How Long Does It Take Permethrin to Cure Scabies?
Permethrin cream, the gold standard treatment for scabies, typically requires two applications, spaced one week apart, to effectively eliminate the mites and resolve the infestation. However, complete resolution of symptoms like itching can take several weeks even after successful treatment.
Understanding Scabies and Permethrin
Scabies is a highly contagious skin infestation caused by the microscopic human itch mite, Sarcoptes scabiei var. hominis. These mites burrow into the upper layer of the skin where they live and lay eggs, leading to intense itching, especially at night, and a characteristic rash. Permethrin is a synthetic pyrethroid insecticide that paralyzes and kills the mites, effectively treating the infestation. Understanding how permethrin works and how it needs to be applied is crucial to successfully eradicating scabies.
How Permethrin Works
Permethrin disrupts the nervous system of the scabies mite, causing paralysis and ultimately death. It’s effective against both adult mites and their larvae, although it may not always kill all eggs. This is why a second application is typically recommended.
- Permethrin is a topical cream.
- It is typically prescribed in a 5% concentration.
- It is considered safe and effective when used as directed.
The Treatment Process: Application is Key
The effectiveness of permethrin depends heavily on proper application. Missing areas or not leaving the cream on for the prescribed time can lead to treatment failure. Following your doctor’s instructions meticulously is essential. Here are the key steps:
- Shower or bath: Before each application, thoroughly cleanse your body with soap and water.
- Apply the cream: Cover the entire body from the neck down to the toes, including between fingers and toes, under fingernails, on the soles of the feet, and in skin folds.
- Pay special attention: Focus on areas most commonly affected, such as wrists, elbows, armpits, genitals, and buttocks.
- Leave it on: Leave the cream on for 8-14 hours. This is typically done overnight.
- Wash it off: After the recommended time, thoroughly wash off the cream with soap and water.
- Second application: Repeat the entire process one week later. This is to kill any mites that may have hatched from eggs that survived the first treatment.
- Treat household contacts: To prevent re-infestation, all close contacts (family members, sexual partners) should be treated at the same time, even if they don’t have symptoms.
What To Expect After Treatment: Itching Persists
While permethrin kills the scabies mites relatively quickly, the itching may persist for several weeks after treatment. This is because the dead mites and their waste products remain in the skin, continuing to trigger an allergic reaction.
Common Mistakes to Avoid
Treatment failure with permethrin is often due to preventable mistakes. Here’s what not to do:
- Incomplete application: Not covering the entire body from the neck down.
- Not leaving it on long enough: Washing the cream off too soon.
- Skipping the second application: Assuming one treatment is sufficient.
- Not treating household contacts: Allowing for re-infestation from untreated individuals.
- Not treating bedding and clothing: Mites can survive off the body for a short time.
Managing Post-Treatment Itching
The persistent itching after treatment can be quite bothersome. Here are some strategies to manage it:
- Antihistamines: Over-the-counter antihistamines can help reduce the allergic reaction causing the itching.
- Corticosteroid creams: Topical corticosteroid creams can help reduce inflammation and itching.
- Cool compresses: Applying cool compresses to the affected areas can provide temporary relief.
- Emollients: Keeping the skin well-moisturized can help soothe irritated skin.
- See a doctor: If the itching is severe or doesn’t improve after several weeks, consult your doctor. They may prescribe stronger medications.
Frequently Asked Questions
When Should I Expect to See Improvement After Permethrin Treatment?
You should start to see a reduction in itching and the appearance of new lesions within a few days of the second permethrin application. However, it is important to remember that complete resolution of all symptoms can take several weeks. Persistent itching doesn’t necessarily mean the treatment failed.
What If the Itching Gets Worse After Applying Permethrin?
It’s not uncommon for itching to initially worsen slightly after applying permethrin. This can be due to an allergic reaction to the dead mites or the permethrin cream itself. However, if the itching becomes significantly worse or new lesions appear, consult your doctor. It could indicate treatment failure or a secondary infection.
Can I Shower or Bathe During the 8-14 Hour Permethrin Treatment Period?
No. It is essential to avoid showering or bathing during the 8-14 hour treatment period to allow the permethrin to be fully absorbed into the skin and kill the mites. Make sure to shower or bathe immediately before applying the cream, and then wait the required time before washing it off.
Do I Need to Wash All My Clothes and Bedding After Permethrin Treatment?
Yes. Wash all clothing, bedding, and towels used in the 3 days prior to treatment in hot water and dry them on high heat. Items that cannot be washed can be dry-cleaned or sealed in a plastic bag for at least 72 hours, as mites cannot survive without a human host for longer than that.
Is Permethrin Safe for Children and Pregnant Women?
Permethrin is generally considered safe for children over 2 months old and pregnant or breastfeeding women when used as directed by a healthcare provider. However, always consult with a doctor before using any medication, especially if pregnant or breastfeeding.
What Are the Side Effects of Permethrin Cream?
Common side effects of permethrin cream include mild burning, stinging, itching, or redness at the application site. These side effects are usually temporary and resolve on their own. More serious side effects are rare.
How Long Does It Take Permethrin to Cure Scabies If I Only Apply It Once?
While some individuals might experience improvement after a single application of permethrin, it’s generally not sufficient to completely eradicate the scabies infestation. A second application one week later is crucial to kill any newly hatched mites and prevent re-infestation.
Can I Use Other Medications While Using Permethrin Cream?
It is generally safe to use other topical medications (like moisturizers or corticosteroid creams for itching) while using permethrin cream. However, avoid applying other topical medications at the same time as the permethrin, as this could interfere with its absorption. Wait at least an hour after applying permethrin before applying other creams.
What If Permethrin Doesn’t Work?
If permethrin treatment fails, consult your doctor. They may prescribe a different medication, such as ivermectin, or investigate possible causes of treatment failure, such as incorrect application, re-infestation, or resistance. Resistance to permethrin is rare, but can occur.
Can I Get Scabies Again After Being Treated?
Yes. It is possible to get scabies again, even after successful treatment. This is usually due to re-exposure to an infected person or contaminated items. Continue practicing good hygiene and avoid close contact with known scabies cases to prevent re-infestation.
How Long Can Scabies Mites Live on Clothing or Bedding?
Scabies mites can survive off the human body for approximately 2-3 days. This is why it’s important to wash or isolate potentially contaminated clothing and bedding to prevent re-infestation.
Is There Anything Else I Can Do to Prevent Spreading Scabies?
Besides treating all household contacts and washing or isolating potentially contaminated items, avoid close skin-to-skin contact with others until you have completed the prescribed treatment and are no longer contagious. Notify any sexual partners or close contacts so they can seek treatment as well. This is paramount for successful eradication of scabies in the home and community.