Hives vs Scabies

Introduction:
Hives or urticaria is an allergic reaction caused due to an exaggerated immune response to seemingly harmless substances entering the body via inhalation, ingestion, or skin contact. It is a skin rash which is pale red, raised and extremely itchy. Scabies, in contrast, is an infectious condition caused due to bite of a parasite called the itch mite which produces rashes in skin folds that are very itchy.

Causes of hives versus scabies:
Hives, commonly referred to as uticaria are an exaggerated response of the body’s immunity to seemingly harmless agents like pollen, dust mite, insect bites, animal dander, any coloring agent, food items like shellfish and peanuts or certain medicines. There is a seasonal allergy which occurs same time every year, due to pollen from trees and grass in the air. Occupational allergies are caused due to exposure to particular substances in the work place. Hives are also caused due to exposure to extreme heat or cold. Stress is also the major factor in producing hives. Acute cases last less than 6 weeks and chronic extend for more than 6 weeks, depending on causative agent and response of the body. It can occur anywhere on the surface of the skin. This reaction of body could be mild and sometimes life threatening. Angioedema is a similar condition in which there is swelling of eye, mouth or throat due to an allergic response and can be fatal if not immediately treated.
Scabies is an infectious condition caused by a parasite called the ‘itch mite’. It is invisible to our naked eye and in humans it can survive for months. The mite makes burrows in the epidermis layer of human skin and lays eggs which hatch and grows into adult mites there. It spreads from contact with animal and infected individuals, family members. It is transmitted through casual or sexual contact with infected person, through sharing of clothes or personal equipment of infected individual like razors.

Difference in Symptoms:
Hives appear as a sudden skin rash which is pale red, raised and extremely itchy. It may cause burning or stinging sensation. There might be a runny nose and sneezing as well.
Symptoms of scabies are severe, continuous itching especially at night. Skin lesions are red and look similar to an insect bite, whereas the burrow of mite may or may not be visible. It usually affects the folds of skin like armpits, webs of fingers and toes, groin, etc.

Difference in investigations:
The cause of hives is difficult to identify. Allergy testing is done to find out the cause but it is not 100% fruitful. Blood counts might show elevated eosinophil counts in hives. Scabies is suspected if one of your family members is suffering from it. The signs and symptoms are sufficient to raise the diagnosis. Skin scraping is done to confirm the diagnosis by identifying the mite.

Difference in Treatment:
Treatment of hives is done by avoiding contact with the causative agent. Avoid using strong soaps, detergents and other chemical agents. Taking anti-histaminic tablet is advisable only after contacting your doctor. One should see the doctor if symptoms do not improve in 2 weeks of home treatment or develops symptoms like difficulty in the breathing, wheezing, chest pain, swelling of tongue, throat. Scabies is taken care at home by maintaining hygiene, washing all clothes, towels and bedding separately in warm water, keeping personal items separate and cutting your nails. Avoid scratching. Anti histamines are used along with permethrin/sulphur application on skin to kill the mite and its eggs.

Summary:
Hives are caused by immune response to harmless substances producing a raised, itchy rash on skin. Scabies is an infectious disease caused by itch mite which is invisible to naked eye. It causes a skin rash with severe itching especially at night. Hives is treated by avoiding the causative agent whereas scabies is treated by taking care of personal hygiene and avoiding contact with the infected person.

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