Effective Treatments and Environmental Management for Scabies

Medications and Environmental Management for Scabies

Hello, doctor;
1.
Can I add some lotion to the b.b lotion when applying it on scabies patients? If a bottle is usually used twice, I tend to add lotion because my skin is drier.
Will this affect the effectiveness?
2.
Regarding the environment, if sulfur water is unavailable, can I use a 1:100 bleach solution instead?
3.
For patients in a vegetative state, which treatment would you recommend? If it's for prevention, which option is milder? Can I use b.b lotion combined with lotion for prevention?

Xiao Zhu, 30~39 year old female. Ask Date: 2003/12/09

Dr. Zhong Yitun reply Dermatology

1.
B.B.
Lotion is an effective scabicide.
Since the skin can become dry, it is acceptable to add some lotion.
If the "pure" medication is used, there should be no burning sensation on the skin.
Applying some lotion half an hour after the medication can help alleviate dryness without concerns about diluting the medication's effectiveness.
(It is possible that excessive dilution could affect the drug's efficacy.) If burning occurs, it is advisable to dilute the medication or rinse it off after 5 to 10 minutes.

2.
The patient's clothing, bedding, sheets, and pillowcases should be "disinfected," preferably using sulfur water, as bleach is ineffective against scabies.
Sulfur water is commonly available at pharmacies.

3.
For patients with severe scabies, it is ideal to use a sulfur-containing ointment, which can be applied all over the body to kill the mites and promote the natural shedding of scales and necrotic skin.
Adding a small amount of lotion can enhance spreadability for easier application and help prevent post-application skin dryness.
Preventive measures, whether using B.B.
lotion or sulfur ointment with lotion, are effective as long as they are not excessively diluted.
However, it is important to note that pregnant women should avoid using B.B.
Lotion.

Reply Date: 2003/12/09

More Info

When it comes to treating scabies effectively, a multi-faceted approach is essential, which includes both medical treatment and environmental management. Here’s a comprehensive overview addressing your questions and providing additional insights into effective treatments for scabies.

1. Use of B.B. Lotion with Scabies Treatment
Using B.B. lotion in conjunction with scabies treatment can be a concern, especially if you're considering mixing it with the prescribed lotion. Scabies treatments, such as permethrin cream or benzyl benzoate (B.B. lotion), are specifically formulated to kill the mites causing the infestation. Adding a moisturizer or lotion may dilute the active ingredients, potentially reducing their effectiveness. If your skin is dry, it’s advisable to apply the scabies treatment first, allow it to absorb fully, and then apply a moisturizer afterward. This way, you can maintain skin hydration without compromising the treatment's efficacy.

2. Environmental Management: Alternatives to Sulfur Water
For environmental management, it’s crucial to eliminate scabies mites from your surroundings to prevent re-infestation. While sulfur water is a traditional method, if it’s not available, a diluted bleach solution (1:100) can be an effective alternative. However, it’s important to use this solution cautiously. Ensure that the area is well-ventilated, and avoid direct contact with skin, as bleach can cause irritation. When using bleach, it should be applied to surfaces that can withstand it, and you should allow it to sit for at least 10 minutes before rinsing or wiping it off. Always follow up with thorough cleaning of bedding, clothing, and personal items in hot water, and consider using a dryer on high heat to kill any remaining mites.

3. Recommendations for Patients with Limited Mobility
For patients who are bedridden or have limited mobility, the choice of treatment should be gentle yet effective. In such cases, topical treatments like permethrin cream are often recommended due to their efficacy and relatively lower irritation potential. It’s crucial to consult with a healthcare provider to determine the best course of action, especially for those with sensitive skin or other underlying health conditions.
For prevention, maintaining good hygiene practices is vital. Regular washing of bed linens, clothing, and towels in hot water can help prevent the spread of scabies. If you’re considering using B.B. lotion as a preventive measure, it’s essential to consult with a healthcare professional first. While it may provide some level of skin protection, it should not replace proper scabies treatment or preventive measures.

Additional Considerations
- Follow-Up Care: After treatment, it’s important to monitor for any signs of persistent infestation, such as itching or rash. If symptoms continue, a follow-up with a healthcare provider is necessary.

- Avoiding Re-Infestation: Scabies is highly contagious, so it’s crucial to treat all close contacts simultaneously to prevent reinfestation. This includes family members and anyone who has had close physical contact.

- Skin Care Post-Treatment: After completing treatment, your skin may still be sensitive. Using gentle, fragrance-free moisturizers can help soothe irritation and dryness.

In conclusion, effective treatment for scabies involves a combination of appropriate topical medications, diligent environmental cleaning, and preventive measures. Always consult with a healthcare provider for personalized advice and treatment plans tailored to your specific situation.

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