Scabies: Treatment Challenges and Skin Care Tips

About scabies?

Hello Dr.
Du,
I would like to ask about my prolonged scabies infection (which started around the end of February).
I have seen multiple doctors, and they all diagnosed me with dyshidrotic eczema or dermatitis.
It wasn't until I visited a different regional hospital in mid-June that I was finally diagnosed with scabies.
After learning about the scabies diagnosis, I regularly applied BB solution, and after about two weeks, the rash stopped appearing, and my condition improved.
Occasionally, I still experience itching, but it is not as severe as before.
During a follow-up visit, the doctor said that the absence of new rashes indicates that I have recovered.
However, just four days later, the rash reappeared.
I chose to visit a nearby dermatology clinic, where the doctor stated that the appearance of a few new rashes is normal and that the BB solution typically kills the mites within three days, so only symptomatic treatment is necessary.

However, unexpectedly, the day after my visit, two new blisters appeared in the areas where the previous blisters had disappeared.
I would like to ask if my scabies is actually not fully cured and if I need to continue applying the BB solution or ULEX Cream? Or is the appearance of rashes and blisters a normal phenomenon?
Additionally, the doctor at the nearby clinic mentioned that prolonged use of the BB solution could lead to dermatitis symptoms.
Is it possible that my continued application of the BB solution after seeing the rash could have caused this? I kindly ask for your guidance.
Thank you.

Ms. Li, 20~29 year old female. Ask Date: 2010/07/10

Dr. Du Zhiqiang reply Dermatology

Dear Ms.
Li,
Regarding the diagnosis of scabies, severe cases are easy to identify and unlikely to be misdiagnosed, while mild cases are more challenging to diagnose.
A severe case is defined as one where family members or housemates are already infected, or the individual experiences intense itching all over the body at night.
In cases of mild symptoms, individuals with good personal hygiene may not be easily diagnosed.
If BBL (benzyl benzoate lotion) is used for several days, improvement should be expected.
It is crucial to ensure that clothing and bedding are properly disinfected at high temperatures and that all family members receive treatment together.
If, after treatment, rashes and blisters persist in specific areas, it is essential to consult a dermatologist again to confirm whether scabies is present.
Wishing you peace and health.
Sincerely,
Dr.
Du Zhi-Liang
Director of Dermatology
Taoyuan Hospital, Department of Health

Reply Date: 2010/07/10

More Info

Scabies, caused by the Sarcoptes scabiei mite, is a highly contagious skin condition characterized by intense itching and a rash. The treatment for scabies typically involves topical medications such as permethrin cream or benzyl benzoate, which are designed to kill the mites. In your case, it seems you have been using a product referred to as "bb solution," which may be a topical treatment aimed at addressing scabies.
From your description, it appears that you initially saw improvement after using the bb solution for two weeks, with the rash subsiding and itching becoming less severe. However, the reappearance of the rash and blisters shortly after stopping treatment raises some concerns. It is essential to understand that while the absence of new lesions can indicate that the infestation has been controlled, it does not always guarantee complete eradication of the mites.
The fact that you are experiencing new blisters suggests that either the treatment was insufficient, or there may be a secondary infection or another skin condition at play. It is also possible that the itching and rash you are experiencing could be a reaction to the treatment itself, especially if the bb solution is used for an extended period. Prolonged use of certain topical treatments can lead to skin irritation or dermatitis, which may mimic or exacerbate the symptoms of scabies.

Given your situation, here are some recommendations:
1. Consult a Dermatologist: Since you have already seen multiple doctors, it might be beneficial to consult a dermatologist who specializes in skin conditions. They can provide a thorough examination and possibly recommend a different treatment plan.

2. Follow Treatment Guidelines: If your doctor has advised that the bb solution should only be applied for a limited number of days, it is crucial to adhere to those guidelines. Overuse can lead to skin irritation and may complicate your recovery.

3. Monitor Symptoms: Keep track of any new symptoms or changes in your skin condition. If the rash worsens or new lesions appear, it is important to seek medical advice promptly.

4. Avoid Self-Medicating: While it may be tempting to continue using the bb solution or other topical treatments, doing so without medical guidance can lead to further complications.
5. Skin Care Routine: Maintain a gentle skin care routine. Use mild, fragrance-free cleansers and moisturizers to help soothe your skin. Avoid harsh soaps or scrubs that can irritate the skin further.

6. Consider Secondary Infections: If you notice any signs of infection, such as increased redness, swelling, or pus, seek medical attention immediately. Secondary bacterial infections can occur in areas where the skin has been compromised.

7. Educate Yourself: Understanding scabies and its treatment can empower you to make informed decisions about your care. Research reputable sources or consult with healthcare professionals to learn more about managing scabies effectively.

In conclusion, while it is possible that your scabies treatment may not have fully eradicated the mites, it is also essential to consider the potential for skin irritation or secondary infections. Consulting with a dermatologist and following their recommendations will be crucial in addressing your symptoms and ensuring a complete recovery.

Similar Q&A

Understanding Scabies: Causes, Symptoms, and Care Tips

Scabies is caused by an infestation of the skin by the Sarcoptes scabiei mite. The mites burrow into the skin, leading to intense itching and a rash. To care for scabies, the following steps should be taken: 1. Medical Treatment: Use prescription topical treatments such as...

Dr. Jiang Zheen reply Dermatology
In addition to applying scabicide ointment, it should be applied to the entire body below the neck once a day for 3-5 consecutive days. Additionally, undergarments should be ironed with hot water, and bedding should be exposed to sunlight. Family members who are infected should a...

Understanding Scabies: Symptoms, Treatment, and Scarring Concerns

It seems that I might have scabies... 1. What are the obvious symptoms? 2. If I have it, how should I treat it? [I have already applied medication - Scabicide] 3. Is it only transmitted through skin contact or contact with clothing? 4. Will there be scars after treatment? [Scars ...

Dr. Jiang Zheen reply Dermatology
Scabies can cause intense itching, especially at night. You can apply permethrin cream, and clothes should be disinfected with hot water. Bed linens should be sun-dried. After treatment, there should be no scarring. You should visit a dermatology clinic for proper diagnosis and t...

Struggling with Scabies: Seeking Effective Treatments and Support

I have been infected with scabies for two months, and my treatment involves applying permethrin (hereafter referred to as "P cream") and using a scabicide. Every week, I send a set of four bed linens to a laundromat where they are washed with bleach and laundry detergen...

Dr. Wu Yuxin reply Dermatology
A clinical assessment may need to be conducted first before recommending medication.

Managing Scabies: Treatment, Skin Irritation, and Returning to Work

Hello Dr. Wu! 1. On October 8, 2015, I was diagnosed with scabies. I used BB lotion for 9 days, but there are still scabietic tunnels and small red rashes on my penis. Additionally, it is not very irritating when applied to the skin on my body. However, it is quite irritating o...

Dr. Wu Yuxin reply Dermatology
1. It is still necessary to use it; otherwise, the treatment will fail. 2. Isolation is required for at least two weeks.