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How can scabies be treated?

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Dr. Prof. Kunal Saha

General & Family Physician

Practicing since :1954

Answered : 4232 Questions

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Posted on Thu, 19 Apr 2018 in Skin Hair and Nails
Question: Hi Doctor ... I'm in the Philippines and fear I may have contracted scabbies from a sexual partner. We slept together 4 weeks back and when I woke up in the morning I noticed the skin on the side of her face peeling. At the time I did not think much of it ... think I even made a joke about exfoliation or too much make up etc.

However 5 days ago I started getting itchy testicles (side of the legs, scrotum sack and towards the rear but not actualy in the anus) after a long day and night working on the computer. I initialy thought this was just jock rash as I had been to the gym earlier and not changed my shorts on the ride home or for a few hours after. Its hot and swetty here so that seemed the logical answer, hence I went and got Lamsil cream and rubbed it on but this made no difference.

A day later I concluded that I must have maybe picked something up from a sexual contact. I had slept with another partner a week ago. She had nothing to indicate scabies but I assumed maybe I had contracted genital lice. I went and got lice shampoo (something called Licealiz with 20 mg/10ml Pyrethrin). I was now starting to feel a crawling sensation across the body especialy on my face and my head and still had itchy testicles. I washed from head to toes, three times leaving the shampoo on twice for about ten minutes. Overkill I know, but I was starting to feel paranoid. I focused on the hair areas, pubic area including anus, armpits, legs, arms, head eyebrows etc. I especially focused on the face, and head. Thinking this must have done the job I went to bed.

In the middle of the night I woke up with a buzzing feeling like something small was a crawling across my face especialy around my cheeks and top lip. My testicles were realy burning at this point. It freaked the hell out of me and I went to check in the mirror. I had two days stuble at that point but I noticed some dry skin and when I rubbed it small, pieces came off like having a facial peel. I shaved and rubbed it all off. It was not a lot very small pieces from the cheek area. And once it was cleared nothing else came off. But it scared me and I went on the computer.

I knew it could not be pubic or body lice as I had treated for this and over killed. Believe me I scrubbed from head to toe and more. Thats when I read about scabbies. So in the morning I went to the local hospital and saw a dermatologist. She was way to relaxed and I was way to stressed. She did not even do any scrapings and initialy wanted to send me home with out any treatment. We both looked for marks but I have nothing realy visible yet. But I read how the sooner you tackle scabies the quicker it will heal so pushed her to give me something. She gave me a pescription for Kwell lotion, some hydro cortison (a steroid for my scrotum) and antihistemiens. When I got home I put the hydro cort on my testicals and this helped alot. So maybe I had done this to myself. I bagged all my stuff, left my bed's matress outside, washed the floors and all furniture utensils and surfaces with bleach and hot water, had a shower and another Pyrethrin shapoo and then treated myself with the kwell lotion. The deramtologist here had said to put the lotion from neck to toe, but I included the head and rubbing head to toe, focused between the hand and foot digits (as demonstrated in a youtube video) ... as i deninitly had sensations on the face I made sure I did this area too. Thats why I also did a further shampoo. Then I took an antihistamien and went and slept on the coach which I had previously cleaned.Despite being 6ft and cover in lotion the anthistamien did its job and I slept fairly well.

I woke up feeling better and washed the lotion off. The shampoo I had washed off the night before after 10 minutes. Stripped my clouthes and put of fresh under wear I had bought ... and re-bleached the floor. I felt a few tingles and noticed my hair rise around the feet area, so I grabbed the last of the Pyrethrin shampoo and getting the hottest water I could stand washed my lower legs focusing between the toes and on the nails again as well as the hands up to and including the elbow. Yes I was paranoid for sure. I also tried to keep my feet in the hot water as long as I could. I finished with another shower and shampoo. A quick one this time.

I then went and got clouthes I had put on the line 3 days ago and had washed with boiling water ... because they were all I had. I know maybe not the smartest ... but I read that scabies die from heat and exposure after 3 days so I thought I would be fairly safe. Everything I have used all day has been bleached and kept in the freezer part of the fridge. I am still feeling tingles and crawling sensations but there is no more serious itching. I read this can be from the chemicals and the mites working there way out of your system and I'm hoping this is true ... I thought I felt more tingles towards the late afternoon evening ... but then I had an antihistimien later this morning and thought maybe this was also just wearing off.

I'm doing the best I can here but what are my otpions. I know I'm being paranoid ... but everyone else seems far to relaxed and I fear having crusted scabbies as I definitly felt a lot of things crawling in many places not just one and definitly on the face as well. Tonight I'm going to leave it and see what happens in the morning. If I'm feeling better I will go for a surf and see if the salt water maybe relaxes the sensations. I'm suppose to go see the dermatologist in a week, but was tempted to go and buy Invermectin tablets and just make double sure. I'm not going partly because I want to have faith and see if this worked, but more because the doctor said they dont have these tablets here in the Philippines ... or at least thats what the she said (internet seems to indicate other wise).

I guess my big fear here is crusted scabbies, because other than my testicals burning and itching in the beginning I only felt wierd buzzing crawling sensations ... no serious itching. I know taking both medicines is the prescribed treatment for crusted scabies. I also know that scabies is linked to HIV and I guess I a little terrified knowing that this is only the first step of the process. But I had protection. I'm try to get answers off the initialy person I slept with but she is being evasive, not answering my questions and now not answering my calls. I also dont remember her scratching at any point ... so hence maybe she does not even realize hence the feer of crusted scabbies.

All advice and help greatly appreciated.

Is there a smell associated with scabies ... or am I smelling the pyrethrin. Because I can smell something on my skin and I am pretty sure I smelt the same thing on the woman I slept with. Maybe she was using pyrethrin too?


By the way, I am following this up using Aloe Vera moisturizer. As a way of soothing the skin but also because I heard aloe vera can kill scabies. I try to rub my whole body every night ... and also have access to wild aloe vera plant which I rub on key areas, between toes and hands and any itchy points I feel. I was using this before against jellyfish stings which are common here when surfing.
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Answered by Dr. Prof. Kunal Saha 5 hours later
Brief Answer:
Likely to be due to a fungal infection.

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone carefully through your query and understand your concerns. Going by the description it seems that you have a fungal infection. Although it should have responded to Lamisil (terbinafine), I would insist you to try Candid (clotrimazole) powder topically instead.

The description does not point to scabies. Scabies does not have any smell. You are possibly smelling something on your skin (assuming that you have applied it). Pyrethrin is not something that one goes around applied on the skin. It is applied and subsequently washed off. So, it is unlikely that the woman had applied it.

I have never heard that aloe vera kills scabies. I doubt if the information is correct.

It is perhaps worthwhile to visit a dermatologist and to get yourself evaluated.

Let me know if I could help further.

Regards
Above answer was peer-reviewed by : Dr. Prasad
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