How Do I Treat Scabies?: A Comprehensive Guide to Relief
To effectively treat scabies, you need a prescription scabicide cream or lotion, meticulously applied to the entire body from the neck down, and thorough environmental cleaning to prevent re-infestation. This comprehensive guide offers expert advice on effective treatment options and preventative measures to help you get rid of scabies fast.
Understanding Scabies: The Itch That Drives You Mad
Scabies is a highly contagious skin infestation caused by the microscopic human itch mite, Sarcoptes scabiei var. hominis. These tiny creatures burrow into the upper layer of the skin where they live and lay eggs. This activity leads to intense itching, which is typically worse at night. While uncomfortable and distressing, scabies is treatable with the correct approach. Understanding how scabies spreads, its symptoms, and the importance of proper treatment is crucial for both personal relief and preventing further transmission.
Recognizing the Signs and Symptoms
Knowing what scabies looks like can help you seek treatment early. Common signs and symptoms include:
- Intense Itching: This is the hallmark of scabies, often worsening at night.
- Rash: Small, red bumps or blisters, often appearing in lines or tracks (burrows).
- Location: Commonly found between fingers, in wrist creases, underarms, around the waistline, on the inner thighs, and around the genitals.
- Secondary Infections: Scratching can lead to skin breakdown and secondary bacterial infections.
Diagnosis: Confirming Your Suspicions
While the symptoms of scabies are often characteristic, a definitive diagnosis requires a healthcare professional. A doctor can diagnose scabies by:
- Visual Examination: Looking for the characteristic rash and burrows.
- Skin Scraping: Taking a small scraping of skin and examining it under a microscope to identify mites, eggs, or fecal matter.
- Dermoscopy: Using a special magnifying device to visualize the burrows more clearly.
The Core of the Cure: Scabicide Medications
The cornerstone of scabies treatment is the use of scabicide medications, which are specifically designed to kill the mites and their eggs. These medications are available only by prescription and come in the form of creams or lotions. The two most commonly prescribed scabicides are:
- Permethrin 5% cream: This is generally considered the first-line treatment. Apply it to the entire body from the neck down (including soles of feet) and leave it on for 8-14 hours before washing off.
- Ivermectin: This oral medication is sometimes prescribed for those who cannot tolerate topical treatments or when topical treatments have failed. It is not recommended for pregnant women or children under 5 years old.
Always follow your doctor’s instructions carefully when applying scabicide medications. A second application may be necessary after one to two weeks.
Beyond Medication: Treating the Environment
Treating the environment is just as important as treating the affected individual. The mites can survive off the human body for a short period, so it’s crucial to prevent re-infestation. Here’s how:
- Wash all bedding, clothing, and towels: Use hot water and dry on high heat. Do this for all items used in the 3 days before treatment.
- Seal non-washable items: Place items like pillows, comforters, and stuffed animals in a sealed plastic bag for at least 72 hours (some experts recommend two weeks).
- Vacuum thoroughly: Vacuum carpets, rugs, and upholstered furniture.
Treating Contacts: Protecting Others and Yourself
Scabies is highly contagious, so it’s crucial to treat close contacts, even if they don’t have symptoms.
- Household Members: All household members should be treated simultaneously.
- Close Contacts: Inform and encourage close contacts (sexual partners, caregivers) to seek treatment.
Managing the Itch: Symptomatic Relief
While the scabicide medication works to kill the mites, you will likely experience itching for some time afterward. Here are some ways to manage the itch:
- Cool Compresses: Apply cool, wet compresses to the affected areas.
- Calamine Lotion: This can help soothe and protect the skin.
- Antihistamines: Over-the-counter or prescription antihistamines can help relieve itching, especially at night.
- Topical Corticosteroids: Your doctor may prescribe a mild topical corticosteroid to reduce inflammation and itching.
Common Mistakes to Avoid When Treating Scabies
Treating scabies effectively requires diligence and attention to detail. Here are some common mistakes to avoid:
- Not applying medication correctly: Ensure the medication is applied to the entire body from the neck down, including creases and folds.
- Not treating all close contacts: This will lead to re-infestation.
- Not treating the environment: The mites can survive off the body for a few days, so cleaning is essential.
- Stopping treatment too early: Even if the itching subsides, complete the full course of treatment as prescribed by your doctor.
- Scratching excessively: This can lead to skin breakdown and secondary infections.
Prevention: Stopping Scabies Before It Starts
While completely preventing scabies can be difficult, these measures can significantly reduce your risk:
- Avoid close contact with infected individuals: Limit skin-to-skin contact and avoid sharing personal items.
