Scabies

What is Scabies?
Scabies is a highly contagious disease of the skin which has caused unsuspected and intense itching in man for the last 2,500 years. To contract this disorder does not mean that one is "dirty" or unkempt. In fact, most cases of scabies occur because of incidental contact. Scabies is attributed to a female parasite, which is too small to see with the naked eye. This mite can burrow into the superficial layers of the skin where it thrives. Itching is a result of our bodies attempt to eliminate the mite from the skin.

Scabies Burrows-seen a linear eruptions between fingers and toes.

What are some common symptoms of Scabies?
The most common symptom of scabies is intense nightly itching. The rash from the scabies mite can affect the neck line, fingers, waist line and belly button area. Genitals, breasts, and underarm regions can also be affected. Initially, the rash may give patients a sensation of burning or tingling. Manipulation can result In a linear scratch. This scratch (or burrow) can be examined in order to detect the mite or one of its products. Once a family member has been diagnosed with scabies, it is important that all family members and close contacts are promptly treated.

More burrows- seen on gluteal and posterior neck creases. Rash usually spares the head and face regions.

"The most common symptom of scabies is intense nightly itching."

Who is at risk for developing Scabies?
The scabies mite can infect the rich and poor, old and young. However, the disease is far more common among groups living in crowded conditions. Scabies is most common in those who have close physical contact with others, particularly children, mothers of infants and elderly people in nursing homes.

Scabies Mite-Female tunneling a "burrow" and causing raised rash 

If I contract Scabies., am I at risk for developing other diseases?
Outside of an occasional bacterial infection, scabies infections do not place one at risk for other diseases.

How easy is Scabies to treat?
Thankfully, treatment today is very safe and effective. The therapy most often employed utilizes a special cream Elimite. The cream is applied from the neck down and thoroughly massaged into the skin. It is left on overnight and removed the next morning by bathing or shampooing. Remember to apply the medication thoroughly and liberally. Many patients forget this and just apply the medication where the rash is apparent. For treatment to be successful, it is essential to apply the cream to fingernails, toenails, and in the genital area. If you unexpectedly wash your hands during the treatment period, then you must reapply the medication In this area as well.

Here are a few other things to know about treatment:

• 1. Itching and mild burning may occur after one treatment with your prescribed cream. If this occurs, please let Dr. Harvey and Dr. Hardy know as this may suggest a contact allergy. Typically, itching improves within the first 24 hours after medication application.

• 2. Remember to treat all close contacts at the same time.

• 3. It is important to change all clothes and bed linens and to have affected clothing articles washed at the same time using hot water. Often it is useful to place clothing through an extra rinse cycle to ensure appropriate cleaning. It is usually not necessary to treat sweaters, jackets, furniture, drapes or rugs as the mite cannot survive on these areas for long periods of time.

• 4. Once a family member has been diagnosed with scabies, it is important that all family members and close contacts are promptly treated.

How long am I contagious after treatment? Can I return to work?
You will not usually be contagious after one treatment if you follow Dr. Harvey and Dr. Hardy's instructions. The scabies mite does not usually survive the first treatment however, your rash and itching may persist up to 4 weeks after treatment because of your bodies reaction to mite by-products. Sometimes, Dr. Harvey and Dr. Hardy will have patients reapply their prescribed cream one week after the first application to ensure that all mites are eliminated. He also employees a topical anti-itch compound which contains a mild corticosteroid combined with Sarna lotion. This is kept refrigerated to provide a more soothing and comforting treatment. Finally, an oral antihistamine may be prescribed to help with itching and insomnia. You may return to work after one application of your prescription cream. It is important to let your employer know if you have been treated for scabies so that contacts with other employees can be evaluated. All contacts should be forewarned and, if they have symptoms, they should be examined and followed by a qualified dermatologist.

Overall Review
Scabies is one of the most common disorders that affects man. It is easily treated. If you would like fur your "Complete Skin Care Specialists". We look forward to continuing to serve you and the rest of the First Coast  Area.

Dr. Harvey and Dr. Hardy's  may recommend:

• Lindane I % lotion as directed.

• 6% Sulfur mixed in  petrolatum as directed.

• Elimite (Permethrin) 5% Cream as directed.

• Ivermectin orally as diretced. One dose is usually curative

• To apply thoroughly and gently massage the prescription cream  to all skin surfaces from your head to your feet. Be Sure that infants and elderly patients are treated on the neck, scalp, temple and forehead. The prescription cream should be left on overnight for 8 to 14 hours and removed the next morning by bathing or shampooing.

• It is extremely important to put your prescription cream on every square inch of your body; not just where the rash is. That includes applying it under your fingernails and toenails, around the nail beds, between  your fingers and toes, and in the cleft of \our buttocks and genital area. If you wash your hands or any other area during the treatment period, new cream must he reapplied immediately.

• If itching. mild burning and/or stinging occur after the first application of your prescription cream, let  Dr. Harvey and Dr. Hardy know of this immediately.

• Everyone in the family should be treated at the same time as directed.

• Be sure to change your clothes anti bed linens, and have all affected clothing articles washed at the same time  using a hot water cycle or professional dry cleaning. It is not  usually necessary to clean sweaters, jackets. furniture. drapes, or rugs.

• You will not  usually be contagious after one treatment if instructions have been followed carefully. The scabies mite will be eliminated in a matter of days: however, your rash and itching may persist up to 4 weeks after treatment. This is rarely a sign of treatment failure and is not necessarily a indication  for retreatment.  If itching is excessive or if irritation persists, please consult Dr. Harvey and Dr. Hardy immediately.

• Avoid contact with your eyes. If the treatment cream accidentally gets in your eyes, promptly flush with water immediately.

• Triamcinolone and Sarna lotion. Apply 2 to 3 times daily to help with itching. Keep the compound refrigerated to allow for a more soothing and comforting treatment.

• Use an antihistamine as directed to help with itching and insomnia.

• Be sure to see Dr. Harvey and Dr. Hardy for your follow-up examination in 2 weeks.

If you have any questions, or wish to schedule a consultation,  please call Ponte Vedra Dermatology & Aesthetic Surgery at (904) 285-7546 or email consultation@pvderm.com.