Tuesday, February 4, 2014

Scabies II

Remember how I got scabies last summer? Thankfully, there has been no reoccurrence and I'm still not clear on where I picked them up in the first place. As I mentioned in my first scabies post, I had some questions about scabies that had difficult-to-find answers. Here's what I came up with, from a combination of what I could find in the scientific literature and my background in physiology.



Is permethrin a poison? Is it toxic? 
Toxicologists use the saying, "the dose makes the poison". The best example of this is water, which can be considered a poison because drinking enough of it in a short enough timespan can seriously harm or kill you. Permethrin is poisonous to teeny tiny scabies at the dose used to treat human infestations, it is not poisonous to the person being treated if used as directed. Read the directions carefully and call your doctor or pharmacist with any questions. The Centers for Disease Control (CDC) states that permethrin cream can be used on children as young as 2 months of age.

Does permethrin get absorbed into the bloodstream? 
Short answer: no, not if used as directed.
Longer answer: The outer layer of skin is made up of dead skin cells and is called the stratum corneus, meaning "horny layer" in Latin, which implies the deadness of the cells and how they can just sort of get sloughed off like layers on an animal's horn. Scabies mites only burrow in this outer layer; they don't go any deeper. Permethrin also doesn't go any deeper than this outer layer of dead cells. It's part of what makes it so safe to use.

What are the best home remedies for getting rid of scabies?
There are no home remedies that will get rid of a scabies infection as well as being treated with medication from a doctor. If you'd like to try some feel free to google but you won't find any here because they simply aren't proven to work.

Why do I need to use permethrin cream at night?
It is convenient to put the cream on when you're going to be laying mostly still for at least 8 hours. It's less likely to rub off or be washed off cuz, you know, you're just laying there. Permethrin also degrades with exposure to light so, theoretically, this could be another reason. It needs to stay on for many hours to ensure it gets absorbed into the tough outer skin cells to get to as many of the mites as possible and night time is just the most convenient time.

Why don't you have to put permethrin cream on your face or scalp? 
Hey, if you wanna shave your head go right ahead but don't blame it on the scabies, they don't really hang out on kid or adult faces because the pH is not to their liking. In the elderly and babies, scabies can be found on the face and scalp because their skin pH is higher and more hospitable to mites. If the hairline and neck isn't treated in these populations, the scalp mites can be a cause of reinfestation but for the average Joe or Jane, it's not needed.

Why does the permethrin cream take so long to work? Eight hours, really? 
The scientific literature doesn't explain why it must be on the skin for 8-14 hrs, just that it does. It's likely the long treatment time increases the amount of absorption (ONLY in the outer layer of the skin) and also ensures the medication will come into contact with as many mites as possible.

Why do scabies itch more at night? Are scabies mites nocturnal or something?
Scabies infestations are highly associated with nighttime itching. So much so there is a paper out there called "Intense nocturnal itching should raise suspicion of scabies". But could I find a paper that explained WHY scabies itch more at night? Nope. The closest I found was a paper examining why, in general, itch is worse at night and they happened to mention scabies as one possible cause of night time itching.

The first likely answer is that at night we are no longer busy with other things so the itch is more difficult to ignore. There are also changes in the way our body does certain things based on time of day, called circadian rhythm effects. Some of these natural changes can contribute to increased itch. At night, our skin temperature increases and mite movement has been correlated to movement: higher temps = more movement. Our bodies also lose more water at night through the skin which can make it easier for the mites to burrow in - think about how things shrink up and contract when they get dried out like, say, sour cream that's been left on the counter for days. The components making up skin can shrink up a minuscule amount leaving microscopic gaps that mites can use to pry in. Finally, corticosteroids are naturally occurring hormones that are at their lowest levels at night. Corticosteroids are normally anti-inflammatory so lower levels may lead to increased inflammation and itchiness. 

Why are scabies associated with dirty places or people?
Scabies infestations are related to crowded places not necessarily dirty places. Nursing homes, prisons, dorms, and schools are all common locations of scabies outbreaks. In the United States and other developed countries, the biggest problem with a scabies infestation is the annoyance of itching and loss of sleep. In other countries, the risk of infection in the open wounds is a serious issue. Scabies themselves don't cause death but infection of the wounds created by the scratching can.

