Do Scabies Come Back? Understanding Re-infestation and Prevention
Do scabies come back? Yes, scabies can come back, but this is typically due to re-infestation from continued exposure or treatment failure, rather than a true recurrence of the original infestation. This article provides a comprehensive understanding of why scabies might seem to return, how to avoid re-infestation, and what to do if it happens.
What is Scabies and Why Does It Seem To Return?
Scabies is a highly contagious skin condition caused by tiny mites called Sarcoptes scabiei. These mites burrow into the upper layer of the skin, where they live and lay eggs. This burrowing activity causes intense itching, often worse at night. The itch is actually an allergic reaction to the mites, their eggs, and their waste. The perceived return of scabies symptoms often isn’t due to a true recurrence, but rather either a re-infestation or continued mite activity because of ineffective treatment.
Scabies spreads through prolonged, skin-to-skin contact with an infected person. Less commonly, it can spread by sharing infested items such as bedding, clothing, or towels. While not a hygiene issue, crowded living conditions increase the risk of transmission.
Common Reasons for Scabies “Returning”
The sensation of scabies coming back can be frustrating. Here’s a breakdown of the primary causes:
- Re-infestation: This is the most frequent reason. If you are exposed to scabies mites again after successful treatment, you will develop another infestation. This often happens if a close contact was not treated simultaneously or if you were re-exposed in a shared environment.
- Treatment Failure: In some cases, the prescribed treatment may not fully eradicate the mites. This can be due to factors like:
- Improper application of topical medications.
- Resistance to the medication (though rare).
- Not treating all household contacts or close contacts at the same time.
- Skipping doses of oral medications.
- Post-Scabietic Itch: Even after the mites are gone, the allergic reaction and skin irritation can persist for several weeks. This lingering itch, known as post-scabietic itch, can feel like the infestation is still active, even when it isn’t.
Ensuring Effective Scabies Treatment
Effective scabies treatment is crucial for preventing the need to ask, “Do Scabies Come Back?” These steps will greatly improve the chances of clearing the infection completely:
- Follow your doctor’s instructions precisely. This includes the correct application method, dosage, and duration of treatment.
- Treat all household members and close contacts simultaneously, even if they don’t have symptoms. This eliminates the risk of re-infestation.
- Wash all bedding, clothing, and towels used in the 3 days prior to treatment in hot water and dry them on high heat. If items can’t be washed, seal them in a plastic bag for at least 72 hours to kill the mites.
- Vacuum carpets and furniture thoroughly. Dispose of the vacuum bag carefully.
- Apply topical medications to the entire body, from the neck down, paying particular attention to folds of the skin, between fingers and toes, and under the nails.
- Consider a second treatment dose, typically one week after the initial application, as prescribed by your doctor.
Distinguishing Between Re-infestation and Post-Scabietic Itch
Differentiating between a new infestation and post-scabietic itch is important for determining the correct course of action. Consider these factors:
| Feature | Re-infestation | Post-Scabietic Itch |
|---|---|---|
| Itch Intensity | Usually new burrows and intense itching, potentially worse than before | Gradual improvement, may be persistent but not necessarily worsening |
| New Lesions | New bumps, burrows, or rashes appear | No new lesions; existing lesions may be healing |
| Contact History | Possible recent exposure to someone with scabies | No recent exposure to scabies |
| Response to Antihistamines | May provide some temporary relief, but scabicides needed to kill mites | Antihistamines often help reduce itching |
If you suspect a re-infestation, consult your doctor for diagnosis and further treatment. If you believe it is post-scabietic itch, your doctor can recommend treatments to relieve the itching, such as moisturizers, antihistamines, or topical corticosteroids.
Preventing Scabies Re-infestation
Prevention is key in stopping the cycle of infestation and the anxiety of wondering, “Do Scabies Come Back?” Here’s how to lower your risk:
- Avoid close contact with individuals known to have scabies.
- Do not share bedding, clothing, or towels with others, especially in situations where scabies is prevalent.
- If you live or work in a high-risk environment (e.g., nursing home, childcare center), be vigilant about early detection and treatment.
- Educate yourself and others about scabies prevention measures.
Frequently Asked Questions (FAQs)
Why am I still itching after scabies treatment?
The itch associated with scabies is due to an allergic reaction to the mites, their eggs, and their waste. Even after the mites are killed, this allergic response can persist for several weeks. This is called post-scabietic itch and does not necessarily mean the treatment failed.
How long does post-scabietic itch last?
Post-scabietic itch can last from 2 to 6 weeks, or even longer in some cases. It usually gradually improves over time. If the itching is severe or worsening, or if new lesions appear, it’s important to consult a doctor to rule out re-infestation.
What can I do to relieve post-scabietic itch?
Several measures can help relieve post-scabietic itch: Moisturizing the skin regularly, using antihistamines to reduce the allergic reaction, applying topical corticosteroids to reduce inflammation, and avoiding hot showers and harsh soaps that can dry out the skin.
Can scabies live on surfaces for long?
Scabies mites can only survive for 2 to 3 days away from human skin. Therefore, transmission through casual contact with surfaces is relatively uncommon.
How do I know if my scabies treatment has failed?
Signs that your scabies treatment may have failed include the persistence of intense itching, the appearance of new burrows or lesions, and a lack of improvement in symptoms after a week or two of treatment.
Are there any natural remedies for scabies?
While some natural remedies, such as tea tree oil and neem oil, are purported to have scabicidal properties, there is limited scientific evidence to support their effectiveness. It is crucial to seek conventional medical treatment from a doctor.
Can I get scabies from my pet?
Human scabies mites are different from the mites that cause mange in animals. You cannot get human scabies from your pet, nor can your pet get mange from you.
What happens if scabies is left untreated?
Untreated scabies can lead to secondary bacterial infections from scratching, such as impetigo. In rare cases, it can develop into crusted scabies (Norwegian scabies), a severe and highly contagious form of the infestation.
Is crusted scabies more contagious than regular scabies?
Yes, crusted scabies is far more contagious than regular scabies because it involves a much higher mite burden (hundreds to thousands of mites) compared to regular scabies (typically fewer than 20 mites).
How soon after exposure will I develop symptoms of scabies?
If you’ve never had scabies before, it can take 2 to 6 weeks for symptoms to develop. If you’ve had scabies previously, symptoms may appear within 1 to 4 days of re-exposure.
Can I return to work or school after scabies treatment?
You can typically return to work or school 24 hours after completing the first application of scabies treatment, provided that all household members and close contacts have also been treated simultaneously.
How is scabies diagnosed?
Scabies is typically diagnosed by a visual examination of the skin, looking for characteristic burrows and lesions. Your doctor may also take a skin scraping to examine under a microscope to confirm the presence of mites, eggs, or fecal matter.