Scabies Treatment: Managing Symptoms and Concerns

Q: Scabies Treatment: Managing Symptoms and Concerns

Hello： For a detailed introduction to scabies, you can refer to a series of articles on the Dermatology Expert Health website at http：//www.drskincare.com.tw/Qa/Index.aspx?CID=15. <br>Generally, a single treatment with Lyclear is effective, and if there is no improvement, retreat

Scabies treatment

Hello Doctor, my condition started about two months ago when I noticed a rash on my ankle.
At first, I thought it was a flea bite.
I kept scratching it and applied a general antihistamine cream, but it didn't improve for a long time.
It persisted for over a month, and the wound became increasingly severe.
About two weeks ago, I started developing other rashes on my body and hands, which have been multiplying and forming clusters with small blisters.
A roommate suggested it might be scabies, which I had never heard of before, so I didn't pay much attention since I am in Australia and medical consultations are very expensive.
It wasn't until last week when I couldn't sleep due to unbearable itching that I finally went to see a doctor.
The doctor examined me but didn't provide much explanation, only prescribed a scabies cream and instructed me to apply it from the neck down once, then return for a follow-up in a week.
However, I feel my condition is quite serious, so I researched a lot online and learned that I need to clean my bedding and clothing.
The doctor prescribed Lyclear, which is available in Australia.
I found out that in Taiwan, there doesn't seem to be a similar scabies cream.
I know the application method is to apply it all over the body once, leave it on for 8-12 hours, and then wash it off weekly.
After I started applying the cream, I washed all my sheets, duvet covers, pillowcases, and clothes daily with a hot wash (the washing machine has a 95-degree setting).
On the first day, after applying the cream, the itching was somewhat reduced, and I had a good night's sleep.
However, after washing it off at noon, the itching returned, and the next day, I noticed a few new rashes appearing, which also itched.
I am really worried, so I went to the pharmacy to buy more cream.
After a day, I did the same hot wash and applied the cream before bed, washing it off after 12 hours.
I have done this for two consecutive days, and today is the third time applying the cream, again washing it off after 12 hours.
However, I noticed that the small blistering rashes on my hands are increasing...
they are almost covering my entire arm.
I am really going crazy.
Is it possible that using the cream for too many days has caused this rash, or is it an incomplete treatment? I have been very thorough in applying it everywhere.
Can you tell me if Lyclear and the scabies creams available in Taiwan can be used continuously for several days? I really don’t know what to do.
The doctors here are not good, and I don’t have much money to keep seeing doctors.
I’m afraid the new rashes are caused by applying too much cream, but I’m also worried that the treatment is incomplete.
They all look the same, small red bumps with tiny blisters on top.
Should I continue applying the cream and washing it off daily, or follow the instructions to apply it once a week? If I only use it once and wait six days, wouldn’t that mean if I didn’t kill all the mites, the condition would spread more severely? What should I do? I have read a lot of information online and from this site.
If I have been applying the cream for three consecutive days and still have new small rashes appearing, how can I differentiate between a rash caused by irritation from the cream and a rash from scabies? This is the fourth day since I started applying the cream.
If I no longer have scabies, is it still possible to have red rashes? Is this a normal allergic reaction? Should I continue applying the cream or wait a week to decide? Please help me as much as you can.
Thank you.

K, 20~29 year old female. Ask Date: 2016/04/18

Dr. Li Yufen reply Dermatology

Hello: For a detailed introduction to scabies, you can refer to a series of articles on the Dermatology Expert Health website at http://www.drskincare.com.tw/Qa/Index.aspx?CID=15.
Generally, a single treatment with Lyclear is effective, and if there is no improvement, retreatment can be done after one week.
The rash caused by the irritation of the ointment and the rash due to scabies sensitivity cannot be clearly distinguished in writing.
It is recommended to first ensure proper disinfection of the environment, and if any roommates have skin abnormalities, they should also be treated simultaneously to avoid cross-infection.
Oral antihistamines can also be taken to alleviate itching discomfort.
If the skin rash and itching persist, a follow-up appointment may be necessary for further treatment.
Thank you!

Reply Date: 2016/04/18

More Info

It sounds like you are experiencing a challenging situation with what may be scabies, and I understand your concerns regarding the treatment and symptoms. Scabies is caused by a mite infestation that leads to intense itching and a rash, typically characterized by small red bumps and blisters. The treatment usually involves topical medications, such as permethrin or benzyl benzoate, which are designed to kill the mites.

From your description, it seems that you have been using Lyclear, which is a scabies treatment available in Australia. The standard application involves applying the cream from the neck down, leaving it on for 8 to 12 hours, and then washing it off. It is crucial to follow the instructions provided by your healthcare provider or the medication's packaging. Generally, the treatment is applied once, and then repeated a week later to ensure that any newly hatched mites are also eliminated.

Regarding your concerns about the new rashes and blisters appearing after treatment, it is essential to differentiate between a few possibilities:
1. Residual Itching: After the mites are killed, the skin may still react for some time, leading to continued itching and redness. This is often due to an allergic reaction to the mites or their waste products, which can persist even after successful treatment.

2. Secondary Infection: Scratching the affected areas can lead to secondary bacterial infections, which may cause new rashes or worsening symptoms. If you notice increased redness, warmth, or pus, it may indicate an infection that requires medical attention.

3. Irritation from the Medication: Overuse of topical treatments can lead to skin irritation, resulting in rashes or blisters. If you are applying the cream more frequently than recommended, it could be causing irritation rather than helping.

Given your situation, here are some recommendations:
- Follow the Treatment Protocol: Stick to the recommended application schedule for Lyclear. If the instructions say to apply it once and then again a week later, it is best to adhere to that schedule unless directed otherwise by a healthcare professional.

- Avoid Overuse: Applying the cream daily may lead to skin irritation. If you have already applied it for three consecutive days, it would be wise to stop and wait for the recommended time before reapplying.

- Monitor Symptoms: Keep an eye on your symptoms. If the new rashes continue to appear or worsen, or if you develop signs of infection, it is crucial to seek medical advice, even if it means finding a more affordable option.

- Consult a Healthcare Provider: If possible, consider consulting another healthcare provider or a dermatologist. They can provide a more thorough evaluation and may suggest alternative treatments or solutions.

- Clean Your Environment: Continue to wash your bedding, clothing, and towels in hot water to prevent re-infestation. Vacuuming your living space can also help eliminate any mites that may be present.

In summary, while it is understandable to feel anxious about your symptoms and treatment, it is essential to follow the prescribed treatment plan and monitor your condition closely. If you have concerns about the effectiveness of the treatment or the appearance of new rashes, seeking further medical advice is crucial. Remember, patience is key in the treatment of scabies, and with the right approach, you should see improvement.

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