affect the scalp