Feeling Bugs After Visiting Homeless: Should I Worry About Scabies?

After caring for the homeless, I feel like there are bugs jumping on me?

Hello Dr.
Wu, last Sunday, I visited several homeless individuals for a report and sat on their mattresses chatting for about 30 minutes (while wearing shorts).
After the visit, I immediately felt as if several bugs were jumping on me, and even my classmate sitting next to me felt bugs jumping onto him.
I delayed taking a shower and doing laundry until I got home that night, and upon checking my body, I found no obvious rash symptoms.
However, over the past few days (about five days later), I have intermittently felt as if bugs are biting my skin (not sure if it's psychological), and there are still no obvious rash symptoms.
Doctor, should I be concerned about a scabies infection? After researching scabies, I learned that it may take weeks for symptoms to develop.
Should I consider using preventive topical medication? However, would a clinic doctor prescribe medication to me without any obvious symptoms? Thank you.

Nan Tongxue, 20~29 year old female. Ask Date: 2017/04/14

Dr. Wu Yuxin reply Dermatology

Scabies cannot be seen with the naked eye.
Without actually seeing the lesions, it is impossible to determine the issue.
If it is causing significant distress, please seek medical attention promptly.
A proper examination is necessary to identify the problem and determine the appropriate treatment.

Reply Date: 2017/04/14

More Info

It sounds like you are experiencing a significant amount of anxiety and concern regarding the possibility of having contracted scabies after your recent visit with homeless individuals. Your feelings are understandable, especially given the context of your interaction and the subsequent sensations you have been experiencing. Let’s break down your concerns and provide some clarity on the situation.

Scabies is a skin condition caused by a tiny mite called Sarcoptes scabiei. It is highly contagious and is typically spread through prolonged skin-to-skin contact with an infected person. Symptoms usually include intense itching, especially at night, and a rash that may appear as small red bumps or blisters. The rash often develops in specific areas, such as between the fingers, on the wrists, elbows, buttocks, and genital areas.

Given that you spent about 30 minutes sitting on a mattress with individuals who may have been living in unsanitary conditions, it is reasonable to be concerned about potential exposure. However, it is important to note that scabies does not typically manifest immediately after exposure. The incubation period can range from 2 to 6 weeks, meaning that if you were to develop symptoms, they would not appear right away.

You mentioned that you have not noticed any visible rashes or significant itching, which is a positive sign. The sensation of bugs crawling on your skin could be a psychological response to your anxiety about the situation, especially since you have been researching scabies and its symptoms. This phenomenon is sometimes referred to as "formication," where individuals feel sensations on their skin that are not caused by actual insects.

In terms of preventive measures, it is generally not recommended to use scabies treatment without a confirmed diagnosis. If you do not have any visible symptoms, applying medication may not be necessary and could lead to unnecessary side effects. However, if you are feeling particularly anxious, it might be beneficial to consult with a healthcare provider. They can evaluate your symptoms, provide reassurance, and determine if any treatment is warranted.

If you decide to visit a doctor, be sure to communicate your concerns clearly. Explain the context of your exposure, the sensations you are experiencing, and your anxiety about the possibility of scabies. A healthcare professional can perform a thorough examination and may conduct a skin scraping if they suspect scabies. This test can confirm the presence of mites or their eggs.

In the meantime, to alleviate your anxiety, consider practicing relaxation techniques such as deep breathing, mindfulness, or meditation. Engaging in activities that distract you from your worries, such as exercise or hobbies, can also be beneficial. If your anxiety continues or worsens, seeking support from a mental health professional may be helpful.

In summary, while your concerns about scabies are valid given the circumstances, the absence of visible symptoms is encouraging. It is advisable to consult a healthcare provider for a professional evaluation rather than self-treating. Remember that anxiety can manifest physically, and addressing your mental health is just as important as addressing any potential physical health concerns.

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