Can I give scabies to my cat/ dog/ mouse/ fish/ rat/ other cuddly pet?
Nope, scabies can't cross species which means the human form of scabies, Sarcoptes scabiei, can't survive on other animals. The opposite is also true, the dog form of scabies, Sarcoptes scabiei canis, popularly known as mange, can't survive on humans but can survive on cats.

My co-worker has scabies and I sat at the same lunch table with him. Am I infected?
Scabies are transmitted by skin-to-skin contact and VERY rarely through infested clothing or furniture. They can only crawl, not jump like fleas, so the skin-to-skin contact has to be at least 10 min... which is why it's often transmitted sexually. Not because the mites are on the genitals (though they do like to go there) but because of the closeness of the act. Sometimes the doctor will prescribe treatment for everyone in a household because of the close contact that families have even if they don't show symptoms.

References 
Fawcett, R. S. (2003). Ivermectin use in scabies. American Family Physician, 68(6), 1089–92.

Hurwitz, S. (1973). Scabies In Babies. American Journal of Diseases of Children, 126, 226–228.

Patel, T., Ishiuji, Y., & Yosipovitch, G. (2007). Nocturnal itch: why do we itch at night? Acta Dermato-Venereologica, 87(4), 295–8. doi:10.2340/00015555-0280

***
Please note: I will no longer publish comments mentioning "treatments" for scabies that have not been scientifically and clinically proven to work. If you have or think you have scabies, please see a medical doctor and use only medically approved treatments. There are many "treatments" and home remedies out there that are very dangerous and unproven. 
***

I am not a medical doctor, none of this is intended as medical advice, and I cannot diagnose you in the comments. If you are concerned about your health, please see your physician.

89 comments:

  1. Thank you for taking the time to find this information and sharing it with us! My daughter came down with scabies and my family is freaking out! We have a family function planned and they are already planning on calling their doctor to get the cream. I printed this information to hopefully ease their mind a little!

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  2. I'm glad it was helpful for you! Did you see the first post I wrote about scabies? http://sicknessisfascinating.blogspot.com/2013/09/scabies-i.html

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  3. Just going through this myself... did you find more bumps in the days after your initial dosage of permethrin? I have found a few more and I'm not sure if that's just residual allergic reaction from these little fu..ers.

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    1. Yes, I did notice more bumps after my first permethrin treatment. I this is due to the delayed reaction to the eggs and feces (gross, I know). If you notice more bumps after your second treatment you might want to go back to the doctor. Be forewarned though, after my second treatment (7 days after the first) I got contact dermitis, which is just a fancy way of saying a bumpy rash all over the place. Cortisol and benadryl helped and it was better than the scabies itch!

      Good luck!

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    2. Commenting from an iPad sucks! I wanted to say, I think you're right that it's the residual reaction.

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  4. Tea tree oil in you bath water then on you skin all night. go get it asap I had em I used it, it works.

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  5. There have been no clinical trials to suggest tea tree oil works to get rid of scabies. If it got rid of your scabies, I don't think you had scabies. Permethrin cream is very inexpensive (mine was $7 without insurance) and has been medically proven to work.

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    1. Intretesting that your cream was 7 dollars. I just unquestionably paid 20 dollars in a scabies killing frenzy at CVS

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    2. $7?! I don't have insurance and it is costing me $110 for a bottle!

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    3. The range in prices is confusing to me and I don't know enough about pharmaceutical pricing to explain it. I'm sorry yours was so expensive. I hope it worked!

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    4. My cream was $76 but was so desperate i would have paid anything for it!

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    5. Dang, I feel robbed now. Mine was nearly $80.

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    6. I'm not sure why the price ranges so much! It is available as a generic so maybe some people get prescribed the brand name (Elimite) instead of the generic (permethrin)?

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    7. Mine was almost 189. That's bull

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    8. My bottle was free at the grocery store and $2 at the pharmacy.

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    9. Mine was $94 without insurance.where do you find it cheaper??I have had cream for a couple days,a little scared to use it due to all saying it's toxic.

