[Question #7207] Scabies - failed treatment

8 months ago
Hello, I caught scabies by some unknown reasons. I treated them with Permertin 5% lotion, applying carefully on affect areas- in week 7th- I had rashes and intense itch again. The rashes/scabies has Even extended to Entire body which the areas was not infected before. I keep applying permethrin 5% four times entire body no use/treatment failed/new rashes keep developed. My question are below:- 
1. I think I have tried all first line treatments, bb lotion 25% failed as well. I want to know for complicated scabies in this cases (no sexual partner but keeping re infection/treatment failed). What is the successful rates of oral ivermectin ? Does the ivermectin sold by Vet is the same in human ivermectin? . If I taken Ivermectin- how long will I stop infecting others after intakes?  2. Prevention management - I am actually seeing a guy and we will start sex / skin touching very soon, for his protection, can he taken ivermectin too for precaution and prevention? How many hours he has to take before touching me? How many percentage of prevention he will get if he taken ivermectin in advance? 
If I use oral ivermectin- what is the time I can have sex again? (With condom). 
How will I know if my scabies mites all dead? 
I think I caught this 3 years ago- in this case do I need longer treatment? Because the scabies is too long? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
8 months ago
Welcome back. But these really aren't STD issues -- certainly a borderline topic for this forum. Scabies is best viewed as a sexually transmissible infestation, but not usually sexually transmitted. It's commonly shared by sex partners, but not necessarily by sex itself. And scabies treatment is more in the domain of dermatology, not STDs. STD clinics often treat scabies when diagnosed, but if the problem persists or recurs, we would refer the patient to a dermatologist. And that's what you should do:  see a dermatologist. To your specific questions:

1. I believe ivermectin is always effective, but so is permethrin lotion. Seems to me it is possible your continued rash is something other than scabies -- maybe an allergic reaction triggered by scabies? Therefore, I would guess you are no longer infectious for other persons. I have no knowledge of whether veterinary formulations of ivermectin are the same as human or safe for human use.

2. For these reasons, I doubt your potential new partner would be at risk of catching scabies from you.

I am unaware of any data that scables can last 3 years. I suppose it is possible, but this too is an issue for a dermatologist, not an STD specialist.

Sorry I can't be more precise, but I hope these comments are somewhat helpful. Good luck to you.

HHH, MD
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8 months ago
Ok I agree- I think the new rashes could be the allergic reactions to mites cells/waste which lingers in the dead skin cells after mites dead. Plus more it could be ecmeza more than anything. If the guy is still scared, I recommend he takes Ivermectin- that has prevention purpose as well? Thanks. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
8 months ago
I have never heard of ivermectin being used prophylactically, and would advise against it since you probably don't have scabies anyway.

It is true that allergy to mites and their debris explains delayed clearing of symptoms of scables. But that rarely if ever lasts more than 3 weeks.

Please do see a dermatologist. There's no way you should be trying to diagnose or treat yourself for this problem.
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8 months ago
Ok no problem. Yes the rash is on my chest and legs now. I will go to skin doctor 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
8 months ago
Good move. Thanks for the thanks; I'm glad to have helped.---