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General Information: Persistent Rashes: Scabies

Persistent Rashes: Scabies
Scabies is a highly contagious, but curable, skin disease that affects nearly 1/3 of a billion people worldwide. It is caused by a tiny mite, just barely visible to the naked eye, that spends nearly its entire life in, or on, the human skin. Although more common in warm climates, scabies can occur anywhere and within all social and income levels. It affects men, women and children of all ages from infants to the elderly.

Because of its highly contagious nature, scabies is easily transmitted from person to person through close physical contact such as between family members, sexual partners and children playing at school. Although scabies mites cannot live long without a human host, there have been a few cases of apparent transmission through infested clothing and bedding. Even so, heroic cleaning efforts are generally unnecessary. Normal, hot water laundering of towels, linens and all clothes used within the previous 48 hours is typically sufficient to prevent reinfestation. Clean clothes or heavy winter jackets and sweaters need not be cleaned.

The safest and most effective topical treatment for scabies is called Elimite (permethrin) 5% cream. It kills the mites and relieves the itching. Elimite cream is proven safe for children as young as two months old. To avoid reinfestation, your doctor may recommend that all affected household members be treated at the same time within the same 24-hour period.

For treatment, thoroughly and gently massage Elimite cream into all skin surfaces from the head to the soles of the feet. It is critical to apply Elimite cream on every square inch of your body and not just on the rash. Apply between the finger and toe creases, in the folds of the wrist and waistline, in the cleft of the buttocks, on the genitals and in the belly button. Keep your nails clipped short.

Scabies mites can hide under your fingernails. Leave the cream on for 8 to 14 hours then remove it by bathing and shampooing. You may notice a mild itching, burning or stinging sensation after applying the cream. This is usually just a minor, temporary reaction to the medication. For infants, younger children, and the elderly, follow the same instructions as above, except also apply Elimite cream into the additional areas of the neck, scalp, hairline, temples and forehead. If you wash your hands or any other area of your body during the treatment period, new cream must be reapplied immediately. It is not unusual for the itching and redness to continue for as long as two to six weeks after treatment. These symptoms may be a temporary reaction to the remains of the mites. This does not mean the Elimite cream did not work or that it needs to be reapplied. If you feel that the itching and rash are excessive or persistent, consult your physician.

The most effective oral treatment for scabies is ivermectin (Stromectol). A single dose of ivermectin can eliminate scabies. This oral dose is especially useful for patients who cannot adequately apply topical permethrin due to physical or mental disability.


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