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    10. It seems very variable depending on people's insurance or maybe other reasons (location? store?). I hope this post helped you realize it's not toxic to you! Just the scabies. :-)

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    11. mine was 80 with insurance

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  6. Can they get in your scalp? I didn't think so but then scratching and a bump popped up on the back of my neck at the hairline. Thursday will be me and my son's 3rd treatment and my husband's 2nd. Please help

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    1. I agree, just like all mammals, mites most definitely can infest the face and scalp. If not treated there you will continue to get reinfected. From my research (reading Rick Speare from James Cook University Department of Health and Tropical Disease) the origin of the mites not infecting the face and scalp myth was due to the limitations of the medicine being used. One example is Benzyl Benzoate which is an irritant on the face. Then it just became accepted that mites do not infest the face and scalp. I can tell you from personal experience that mites can infect the face and scalp.

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    2. Interesting! All the literature I read was very adamant that "normal" scabies infestations do *not* affect the face and scalp. Norwegian scabies were the only type mentioned that do that - and that is definitely different than the common scabies most people get.

      Thanks for the comment!

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    3. I was curious about that too. My scalp has been itching so bad but I was told it was just dry scalp. We keep getting scabies and I havent treated my scalp.

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    4. As you can see by my replies, I have not read that scabies can reside on the scalp but there is some research that says they can. Check with your doctor before using any treatment in a manner they didn't specify.

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    5. My son passed it to me recently and i can confirm that there are several bumps on my forehead

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  7. From the research I read about it, scabies on the face and scalp generally only happens in the elderly and in babies. There are always exceptions to the rule but I'm not a doctor. You should ask your doctor to take a look! Good luck with your treatment! When I did the permethrin cream I put it on my neck up to my hairline and the bottom of my chin.

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    1. Ya well I'm not that old, 55. And I do believe they are on my face and scalp. So gross! My head is the worst itch of my body, Then my nose and face started itching also. So yes you can get them on face and scalp. I had first perm treatment in Feb, By end of March I was itching and rashy again. Had second treatment then 3rd in 7 days after second treatment. Well guess what, It's been 3 weeks and I'm itching and rashy again! I am exhausted from all the cleaning, vacuuming, clothes, towels and bedding washing every other day. I put everything in plastic bags including pillows after running them through a hot dryer. I am devastated, wake up crying. I cannot hug my children or grandkids. Thankfully they don't live with me, I wouldn't wish this nightmare on anyone. Still have no idea how I came in contact with scabies, I'm not a social person, Go to work and come home. I do handle a lot of money at work, customers hands brushing against mine is the only possible way I could have gotten them. I just hope I can wake up soon from this awful nightmare.

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    2. I did not intend to imply that you were elderly, just that I have not heard of it on the scalp or face in adults. Good luck!

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    3. Hello I am 47 and treated with Permethrin 3 times but because of 5 doctors' misdiagnoses the scabies were in my hairline and scalp. I followed the instructions for neck down but as the mite were repopulating in my scalp I got re-infested quite badly. I did not want to go through 3 additional Permethrin treatments and have been using 10% sulphur soap. It is slow but appears to be working. I have also been very fastidious with cleaning.

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    4. I'm sorry to hear this. I did not come across any scientific studies showing that sulfur soap was an effective treatment of scabies. I hope that you are free from them soon.

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  8. I don't know where you got your permethrin cream for $7, mine was $100 for 60gm. I used it 2x and it didn't work for me. I'm still dealing with them after about 4 months. I didn't sleep in the first treatment but covered myself all over. The second treatment I did sleep in and the bumps came out way worse about 2 days after. So I thought this is normal and have left it now for 3 more weeks and they keep on coming out. I'm very upset and frustrated. Not sure if I should do another 2 treatments but at this point I don't have a lot of faith in permethrin.

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    1. I read that there is something that you can take orally. Im almost to that step too! This is exhausting!

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    2. There is. Please see my first scabies post for a little more info. http://sicknessisfascinating.blogspot.com/2013/09/scabies-i.html

      You'll need a doctor to assess whether the oral drug is needed and a prescription. Good luck!