- Good hygiene: Regularly wash your hands with soap and water.
- Prompt treatment: If you suspect you have scabies, seek treatment immediately to prevent further spread.
Monitoring for Treatment Success
After completing treatment, it’s essential to monitor for signs of improvement. The itching may persist for several weeks, even after the mites are dead. Contact your doctor if:
- The itching worsens or new lesions appear.
- You develop signs of a secondary infection, such as redness, swelling, or pus.
- Your symptoms don’t improve after several weeks.
Frequently Asked Questions About Scabies Treatment
What happens if scabies is left untreated?
Untreated scabies can lead to several complications. Prolonged itching can cause severe skin irritation, leading to secondary bacterial infections like impetigo or cellulitis. In rare cases, a severe form called crusted scabies (Norwegian scabies) can develop, particularly in individuals with weakened immune systems. Crusted scabies is highly contagious and difficult to treat. Therefore, prompt treatment is essential to prevent these complications and stop the spread.
Can I treat scabies with home remedies?
While some home remedies might offer temporary relief from itching, they are not effective at killing the scabies mites. Tea tree oil, neem oil, and other natural remedies have been suggested, but scientific evidence supporting their effectiveness is limited. Prescription scabicides are the only proven treatment for scabies, and attempting to rely solely on home remedies can prolong the infestation and increase the risk of complications.
How long does it take for scabies treatment to work?
Itching may persist for up to 2-4 weeks even after successful treatment. This is because the allergic reaction to the dead mites and their waste products continues. However, the rash and burrows should start to fade within a few days of starting treatment. If new burrows or rash continue to appear after a week, a second treatment is often needed. Contact your doctor if symptoms worsen or don’t improve.
Is it possible to get scabies more than once?
Yes, it’s certainly possible to get scabies more than once. Having scabies once doesn’t provide immunity. Reinfection can occur through close contact with another infected person or from environmental contamination if treatment and cleaning weren’t thorough during the initial infection. Strict adherence to treatment protocols and preventative measures is crucial to avoid repeated infestations.
How do I know if my scabies treatment has failed?
Signs that your scabies treatment has failed include the continued presence of new burrows or rashes, worsening itching despite treatment, and persistent symptoms after two weeks of treatment. A failed treatment often points to medication resistance, re-exposure, or incomplete application of the treatment. Consult your doctor for an alternative treatment plan.
Can I go to school or work while being treated for scabies?
It is generally recommended to stay home from school or work until at least 24 hours after completing the first application of scabicide medication. This helps to minimize the risk of spreading the mites to others. After the first treatment, the contagious period reduces significantly, but maintaining good hygiene and avoiding close contact is still advised until the infestation is fully resolved.
Are there any side effects to scabies medication?
Common side effects of scabicide medications like permethrin cream include mild itching, burning, or stinging at the application site. These side effects are usually temporary and resolve on their own. More severe side effects are rare. Ivermectin, an oral medication, may cause gastrointestinal upset or other side effects. Discuss any concerns with your doctor.
Can pregnant women or breastfeeding mothers safely treat scabies?
Pregnant women and breastfeeding mothers should consult with their doctor before using any scabicide medication. Permethrin cream is generally considered safe for use during pregnancy and breastfeeding, but it’s essential to weigh the potential risks and benefits. Ivermectin is generally not recommended during pregnancy. Your doctor can help determine the safest treatment option.
How do I treat scabies in infants and young children?
Treating scabies in infants and young children requires special consideration. Permethrin cream is often used, but the application needs to be done carefully to avoid ingestion. In infants, the cream should be applied to the entire body, including the face and scalp (avoiding the eyes and mouth). Consult with your pediatrician for specific instructions and dosages.
What is crusted scabies, and how is it different?
Crusted scabies, also known as Norwegian scabies, is a severe form of scabies characterized by thick crusts on the skin. It contains a very high number of mites and is extremely contagious. It typically affects individuals with weakened immune systems, the elderly, and those with certain medical conditions. Treatment usually involves a combination of topical scabicides and oral ivermectin.
How long can scabies mites live off the body?
Scabies mites can survive off the human body for approximately 24-72 hours (1-3 days). This survival time depends on environmental conditions such as humidity and temperature. This is why thorough cleaning of bedding, clothing, and other personal items is crucial to prevent re-infestation.
When should I see a doctor for scabies?
You should see a doctor if you suspect you have scabies, especially if you experience intense itching and a rash that doesn’t improve with over-the-counter treatments. Early diagnosis and treatment are essential to prevent the spread of the infestation and avoid complications. Additionally, if you have a weakened immune system or are pregnant, seeking medical attention is especially important.