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Scabies: Tips for managing


What to do if you have scabies

Scabies is a common skin condition caused by the human itch mite. People get scabies when the mite burrows into the top layer of their skin to live and feed. When the skin reacts to the mite, an extremely itchy rash develops.

If you suspect you have scabies, follow these tips from board-certified dermatologists to help you get rid of the mites.

The mite that causes scabies is hardy. These tips can help you get rid of the mites.

  1. If you think you have scabies, don’t be embarrassed to see a dermatologist. Some people do not seek medical help because they feel this reflects poorly on them. This is not true. People who are very clean and neat can get scabies. People of all ages, races, and income levels get scabies.

  2. Everyone you had close contact with needs treatment. Scabies is very contagious. If you get treatment and people with whom you live or have close contact do not get treatment, you can get the mites again. People do not have to have signs and symptoms of scabies to have mites on their skin. Someone who has never had scabies may not have any symptoms for two to six weeks.

  3. If your dermatologist prescribes a medicine that you apply to your skin, be sure to take a bath or shower before you apply the medicine. You should then massage the medicine onto clean, dry skin. The medicine must remain on the skin for 8 to 14 hours. You will then wash off the medicine. For this reason, most people apply the medicine at bedtime and wash it off in the morning.

  4. Apply the medicine from your neck to your toes. This includes all skin between your neck and toes—the skin around your nails, the crease between your buttocks, and the skin between your toes. Infants, children, and the elderly often need to treat their scalp, temples, and forehead. You should never apply medicine to the nose, lips, eyelids, nor around the eyes or mouth.

  5. If you wash your hands after applying the medicine, be sure to reapply the medicine to your hands. Mites like to burrow in the hands, so it is important to treat the hands. Be sure to apply the medicine to the skin between your fingers.

  6. The day you start treatment, wash your clothes, bedding, towels, and washcloths. Mites can survive for a few days without human skin. If a mite survives, you can get scabies again. To prevent this, you must wash clothes, sheets, comforters, blankets, towels, and other items. Be sure to follow these instructions when washing:

    • Wash all items in a washing machine, using the hottest water possible.
    • After washing, dry everything in a dryer, using the hot setting.
    • If you cannot wash something in a washing machine and then dry it in a dryer, take it to a dry cleaner or seal it in plastic bag for at least one week.
    • Items that have not touched your skin for more than 1 week generally do not need washing. If you are not sure whether you wore clothing or used an item within the past week, be sure to wash and dry it.

    Wash and dry items the day you start treatment

    Washing clothes, bedding, and towels is necessary to get rid of the mites that cause scabies.

  7. Vacuum your entire home on the day you start treatment. Vacuum carpeting, area rugs, and all upholstered furniture.

  8. Do not treat your pets. The human itch mite cannot survive on animals. Pets do not need treatment.


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References
Habif, Campbell, Chapman, et al. In: Dermatology DDxDeck. 2006. China. Mosby Elsevier. Card #92: Scabies.

Jacobson CC, Abel EA. Parasitic infestations. J Am Acad Dermatol 2007; 56: 1026-43

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