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  9. I'm sorry you're having such a hard time with this! I can only suggest going back to the doctor or maybe get a second opinion. Good luck!

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  10. Dear Katie

    I am so glad to have stumbled across your posts. i have read almost all the textbook materials out there.

    I was on Malathion for 72hours after being diagnosed. And i reapplied it again after 7 days for 24hours. I am pretty sure that should have wiped them all off. but i started itching right after the last treatment around the abdomen area and i have bumps and a welt that follows the underwear line. I don't think it can be active scabies mites as the treatment was done just 2 days ago.

    what was your experience post scabies treatment and the time frame? i think this would help a lot of people finding answers after treatment as there are so few articles out there on this :(

    thank you very much!!!

    P.

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    1. Hi P.,

      My personal experience was that new bumps continued to appear for a few days but I also got contact dermatitis so it was hard to tell which were from scabies and which were just the general reaction. Everything I have read says that you can continue to see bumps after treatment (maybe for up to a week? if I remember correctly) likely because the allergic response to the eggs and feces is delayed.

      The best advice I can give is to ask your doctor.

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  11. I am exhausted and so depressed I have not been able to work weeks what is terrible as I am self employed. I am like anonymous 21 april I can not clean anymore, vaccum, wash and dry high heat everything you touch. measure the heat in the dryer and the washing machine that is useless at 95 F to kill scabies I have been and my husband treated with peremethrin twice but the bumps are coming back and I start itching at night again after just 1 night of rest. We tried baths in epsom salt, tea tree oil, borax and peroxyde. It helped at the strart but we are back itching. why can not we get ivermectine in usa like in europe. thiis is a nightmare and I will not last long with these sleepless nights, itchy days. they sell spregal in france without a prescription but can not be shipped in usa. I will go cry to my dermatologist to try to get ivermectine but I am sure he will refuse being to early, They are funny you are suppose to itch for an other 6 weeks after the treatment they say. ah I forgot we are also using sulfur soap, sulfur oitment, hot bath to cry from burning and today we sat in our car for 25 minutes under the sun with 140 F degrees to try to kill the beats, we are desperate and depressed. we can not see our family not to spread that terrible pest. I would not wish scabies to my worst enemy.the best part is that we do not go anywhere and we do not know how we caught that pest except a short internal flight, great for next trip I will wrap myself in a bin bag! I m so exhausted. 2015 and we can not get a proper treatment, they have it in africa though and europe ? people are drinking borax laundry detergent and horse paste! Crazy and desperate to do anything?where are the doctors to help? I will end taking my dog medecine or horse one as I see people doing. I don't dare to order ivermectin in canada without a prescription not knowing what poison you are going to receive. last measure, I will travel to europe to get better medecine access and I am from Europe it is so sad to be left like that, so many people sufur physically but also mentally trying anything and reading thousands of blogs on internet before crying again.my beautifull skin is damaged for years or for ever, I can not wear a skirt or a tee shirt anymore with these disgusting red bumps and scares I am ashamed of my terrible skin and I live in a hot State.I have not slept for longtime and I still have to fight these monsters withouut seeing an end to the nightmare. How can you hug or meet your family anymore ? Would you take the risk to give them this nightmare ? I don't and I just can cry again;I am scared to hug my husband and give him more scabies. I am so sorry for this depressive message but it is real hell and prison as you can not tell people you have scabies, they would run for ever.you are just alone. my grand mother is slowly dying and I even can not go see her. We are in hell

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    1. I am so sorry that you're having such a hard time getting rid of the scabies! Having them really does disrupt your whole life.

      It looks like ivermectin is sold under a different name in the US so you should definitely ask your doctor about it.

      I itched very much after I used permethrin due to the contact dermatitis but the rash was everywhere rather than in the trails that scabies leave.

      The only advice I can give is to keep seeing your doctor until you get something that provides relief. Good luck!

