Scabies: Treatment Options and Home Care Tips

Has my whole family contracted scabies? How can we treat and cure it?

Hello Dr.
Huang,
First, let me mention that my family lives in Kaohsiung, while I work at the Hsinchu Science Park.
About two years ago, my father visited the Datong Hospital due to itching, and the doctor diagnosed him with scabies.
He was treated intermittently for two to three months before stopping.
However, my mother then began to experience itching as well, which has become more severe, especially in skin folds such as between her fingers, around the navel, under the armpits, and in the groin area.
The affected areas are red and swollen, appearing in spots that shift around.
She mentioned that during the day, she doesn’t feel much discomfort, but at night, when she covers herself with a blanket, her body temperature rises, leading to intense itching.
I purchased some over-the-counter medications, such as Xinghui and Yongxin, but the improvement has been slow.
Whenever I return to Kaohsiung and then back to Hsinchu, I also experience localized symptoms, though not as severe.
The dermatologist in Hsinchu initially prescribed antihistamines, but after I explained the situation, he suggested it could be scabies.

A year ago, during a business trip to mainland China, I stayed in a poor-quality hotel and was diagnosed with scabies upon returning, which took a long time to treat, and I didn’t realize it hadn’t fully resolved.

Aside from topical treatments, what other methods can be used for treatment? How should cleaning be conducted? Is it possible to completely cure this condition? Since my mother has difficulty seeing a doctor and her redness and swelling are severe, can she use over-the-counter medications? Which types would be more suitable?
Thank you for your assistance!
Mr.
Ma

Mr. Ma, 40~49 year old female. Ask Date: 2005/05/17

Dr. Huang Ruiyun reply Dermatology

It is still advisable to seek in-person medical care rather than relying on online diagnosis and prescriptions.
Scabies can be effectively treated if the correct methods are followed.
After the scabies mites are eliminated, there may still be some residual itching, but it will be significantly less severe.
Here are some important points to consider:
1.
Scabies treatment medications should be applied after bathing, covering every inch of skin from the neck down to the soles of the feet.
The duration of application varies depending on the type of medication used.
2.
All family members should be treated to prevent reinfestation and to effectively eradicate the condition.
3.
Underwear, bed linens, and blankets should be handled in one of the following ways (any one method is sufficient):
1.
Wash in water above 60 degrees Celsius.
2.
Thoroughly dry in a dryer.
3.
Iron carefully.
4.
Dry clean.
5.
Seal in a large plastic bag and set aside for two weeks.
P.S.
Sun exposure does not kill scabies mites and is ineffective.

Reply Date: 2005/05/17

More Info

Scabies, caused by the Sarcoptes scabiei mite, is a highly contagious skin condition characterized by intense itching and a rash. It often affects areas of the body where skin folds, such as between the fingers, around the belly button, under the arms, and in the groin. Given your family's experience with scabies, it's essential to understand the treatment options and home care tips to effectively manage this condition.

Treatment Options
1. Prescription Medications: The most effective treatment for scabies is the use of topical scabicides, which are medications specifically designed to kill the mites. Commonly prescribed options include permethrin cream (5%) and ivermectin, which can be taken orally. Permethrin is typically applied to the entire body from the neck down and left on for 8-14 hours before washing off. Ivermectin may be recommended for severe cases or when topical treatments fail.

2. Over-the-Counter Treatments: While some over-the-counter creams and lotions claim to relieve itching, they may not effectively eliminate the mites. It's crucial to consult a healthcare provider before using any over-the-counter products, especially if your mother has severe symptoms.

3. Follow-Up Care: After treatment, itching may persist for several weeks due to the body's reaction to the dead mites and their waste. If symptoms do not improve after a week of treatment, or if they worsen, a follow-up appointment with a healthcare provider is necessary.

Home Care Tips
1. Clean the Environment: Scabies mites can survive for a short time away from human skin, so it's essential to clean your living environment thoroughly. Wash all bedding, clothing, and towels in hot water and dry them on a hot setting. Items that cannot be washed should be sealed in a plastic bag for at least 72 hours to kill any remaining mites.

2. Avoid Close Contact: Since scabies is highly contagious, it's crucial to avoid close contact with others until treatment is completed. Inform anyone who has had close contact with your family members so they can also seek treatment if necessary.

3. Manage Itching: To alleviate itching, antihistamines or topical corticosteroids may be recommended. However, these should be used under the guidance of a healthcare provider, especially for your mother, who may have other underlying health issues.

4. Monitor Symptoms: Keep an eye on the affected areas for signs of secondary infections, such as increased redness, swelling, or pus. If these symptoms occur, seek medical attention promptly.

5. Educate Family Members: Ensure that all family members understand the nature of scabies, its transmission, and the importance of adhering to treatment protocols. This will help prevent reinfestation and spread within the household.

Conclusion
Scabies can be a challenging condition to manage, especially in a family setting. It's crucial to follow a comprehensive treatment plan that includes both medical intervention and diligent home care practices. If your mother is unable to visit a doctor, consider seeking telehealth options or home healthcare services that can provide guidance and support. With proper treatment and care, scabies can be effectively eradicated, allowing your family to return to a comfortable and itch-free life.

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