Scabies: Common Questions and Concerns for Families - Dermatology

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Scabies, caused by the Sarcoptes scabiei mite, is a highly contagious skin condition that can lead to intense itching and discomfort. It is essential for families dealing with scabies to understand the nature of the infestation, treatment options, and preventive measures to avoid reinfestation. Here, I will address your concerns and provide additional insights into managing scabies effectively.

Question 1: Is it safe for my father to hold my daughter if he refuses to apply the medication?
While your father may not exhibit any symptoms of scabies, it is crucial to understand that the mites can be asymptomatic in some individuals. If he has been in close contact with your daughter, there is a risk that he could carry the mites and potentially transmit them back to her. It is highly recommended that anyone who has had close contact with an infected person, even if they do not show symptoms, should apply the prescribed treatment to prevent the spread of scabies. If your father is unwilling to use the medication, it would be best to limit close contact until he does so or until you have consulted with a healthcare provider for further guidance.

Question 2: Why do I and my daughter continue to develop new red spots after treatment?
The appearance of new red spots after treatment can be concerning. It is important to note that the itching and rash may persist even after the mites have been eliminated. This can be due to several reasons:
1. Post-Scabies Itch: After successful treatment, the skin may remain irritated and itchy for several weeks as it heals. This is known as post-scabies itch and can occur even after the mites are gone.

2. Reinfestation: If there is any contact with untreated individuals or contaminated items, reinfestation can occur. Ensure that all clothing, bedding, and towels are washed in hot water and dried on high heat.

3. Incomplete Treatment: If the treatment was not applied correctly or for the recommended duration, it may not have been fully effective. Ensure that you and your daughter are following the treatment regimen as prescribed by your healthcare provider.

If the new spots continue to appear or if there is significant discomfort, it is advisable to consult with your healthcare provider for further evaluation.

Question 3: Is it safe for my child to use the medication for a month?
Using topical treatments like permethrin (often referred to as "Ulyser" in your context) for an extended period should be done under the guidance of a healthcare provider. While these medications are generally safe for children, prolonged use without medical supervision is not recommended. If your daughter has not developed new lesions for three days, it may indicate that the treatment is effective. However, it is essential to follow up with your healthcare provider to ensure that the treatment plan is appropriate and to discuss any concerns regarding prolonged use.

Question 4: Do asymptomatic family members need to apply treatment daily?
Family members who do not show symptoms but have been in close contact with an infected person should still apply the treatment as a precautionary measure. It is typically recommended that they apply the medication once, as directed, rather than daily. This helps to eliminate any mites that may be present before symptoms develop. However, if they start to notice any itching or rash, they should consult with a healthcare provider for further evaluation and treatment.

In conclusion, managing scabies requires a comprehensive approach that includes treating all close contacts, thorough cleaning of the living environment, and following up with healthcare providers for ongoing concerns. It is essential to communicate openly with family members about the importance of treatment and prevention to ensure a successful resolution of the infestation. If you have any further questions or concerns, do not hesitate to reach out to your healthcare provider for personalized advice and support.