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    2. @Anonymous I got scabies from a hotel bed that had dirty linens. I am 37 and yes they are all over my neck and scalp. How I found this site is I wanted to see if the cream could be applied in the hair to stop the crawlers. I found a couple things do help. Neem soap made from real bark will slow down their reproduction and can over time do the trick. Saunas kill the live ones. Today I am using Perm Cream for the 2nd dose. Before getting the neem I found food grade Diatomaceous Earth. Put this on your carpets because mites cannot crawl through it. Before getting the neem I was washing my hair with borax and spraying my body down with hydrogen peroxide. After air drying i would rub a coat of that DE all over. It is not super easy on the skin but it will heal some wounds and perhaps give you that one night of good rest. I have requested the oral med because I believe the scabies I have are known as Norwegian. Those that have this type of invasion cannot expect permethrin alone to win the war.

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    3. There are a lot of home remedies for getting rid of scabies, none of which have been clinically proven and some that can be downright dangerous. Norwegian scabies can inhabit the scalp but its presentation is quite different from common scabies.

      I'm glad you're following up with your doctor and I hope the oral med plus permethrin works for you!

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  12. I have a question. we had these a few months ago, My head itches like crazy not my body anymore. At first I thought it was hair products I was using but nope, not lice. I'm ready to put the cream on my scalp? I've been looking online. I have 5% cream. Do you know if I can put on scalp? I saw directions for lotion, I will dilute with water id necessary. any help here is welcomed

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    1. Check with your doctor first! It is unlikely that head itching is related to scabies but your doctor will be able to advise you.

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  13. I found out I was infected Monday and then put the ($76) Permethrin cream all over my body overnight, woke up washed all my sheets, clothes, and fabrics. Two days later i have many more bumps that are extremely itchy...they are only on my hands. I have tough skin on my hands and I hope the cream worked...Feels like its just getting worse...I have a dog and I know he can not get them but is it possible for him to carry them? -Andrew

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    1. See my first post which explains the contact dermatitis that can occur after using permethrin: http://sicknessisfascinating.blogspot.com/2013/09/scabies-i.html.

      The scabies mite that survives on humans cannot survive on another animal, like a dog. You can ask your doctor if the dog could carry them for a sufficient amount of time to reinfest you but my understanding is that they cannot survive long enough in high enough numbers to cause a reinfestation.

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  14. After my first Permethrin treatment I've developed even more bumps that are not red but white and are more itchy than before I used the cream. Is this a sign that I am sill infected? -A

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    1. Please read my first post: http://sicknessisfascinating.blogspot.com/2013/09/scabies-i.html. In it, I explain that permethrin can cause what's called "contact dermatitis". This may be the source of the bumps you're seeing. I have a picture in that post of my leg with contact dermatitis after using Permethrin.

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  15. Please note the update in the post: I will no longer publish comments mentioning non-scientifically or non-clinically proven "treatments" and home remedies for scabies.

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  16. I was diagnosed with scabies 15 days ago. I used permethrin twice. The first time I applied I got new bumps. Now it is 3 days after 2nd application and i have one new bump and a very tiny red scratch on my wrist. The bump is on my hand. I am freaking out! Can scabies cause a small straight red scratch mark? Or did I scratch myself during the night and I'm just going insane with worry that everything might be from them? I will call my doctor today but I believe she will laugh it off as a scratch.

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    1. Having new bumps after treatment is normal. Could be contact dermatitis or just a reaction from the dead scabies in your skin (I know, super gross; sorry). See my first Scabies post for more on contact dermatitis (with pictures! I got it bad). http://sicknessisfascinating.blogspot.com/2013/09/scabies-i.html

      In my reading about scabies, I haven't seen anything about straight scratch marks - just the curvy trails of bumps. Always good to check with your doctor though. I completely understand about the heightened paranoia while getting rid of scabies!

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  17. Thank you so much for your reply! I'll call the nurse. I was ready to reapply a third round of treatment tonight cuz I still get like a creepy crawly tingling sensation on my face! Your blog has made the most sense and been very helpful.

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    1. No problem! Thanks for letting me know it was helpful. :-) It's my top viewed post by far!

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  18. me and my girlfriend recently had stagnant water come up through our kitchen sink and through the carpets, four - five days ago my girlfriend has had scabies a few years ago and now she has them again but i dont have them at all, is this from the stagnant water ??

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  19. No, they can only travel from person to person. They die after a couple days without a host.

