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Have crusted scabies, get relief from Permetherin and Ivermectin but comes back. Permanent cure?

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Posted on Fri, 6 Sep 2013
Question: I need a Doctor who specializes in getting rid of crusted scabies ! I have been to 4 dermetoligests , last one said he didn't know what to do more Permetherin and Ivermectin knock them back for awhile they come back in a week or less , I've done all the things I'm to do and even moved out of my house for a week , even froze phones and any thing that I cannot scald with boiling water
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Answered by Dr. Vidya KR (2 hours later)
Hi, Thanks for using XXXXXXX

1. For crusted scabies topical permethrin 5% cream is presently the preferred topical scabicidal agent. So your doctor has selected a right drug for you.

2. But treatment failure is common in this condition. So you should always use combination treatment regimens like topical permethrin 5% cream with oral ivermectin.

Since you have used it and not benefited you can use benzyl benzoate as a 25% emulsion with the contact period is 24-36 h with oral ivermectin.
This may be help you as it is effective in permethrin resistant crusted scabies and in patients with relapses after a single treatment with ivermectin. But discuss with your dermatologist before its use.

2. Early recognition and treatment is required here. Now for time being, you should take precautions to avoid its outbreak. Always wash your clothes and beddings with hot water. Never mix your clothes with any one.

3. I advice you to get checked for your blood sugar levels and HIV test to rule out any of these.
As crusted scabies occurs mainly in immunocompromised patients, so chances in diabetes, human immunodeficiency virus-infected patients and use of immunosuppressive agents are more commonly affected.

4. You can take symptomatic treatment like antihistamines for pruritis and an emollient for dry skin.
If any secondary bacterial infection then it should be aggressively treated with broad-spectrum antibiotics.

Hope I answered your question. Consult your doctor for further examination and management. Feel free to ask me if you have any further queries.
Wish you good health. Take care.

Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Vidya KR

General & Family Physician

Practicing since :2011

Answered : 1561 Questions

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Have crusted scabies, get relief from Permetherin and Ivermectin but comes back. Permanent cure?

Hi, Thanks for using XXXXXXX

1. For crusted scabies topical permethrin 5% cream is presently the preferred topical scabicidal agent. So your doctor has selected a right drug for you.

2. But treatment failure is common in this condition. So you should always use combination treatment regimens like topical permethrin 5% cream with oral ivermectin.

Since you have used it and not benefited you can use benzyl benzoate as a 25% emulsion with the contact period is 24-36 h with oral ivermectin.
This may be help you as it is effective in permethrin resistant crusted scabies and in patients with relapses after a single treatment with ivermectin. But discuss with your dermatologist before its use.

2. Early recognition and treatment is required here. Now for time being, you should take precautions to avoid its outbreak. Always wash your clothes and beddings with hot water. Never mix your clothes with any one.

3. I advice you to get checked for your blood sugar levels and HIV test to rule out any of these.
As crusted scabies occurs mainly in immunocompromised patients, so chances in diabetes, human immunodeficiency virus-infected patients and use of immunosuppressive agents are more commonly affected.

4. You can take symptomatic treatment like antihistamines for pruritis and an emollient for dry skin.
If any secondary bacterial infection then it should be aggressively treated with broad-spectrum antibiotics.

Hope I answered your question. Consult your doctor for further examination and management. Feel free to ask me if you have any further queries.
Wish you good health. Take care.

Regards