Scabies is a reaction to the scabies mite, which burrows into the skin laying eggs. Hatched larvae burrow upwards, living beneath the surface until they mature. Unless treated, this parasitic cycle repeats indefinitely, although large infestations occur only in people with weakened immune systems.
Except in children, scabies mites don't infest the scalp, preferring warm, damp, non-hairy sites such as skin creases at the elbows, knees and groin or between fingers and toes or under watchbands and waistbands.
Scabies in humans does not cause patchy baldness. Mites burrow below the skin, sometimes in or near hair follicles, and their excretions cause intense itching. Excessive scratching damages tissues including hair, but since human scabies mites prefer non-hairy body folds, hair loss is a symptom only in animal scabies. This is a different species that does not affect humans.
Severe scabies lesions indicate poor nutrition or impaired immunity and are common in AIDS patients and the elderly. They may have brittle or depleting hair for reasons unconnected to the scabies infection, but a complication of scabies, 'crusted scabies' is specific to these patients, does affect the scalp and is highly contagious.
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