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  20. So i saved a puppy a week ago who was found in the middle of nowhere eating a dead deer carcass. Took her to the vet who was actually lucky enough to actually get a sarcoptic scabie from the skin scrape and see it under a microscope. Its the 1 type of mange that IS transferable from dog to human. I didnt have syptoms at first but to now n only have a few itchy bumbs so tonight i applied the permethrin and after applying i started the hourly process of disinfecting my house. My concern is even tho the puppy is confined and i have the cream on as i type.....i ylhave 2 other dogs in my house. How do i know when its ok to touch them without transferring this to them?

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    1. In all my reading, the only information I found on transfer of scabies from another species (including dogs) to humans was that those scabies can transfer but not *survive* for more than 2-3 days on the human host. If you're concerned about transferring it to the other dogs I would guess it would be ok in 2-3 days, probably less if you used the permethrin cream. BUT I'm not a doctor so please check with your doctor about this!

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  21. I'm so glad I stumbled across this blog! My boyfriend and I have been treating scabies for about a week now, I had it for I know about a month before I was actually smart enough to go to the doctor, I was thinking my bumps were an allergic reaction, because I have very sensitive skin I have a lot of reactions to different things. It's been about a week sense we treated with the 5% permethrin cream and took our 7 ivermectin pills. In the meantime I've been using clove oil in our baths, I mix it with coconut oil and use it all over my body, and I also put it in a lotion for us to use. My question is, is it normal to have new bumps and burrows after treating? I'm on day 6 sense treatment and I discovered a new burrow, or what I think looks like one, does this mean my first treatment failed?? We are both doing our second treatment of permethrin cream this weekend. I'm trying very hard to stay positive but I'm terrified that I won't be able to get rid of these nasty things. I wash our bedding and clothes we wear every single day and I dry them on high heat for 60 minutes, I vacuum daily and disinfect like a mad woman! I treated our car as well as vacuumed our couches, chairs and bed. We even went as far as to cover our couch, chair, and box spring in plastic. I will be furious if we get reinfested! I'm just concerned about my bumps showing up a week after treatment and also my new burrow line.

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    1. I first thought they were chigger bites and waited to go in to the doctor too!

      It is normal to have new bumps afterward because the allergic reaction is still going on but if you have new burrows after the second treatment definitely check with your doctor!

      They can't live off of the human body for more than a few days so your cleaning should have taken care of them. Good luck!!

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  22. This has helped me so much. I m 65 using permethrin and some new bumps but mist of itch gone then my face day and night itches so I m now putting the cream in my face. So relieved to figure this out. I thought it was allergies. The red bites were ofyen curved lines. Thanks for this blog.

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  23. I have used Permethrin once and for the past 2 weeks, I have broken out in itchy red welts over 70 % of my body. They come and, after a few hours, they go away. However, it is getting less manageable. I do believe that I have contact dermititis (essentially, I have poisoned myself.) How long did it take for your Contact Dermatitis to go away? Does it just stop flaring up at once or is it a slow transition? It looks as if I have been burned when the flare up is the worst and many times (although not all,) it happens at 2-3:00 am. I have contacted pharmacists and dermalogists and neither have any idea what I am talking about. Do you have any solutions?

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    1. First off, contact dermititis from permethrin is not "poisoning" yourself. If I remember correctly mine was worst for a few days and then got progressively better over a week. I think you should go in to see a doctor because it may not be related to the permethrin treatment at all. Unless maybe it got on your sheets and you didn't wash them.

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  24. Hi i travel to the dominucan republic and a couple of weeks later i had a rash in my belly area i work at a doctors office and the nurse practitioner told me it was scabies i treated my self with permethrin 4 times this will be the last one i actually have it on now . It has been a nightmare i been crying almost everyday im so stress out. I been having crawling and biting in my buttocks area I don't know if is a side effects from the cream but i hope this will end it. Has anyone had crawling and biting sensation in any areas?

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  25. I'd say you need to ask your doctor about that one. Four treatments of permethrin may have caused contact dermatitis in that sensitive area. Check with your doctor!

