Scabies - causes, symptoms, treatment, prevention

Every year, about 300 million people worldwide suffer from scabies [1, 2]. According to foreign authors [3-8], the incidence of scabies in various regions of the globe is increasing, including in European countries: France, Poland, Belgium, England. Scabies is a global health problem in third world countries [9]. It is an endemic disease in tropical and subtropical regions such as Africa, central and South America, northern and central Australia, and Southeast Asia [10–13]. Scabies is also relevant for the countries of the Middle East. During a mass survey of the population of one of the cities of Iraq (2007–2008), this parasitosis was detected in 11.1% of cases [14, 15].

In Russia, over the past two and a half decades, the intensive incidence rate of scabies has decreased from year to year [16–21]. Compared to 2005, by 2012 its value decreased by 3.5 times - from 132.0 to 38.2 [22-24]. A similar situation is typical for Uzbekistan and Tajikistan [25, 26].

At the same time, by decree of the Government of R.F. No. 715 of December 1, 2004 “On approval of the list of socially significant diseases and the list of diseases that pose a danger to others,” scabies is included in this list [27]. The report of the Moscow Minister of Health noted that in the structure of infectious morbidity in the capital's population, the largest share falls on pediculosis and scabies (54.3%), which is 2.8 times more than the incidence of airborne infections (19.3%) and 3.6 times more than intestinal infections (15.1%) [28]. In official documents of the Ministry of Health of the Russian Federation. It was noted that only cases of scabies are registered when patients visit government medical organizations [29].

Using an anonymous survey of 319 dermatovenerologists in 6 federal districts (FD) of the Russian Federation, significant shortcomings in the registration of scabies were identified. More than 2/3 of dermatovenereologists practice treatment of diseases under other diagnoses. The reasons for deliberate concealment of information are uncertainty in the diagnosis (59.2%), personal request of the patient (19.3%) and reluctance to carry out anti-epidemic measures in the outbreak (18.4%). Trial treatment for scabies is practiced by 86.2% of doctors, and more than half (50.6%) with a positive effect are not interested in registering it [30].

It has been mathematically proven that the real incidence of scabies in the Russian Federation is significantly higher than the official one. Several indicators were used for the calculation: the volume of sold scabicides (benzyl benzoate, spregal, medifox, sulfur ointment) for 2010-2012. (according to Рharmexpert); the absolute number of patients with scabies registered in the ministries of health, defense, internal affairs, and the federal penitentiary service over these years; the use of scabicides for the treatment of other dermatoses and prophylactic treatment of contact persons; course consumption of each scabicide. The real number of patients with scabies in the Russian Federation turned out to be 11.8 times (2010), 12.7 (2011) and 16.1 (2012) higher than officially registered [31]. The data obtained indicate the relevance of the problem of scabies for healthcare in the Russian Federation.

In the Order of M.Z. RF No. 162 dated April 24, 2003 “On approval of the industry standard “Protocol for the management of patients. Scabies" (hereinafter Order No. 162) only two treatment models are given - therapy for typical scabies and post-scabiosis itching. Experience in the system of postgraduate professional education shows that doctors often ask questions about the management of patients with complicated scabies (pyoderma, dermatitis, microbial eczema) and scabies with scabious lymphoplasia of the skin [31].

It is well known that the clinical picture of scabies is determined by several factors: the activity of the mite, the body’s allergic reaction to the pathogen and its metabolic products (feces; oral secretion secreted by the female when making a burrow; secretion of the oviduct glands, which serves to glue eggs to the bottom of the burrow), pyogenic microflora [32 ]. In accordance with the parasitism characteristics of the scabies mite Sarcoptes scabiei

(L.) in humans, several clinical variants of scabies are distinguished: typical, Norwegian, complicated, without burrows, “clean” or “incognito” scabies, with scabious skin lymphoplasia (SCL) and pseudosarcoptosis [33-35]. This classification is officially approved by Order No. 162. In addition, a new clinical type of scabies has been described - scabious erythroderma, the treatment model of which is already included in the “Federal Clinical Guidelines for the Management of Patients with Scabies” [36, 37]. Examination and treatment of a large number of patients with scabies made it possible to establish that the occurrence of microbial eczema in scabies is often confined to the localization of the scabies (buttocks, abdomen, axillary folds) [32, 38, 39]. After resolution of infiltration in foci of microbial eczema, lenticular papules with a diameter of 5-7 mm often become visible, which can persist for several months. In the hot climate of the Republic of Tajikistan, during the examination and treatment of 217 patients with scabies, it was clearly demonstrated that MLS is often the cause of the development of secondary pyoderma [40].

