Dr. Aouthmany, MD, FAAD
Board Certified Dermatologist
Scabies is a common infestation with the mite Sacroptes scabiei that results in intense itching.
Scabies is acquired by direct contact with someone or something (bedding) infested with the mite.
The mite infects only the skin; it cannot enter the bloodstream or cause internal problems.
Animals such as dogs have their own form of scabies, which can be acquired by humans, but this form cannot reproduce in humans, is self-limited, and requires no treatment.
The only way to definitively diagnosis scabies to obtain a skin scraping from a suspicious area and view it under the microscope for the mite itself, its eggs or feces; there is no “blood test” for scabies.
The average patient often has only 10–15 mites on their entire body, so many times the mite or its byproducts simply cannot be found. Thus, the diagnosis must often be made presumptively based upon the typical symptoms and clinical findings.
5% permethrin cream (Elimite), or with a pill (ivermectin). The cream is used on the entire skin surface from the neck down in adults in a single application, which is left on overnight. It must be applied everywhere (including between the fingers, toes and genital areas). A single application is then repeated in 1 week.
With the pills, a dose of several pills (based on weight) is taken once, then repeated in a week.
In infants, it is generally recommended to treat the scalp as well as the body.
Mites can survive for up to 3 days away from human skin, so the day after treatment all clothing, towels and bedding used within the last week should be washed in hot water; clothes that cannot be washed should be sealed in a plastic bag for 1 week or professionally dry cleaned.
It is generally recommended that immediate family members and anyone who shares a living space with you should be treated as well.
It is not uncommon for patients to experience continued itching for two or sometimes even three weeks after treatment. Your itching should gradually improve, however.