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  26. Im new to this site . But i started with a few pimple spots on my arm a month ago and now it looks like a pimple chicken pox on my body . I went to my DR and was told foliculitius a week later worse itching , went to a derm im waiting on skin scraping results but being treated for scabies . I got my rx tonight , do i clean my house , bedding , clothes prior to putting cream on overnight ? I'm the only person in my house hat has the rash so my derm will only treat me .

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    1. Sorry I wasn't able to reply right away. Do what your doctor recommends. I washed everything after my treatment.

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  27. i am new to this site. does permethrin also kill mite eggs? do mites spread on scalp and face? i have heard that children at my age do not get scabies on scalp and face and my age is 12

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  28. Thanks for stopping by!

    Permethrin does indeed kill mite eggs. You're right though, at your age they should not be able to live on your face and scalp. You should see a doctor for a diagnosis.

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  29. How much permethrin was used per treatment? Thanks for the post

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    1. I can't remember if I used one tube or two but, in any case, I can't remember how much was in the tube. Your doctor will be able to tell you how much to use.

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  30. hello,

    Sorry if my comment posts twice but i can't see if it sent properly or not. Thanks so much for your informative blog post!

    My question is just what did you do about clothes / items? I have done the treatment 4 times now and still keep getting reinfested (2 treatments in a row, month in between, now 2 more treatments, but can't tell if it's going or not. hopefully it's going and i'm just having a reaction to the cream but can't tell!)

    Do you know how long they can live off the body? I try to keep items i've worn and rugs and bags etc in a separate room for after I do the treatment , is this enough?

    Thanks

    Amy

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    1. I moderate all comments, that's why it didn't show up right away.

      The rash from the cream should look different from the scabies rash - more diffuse rather than discrete bumps or wavy lines of bumps. Your doctor should be able to tell you which your current rash is.

      They can live off of the body for a couple of days. Bagging up items for 3 days is recommended. If possible, washing and drying in really hot water is good and then you don't have to wait 3 days.

      You can check out my first scabies post for more info if you haven't already. https://sicknessisfascinating.blogspot.com/2013/09/scabies-i.html

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  31. Katie, thanks for an excellent resource. It's so upsetting searching for reliable information about scabies online, because of the misinformation and paranoia out there. I feel for the people who have been living with it for months or years but I'm figuring there are probably gaps in the execution of their treatment plan.

    I have been itching for a little over a month. I thought it was bed bugs (I stay in hotels all the time for work), then thought it was bird mites (qualifird exterminators have now eliminated those possibilities), and finally realized a week and a half ago that my bugs were likely living under my skin! I've seen my dermatologist and he believes I most likely picked this up by lying on a hotel bedspread. Hotels launder their sheets daily but not the bedspreads and blankets, and I did often sit or recline on top of the bed to watch TV. (Never again!)

    I just finished my second treatment of permethrin. I'm worried, though, because this morning I have a dozen new "bites". (I have not had any visible burrow lines with this, just tiny pimple-like bumps, surrounded by red skin when fresh or after bathing in hot water.) Each one seems to cease itching and fade away within a couple days of permethrin treatment (I've been spot-treating them between full treatments). The appearance of new ones makes me think I still have some live mites even now after my second treatment. Do you have any thoughts? (Yes, I will probably call my doctor, too. :) )

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    1. Definitely call your doctor! Getting a rash after treatment is normal but checking with your doctor if things are getting worse is important.

      I talked about the post-permethrin rash in my first scabies post. https://sicknessisfascinating.blogspot.com/2013/09/scabies-i.html

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    2. Thanks! I called and talked to the nurse. She said the appearance of new bumps does not necessarily mean live mites, that bumps can appear as things surface. I'm relieved to hear that, and I'll continue to monitor. (I'm much clearer than I was before my first treatment!)

      What did you do, Katie, as far as cleaning your environment? I've been vigilant about laundering all clothes, bedding, and towels. I just realized I should probably swap out bed pillows, so I'm doing that today. To be extra careful I've been putting a towel down on the seat of my car and on any fabric chair I sit in at home, and change it out every day or two. My doctor and nurse said not to worry about furniture, I just feel better doing it. Did you vacuum any carpet and upholstery?