Monitoring the implementation of Order No. 162 in 50 cities of six federal districts of the Russian Federation made it possible to determine the occurrence of clinical variants of scabies in the practice of doctors (Fig. 1) and to determine the need to develop treatment models that are missing in this document [41]. Almost all dermatologists deal with scabies complicated by secondary pyoderma (97.8%), scabies without burrows (92.5%), scabies complicated by allergic dermatitis (89.5%), microbial eczema (74.5%) and scabies with SLK (85.9%). Norwegian scabies was observed less frequently (37.9%). The need to develop models/standards for the treatment of complicated scabies was indicated by 85% of respondents, scabies with LS - 73.4%, scabies without burrows - 66.1%, Norwegian scabies - 46.7% [42].

Rice. 1. The occurrence of various variants of the course of scabies in the practice of dermatovenerologists according to anonymous survey data ().

Complicated scabies occurs quite often, which often masks the true clinical picture of the disease and leads to diagnostic errors. The most common complications are pyoderma and dermatitis, microbial eczema is less common. The incidence of complicated scabies depends on the patient population and is characterized by a wide range of fluctuations - from 2.6 to 83.6% [39, 43-47]. For example, during an active examination of 1094 conscript military personnel, scabies was detected in 119 (10.9%) people [48]. Complicated scabies was registered in 35% of cases. The structure of complications was dominated by pyoderma (86%), allergic dermatitis (14%) and microbial eczema (14%) were less frequently recorded. A combination of complications was registered in 11% of cases. Pyoderma was represented by staphylococcal impetigo (61%), ostiofolliculitis (50%), ecthyma (19%) and boils (11%), combined in 1/3 of patients.

In 76% of military personnel with scabies, limited allergic dermatitis on the buttocks was identified, which is conventionally designated as “gluteal dermatitis.” Clinically, it manifested itself as symmetrical bright red erythema with peeling on the surface the size of a palm. It always occurred with LSK (50%) and in 20% with its absence. The presence in the latter case of many follicular papules indicates infection with larvae, the penetration of which causes severe itching and scratching. Allergic dermatitis occurs, the cause of which is a biological factor [44].

Among patients with scabies treated in a hospital, a complicated process was registered in 33.9% of cases [41]. In the structure of complications, secondary pyoderma sharply predominated (73.8%), characterized by multiple rashes and more severe clinical forms. In the structure of secondary pyoderma, the leaders were ostiofolliculitis (74%), staphylococcal impetigo (54.8%) and ecthyma vulgaris (51.6%). Less common were deep folliculitis (35.5%) and boils (22.6%). Only a third (31.7%) of patients had one nosological form of pyoderma, 2/3 (68.3%) had two or more, and on average 2.4±0.5 per patient. Staphylococcal impetigo was more often combined with ostiofolliculitis and/or ecthyma vulgaris. Almost half of the patients (42.9%) had allergic dermatitis, every fifth had microbial eczema (21.4%). The listed complications were combined in every fourth patient.

The purpose of the study is to analyze the mistakes of dermatovenerologists in choosing treatment tactics for patients with complicated scabies and scabies occurring with LS.

Causes of the disease

This parasitic skin disease does not occur on its own. The source of infection is an already sick person who is in contact with other people. Moreover, most often the direct route of infection occurs at night or in the evening, since at this time the tick is especially active.

The scabies mite spreads more easily and quickly in children's groups, where there is long-term and close contact between children of different ages and their peers. One infected child is enough for everyone to develop the disease.

Main symptoms

The signs of scabies are very pronounced, and it’s simply impossible not to pay attention to them. The main symptom is severe itching, and with the initial infection it begins to bother you after one and a half to two weeks, and with a repeat infection it appears within several days.

The causative agent of scabies is characterized by movement. This is expressed in the appearance of specific grooves - passages in the skin, which often helps to make the correct diagnosis. This is a straight or curved line, the length of which can be 5-7 mm. Nodules and watery blisters measuring 2-3 mm in size also appear. They are found on the wrists and feet.

When scratching the skin, due to severe itching, wounds appear, which later become covered with crusts. There is a great danger of infection here, and then the wounds can turn into ulcers.

