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Scabies

Scabies is an extremely itchy skin condition caused by infection with the mite Sarcoptes scabeii. Most infections are characterized by severely itchy red bumps and tiny blisters that may predominately reside first in the webspaces on the hands and feet, and then spread to the arms and body. Scabies is extremely contagious and may be contracted by anyone despite extremely rigorous hygiene. It may be contracted from contact with an infected person or contaminated objects.

The mite can not be viewed by the naked eye. The diagnosis is usually made by the physician on the clinical appearance and history of the eruption, or by microscopic examination. The treatment of suspected or confirmed scabies may include oral agents, but routinely consists of the following:

  • Use of prescription topical permethrin 5% cream applied from the neck down at night and washed off in the morning. This treatment is then re-applied in the same exact manner in one week. It is important to apply the cream in an even layer to every part of the body including the genital areas, between the fingers, and between the toes.
  • All clothes and bedding should be washer in hot water and dried on high heat. This is routinely done the morning after topical cream application (described above)
  • Oral agents such as ivermectin may be given to you at the discretion of your physician.

Pregnant females or children under the age of 2 should not be given topical permethrin. A sulfur/petrolatum mixture may be used in the same method as described above.

It may also be necessary to treat everyone in the household on the same night in order to minimize reinfection.

Don Mehrabi MD, FAAD
Dermatologist, Certified by the American Board of Dermatology
Los Angeles, California

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