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    3. Awesome! I'm glad the new bumps are ok.

      It's been so long I can't remember exactly what I did but I'm sure I have commented on it earlier in these comments! I remember bagging some things up for a few days, vacuuming EVERYthing, and washing some things in hot water and drying on hot. I didn't do anything with my car but I did vacuum the couch (not sure if that was necessary but I remember doing it).

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    4. I hope they're okay! I'm actually itchier tonight than ever, but (if it's not my imagination) it feels like a healing itch, like the way a wound itches as it scabs and heals. And many of my spots are darkening and looking more defined, almost like chicken pox. Similar to the photos you took of yours during the recovery process. And I'm not feeling any crawlies, twitches, or pin pricks. So I'm feeling hopeful that my nurse is right and I'm on the road to recovery! Thank you so much for sharing your own experience here. It's so helpful.

      The one thing I haven't done much is vacuum. I think I will do a round tomorrow, especially since it's still summery here and I've been walking around barefoot. (Same reason I've been careful with fabric seats, because with shorts on, my skin is actually coming into contact with those surfaces. Does that seem reasonable?)

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  32. That does seem reasonable. I'm glad you're starting to feel better!

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  33. Katie, thanks for your replies and posts. I applied the permethrin cream 3 days ago. After the first day, I noticed that many more red bumps showed up. They had a gloss look to them (they looked as if they were filled with fluid). Is this normal? Are these caused by the male scabies? Is this treatment working? However, it seemed that all the other spots had a gloss to them including the burrows. In your experience, is this normal? My family and I plan on doing a 2nd treatment 5-6 days after our initial treatment. Also, I have been spot treating with 10% permethrin liquid 2-3 times a day (I purchased it from tractor supply - as you know, it's an insecticide for livestock/horses). Other than causing an irritation to my skin, you don't think this is affecting my current treatment with the cream? Any information is appreciated.

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    1. See my first post: the new rash is normal. http://sicknessisfascinating.blogspot.com/2013/09/scabies-i.html

      But you should see a doctor! Self-treating is dangerous and spot treating is not recommended.

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  34. It is reassuring to read some common sense information. My daughter has a bad case, after holidaying in a hotel abroad, we are in the UK. Now I am itching, as I do her laundry quite often, handling towels etc. I have had 1 treatment, still a bit itchy but didn't do my scalp. I am thinking they must go on the scalp, so I will do that next time. My towels are washed after every use, dried in a hot dryer, also sheets and pillow cases the same, although only every couple of days, as for pillows I have steamed them with my steam iron, may as well boil them to death and pillows are not easy to wash and dry. Maybe I will buy new ones, but have checked them with a magnifying glass and no sign of any mites although admittedly I'm not sure what I'm looking for, other than they are the size of a pin head and have 8 legs (ugh) and are a yellowy colour! Great resource for us worried people :)

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    1. I'm glad my posts were useful!

      Ask your doctor before treating your scalp! It is generally not recommended or needed.

      Rather than steaming pillows, you can put them in a garbage bag for several days and the scabies will die without a human to feed on. Finding them, even with a magnifying glass will be like finding a needle in a haystack so I would recommend sealing them or buying new ones if drying in the dryer hasn't helped.

      Good luck!

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    2. Thanks for the advice Katie, I think I will put my pillows in a zipper bag for a week or so, and use spares that we keep for guests, then vice versa. I did talk to our triage nurse about the scalp, she said if there are any signs on scalp or face, to treat that part too. Thats what I have done, and I hope it has worked, still itching on my back but a bit less each day.

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  35. I've been "cleared" (scabies-free) by my doctor since 24 days ago; saw her last week for a last check-up.
    I still have these random bumps, normally, one on different parts of my body. Today, I have about 8 bumps on my rib cage...should I be worried?
    Also, I've been sleeping well already...no more itch at night. But the appearance of bumps still bothers me. is this normal?

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    1. I'm not sure if it's still normal that far out. Give your doctor a call. :-)

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  36. Thank you for this blog. It has helped me immensely emotionally.

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  37. The ever-present itchiness associated with allergies is due to the activation of H1 receptors on sensory neurons, again by histamine.

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