Scabies Symptoms: Am I Infected After Caregiving?

Regarding the symptoms of scabies?

Hello, Doctor: On September 1st, I held a child with scabies for about an hour and a half while wearing a thin jacket.
After that, I took care of the child for a month while wearing isolation gowns, and I always wore gloves as well.
I also took preventive medication for three weeks.
Today, I washed with sulfur water.
In the first week, I used scabicide solution at a 1:2 dilution for the first few days, then at a 1:1 dilution, applying it two to three times a day.
In the second and third weeks, I used Lindane cream once a week along with Ulesfia (benzyl benzoate) applied all over the body twice a day.
Occasionally, I have small red spots on my body, neck, and chest, and sometimes I notice something resembling pimples, but none of these have been itchy.
I have been able to sleep through the night without waking up due to itching, and it has been a full month since I stopped applying medication.
I still sleep soundly without waking up from itching, and the itching I do experience is mild (just a couple of scratches).
Can I trust that I do not have scabies? PS: The child has also been on medication for a month, using scabicide at a 1:2 dilution twice a day for the first two weeks, and Ulesfia all over the body twice a day for the third and fourth weeks.

Lin, 20~29 year old female. Ask Date: 2015/10/29

Dr. Wu Yuxin reply Dermatology

It should be fine, but have your clothes been treated?

Reply Date: 2015/10/29

More Info

It sounds like you have been very proactive in taking care of yourself and the child you were caring for, especially considering the potential risk of scabies transmission. Scabies is caused by the Sarcoptes scabiei mite, which burrows into the skin, leading to intense itching and a rash. The symptoms typically include small red bumps, blisters, and intense itching, especially at night.
Given your description, it seems you have taken several precautions, such as wearing protective clothing and using preventive medication. The fact that you have not experienced significant itching or discomfort is a positive sign. Scabies typically causes severe itching, which is often worse at night. If you were infected, you would likely have experienced more pronounced symptoms by now, especially after a month of exposure.

The small red spots and occasional bumps you mentioned could be due to a variety of reasons unrelated to scabies, such as heat rash, allergic reactions, or even folliculitis (inflammation of hair follicles). Since you have not experienced the hallmark symptoms of scabies, such as intense itching or a rash that worsens over time, it is reasonable to believe that you may not be infected.

However, it is essential to consider a few factors:
1. Incubation Period: Scabies can take several weeks to manifest symptoms after exposure. If you were exposed on September 1st and have been vigilant with your preventive measures, it is less likely that you would develop symptoms now, especially if you have been symptom-free for a month.

2. Treatment Efficacy: You mentioned using various treatments, including Lindane and other topical medications. These are effective against scabies when used correctly. If the child you were caring for has also been treated and is symptom-free, this further reduces the likelihood of transmission.

3. Follow-Up: If you continue to have concerns or if new symptoms arise, it would be wise to consult a healthcare professional. They can perform a thorough examination and possibly a skin scraping to check for the presence of mites.

4. Preventive Measures: Continue to practice good hygiene and avoid close contact with anyone who has scabies until they have completed their treatment and are symptom-free. Washing clothing and bedding in hot water can also help eliminate any potential mites.

In summary, based on your description and the absence of significant symptoms, it is likely that you are not infected with scabies. However, if you have any lingering doubts or if symptoms develop, seeking medical advice would be prudent. Your proactive approach to health and safety is commendable, and staying informed is key to preventing the spread of infections like scabies.

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