Scabies is a bothersome skin condition caused by tiny mites that burrow into the skin, leading to intense itching and a pimple-like rash. If you suspect you might have scabies, seeing a doctor is crucial for accurate diagnosis and effective treatment. A dermatologist, often referred to as a “Scabies Doctor,” is a specialist in skin conditions and is the best medical professional to consult.
Why Consult a Scabies Doctor (Dermatologist)?
Dermatologists possess specialized expertise in diagnosing and treating a wide range of skin disorders, including scabies. Their in-depth knowledge of skin conditions allows for a precise diagnosis, differentiating scabies from other skin issues that may present similar symptoms. Accurate diagnosis is the first and most important step in effectively getting rid of scabies. Furthermore, effective scabies treatments are prescription-based, meaning you’ll need to consult with a doctor to obtain the necessary medication. Over-the-counter remedies are not effective against scabies mites.
How a Scabies Doctor Diagnoses Scabies
A “scabies doctor” or dermatologist typically begins the diagnostic process with a thorough visual examination of your skin. This involves checking the skin all over your body, from head to toe, to identify the characteristic rash and burrows associated with scabies. While a visual exam can often lead to a diagnosis, to confirm the presence of scabies mites definitively, a dermatologist may perform a skin scraping. This is a painless procedure where the doctor gently scrapes a tiny sample of your skin.
The scraped skin sample is then placed on a glass slide and examined under a microscope. By looking at the slide, the dermatologist can identify scabies mites or their eggs, confirming the diagnosis with certainty. This microscopic examination is the definitive way to diagnose scabies.
Scabies Treatment Options Prescribed by Your Doctor
To eliminate scabies, prescription treatment from a “scabies doctor” is essential. These medications, known as scabicides, are designed to kill the scabies mites and their eggs. Several effective prescription options are available, and a dermatologist will determine the most suitable treatment based on individual needs and circumstances.
Topical Scabies Treatments
For most cases of scabies, topical medications applied directly to the skin are prescribed. Common topical scabicides include:
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Permethrin cream (5%): This is a frequently prescribed first-line treatment for scabies. It is safe and FDA-approved for adults and children as young as 2 months old, as well as pregnant women. Typically, permethrin cream is applied to the entire body from the neck down, usually at bedtime, and washed off after 8-14 hours.
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Crotamiton cream or lotion (10%): This medication is another topical option approved for scabies treatment in adults. It generally requires two applications, applied 24 hours apart.
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Benzyl benzoate lotion (25%): Benzyl benzoate is sometimes used, particularly for crusted scabies, a more severe form of the infestation.
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Spinosad liquid (0.9%): A newer scabies treatment option, spinosad is also approved for treating head lice. It is approved for scabies treatment in individuals 4 years and older.
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Sulfur ointment (5% – 10%): While it has a noticeable odor that some find unpleasant, sulfur ointment is a safe option for babies younger than 2 months old.
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Lindane lotion (1%): Due to potential side effects, lindane lotion is generally reserved for cases where other scabies treatments have failed. It is not recommended for pregnant or breastfeeding women.
Your “scabies doctor” will provide detailed instructions on how to apply the prescribed medication, emphasizing the importance of following these directions carefully. Overuse of scabies medication can irritate the skin and worsen symptoms.
Oral Scabies Treatment
In cases of widespread scabies or crusted scabies, oral medication may be necessary. Ivermectin is an oral medication that can be prescribed for scabies, particularly for crusted scabies or outbreaks in institutional settings. It can be used for children and individuals with HIV. The dosage and frequency depend on the severity of the condition, and it may involve one dose or multiple doses taken over a few weeks.
Who Else Needs to See a Doctor for Scabies?
Scabies is highly contagious and spreads through close, prolonged skin-to-skin contact. Therefore, it is crucial that not only the person diagnosed with scabies receives treatment but also all individuals who have had close contact with them. This includes:
- Household members
- Sexual partners
- Close contacts
Even if these individuals do not currently have symptoms, they should be treated to prevent the spread of scabies and avoid future outbreaks. Consulting a “scabies doctor” for all close contacts ensures comprehensive treatment and prevents re-infestation.
Managing Symptoms and Follow-up with Your Scabies Doctor
While scabicides kill the mites, it’s common for itching to persist for a few weeks after treatment. Your dermatologist may recommend additional treatments to alleviate itching and manage other symptoms:
- Antihistamines: To help control itching, especially at night, and improve sleep.
- Pramoxine lotion: A topical lotion to provide relief from itching.
- Antibiotics: If secondary bacterial infection develops from scratching, antibiotics may be prescribed.
- Steroid creams: To reduce redness, swelling, and itching associated with the scabies rash.
It’s important to schedule a follow-up appointment with your “scabies doctor” to ensure the treatment has been successful and to address any persistent symptoms. Typically, skin should heal within four weeks of effective treatment. If symptoms continue beyond this timeframe, further evaluation and potentially repeat treatment may be necessary.
To prevent re-infestation and eliminate mites from your environment, washing all clothing, bedding, and towels in hot water and drying them on high heat is essential. Vacuuming the entire home can also help remove mites.
Seeking timely care from a “scabies doctor” (dermatologist) is the most effective way to diagnose and treat scabies, ensuring relief from symptoms and preventing further spread of this contagious skin condition.
References
Centers for Disease Control. “Scabies: Medications.” Last accessed August 2, 2017.
Chosidow O. Clinical practices. “Scabies.” N Engl J Med 2006; 354: 1718-27.
Czelusta A, Yen-Moore A, Van der Straten M et al. “An overview of sexually transmitted diseases. Part III. Sexually transmitted diseases in HIV-infected patients.” J Am Acad Dermatol 2000; 43: 409-32; quiz 33-6.
Elston DM. “Controversies concerning the treatment of lice and scabies.” J Am Acad Dermatol 2002; 46: 794-6.
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.
Seiler JC, Keech RC, et al. “Spinosad at 0.9% in the treatment of scabies: Efficacy results from 2 multicenter, randomized, double-blind, vehicle-controlled studies.” J Am Acad Dermatol. 2022;86(1):97-103.
Steen CJ, Carbonaro PA, Schwartz RA. “Arthropods in dermatology.” J Am Acad Dermatol 2004; 50: 819-42, quiz 42-4.
Thomas C, Coates et al. “Ectoparasites: Scabies.” J Am Acad Dermatol. 2020;82(3):533-48.
Last updated: 6/8/22