Types of disease

Scabies, or as it is also called, scabies, comes in several types:

Typical occurs more often than others and occurs with a clear clinical picture.
Scabies of clean people appears with frequent bathing in the evenings. Manifests itself as single papules, without scratching or itching.
Norwegian occurs in people with immunodeficiency.
There are no passages in the first two weeks from the moment of infection.
Nodular is observed on the genitals, buttocks, and abdomen.
Scabious erythroderma occurs with prolonged illness and the use of ointments that contain corticosteroids.
Pseudochasotka appears after contact with an infected animal.

Scabies is a contagious, itchy human skin disease caused by a specific parasite, the mite Sarcoptes scabiei var. hominis. Another name for scabies, scabies, has been known for more than 2,500 years and came to us from Ancient Rome. However, the Romans originally used the term scabies to refer to any itchy skin condition. The discovery, detailed description of the scabies mite and proof of its role in the development of scabies occurred in the 17th–19th centuries. The name of the mite Sarcoptes scabiei is derived from the Greek words sarx (flesh), koptein (to strike) and the Latin word scabere (to comb) [1].

Worldwide, approximately 300 million cases of scabies are reported annually. People of all age groups can become infected with scabies, from infants to the elderly. Among patients with scabies, young people under 19 years of age predominate (49.5–96.7%), with preschoolers accounting for 10.3% and schoolchildren 49%. The incidence of the disease in girls is 1.4 times higher than in boys [1, 2].

The classic form of scabies affects sexually active people, while the incidence of scabies is approximately at the same level as that of sexually transmitted diseases. Crusted Norwegian scabies occurs predominantly among persons with immunodeficiency, impaired peripheral sensation or motor nerve function, who are bedridden and receiving immunosuppressive therapy [1, 3].

Today, scabies is well treated, but remains a very common disease due to diagnostic errors, inadequate treatment of patients and people in contact with them, and incorrect anti-epidemic measures. This is facilitated by the lack of trained laboratory workers in medical institutions capable of detecting scabies mites in a patient, insufficient introduction of dermatoscopic diagnostic methods into the practice of dermatovenerologists, and reluctance to carry out anti-epidemic measures in the area of scabies. In practice, if a dermatovenerologist is unable to detect scabies mites in a patient with suspected scabies, ex juvantibus anti-scabies treatment is often prescribed.

Scabies mite Sarcoptes scabiei var. hominis is an obligate parasite of humans, spending most of its life in the skin of the host and only during a short period of settlement leads an ectoparasitic lifestyle on the surface of the skin. The entire life cycle of a tick lasts 30 days. After mating on the surface of the skin, the male mite dies, and the female penetrates into the stratum corneum of the epidermis. It makes its way through the stratum corneum, leaving a trail of eggs and excrement, which induce an immunological response, which leads to the formation of various morphological elements on the skin in the lesions. On average, each patient is simultaneously infected with 10–15 adult female ticks. Over the entire life cycle, each female lays 60–90 eggs, of which less than 10% turn into adult females and males within 10–14 days through the stages of larvae (3–4 days) and nymphs (up to 10 days). The rest are destroyed, including due to the patient scratching the skin. If the patient is unable to itch, for example due to impaired motor function, Norwegian scabies may develop [1, 4, 5].

In patients with weakened immunity, in the case of Norwegian scabies, the number of mites in the skin can exceed 1 million. Moreover, mites can survive outside the host’s body for up to 7 days, feeding on fallen crusts and scales on bedding, clothing, and upholstery of furniture. Therefore, failure to comply with disinfection measures can lead to re-infection and relapse of scabies after successful treatment of the patient.

The source of scabies infection is a sick person. Infection occurs mainly in fertilized females that have not had time to penetrate human skin. There are direct and indirect routes of infection. In 95% of cases, infection occurs through direct contact at the moment of physical contact while sharing a bed, sexual contact, and less often when caring for a patient, massage, or shaking hands. With indirect contact, transmission of the pathogen occurs through clothing, linen, bedding, soft toys, and other objects [1].

It is believed that itching, the main clinical symptom of the disease, develops as a result of a delayed-type hypersensitivity reaction, and not direct exposure to the mite. The first rashes usually appear 3–10 days after contact with a tick. The elements of the rash are represented by scabies, papules, vesicles and pustules. Over the course of several days after infection, their intensity gradually increases and skin itching develops. At the same time, scabies tends to intensify at night. Scabies mites are characterized by a strict daily rhythm of activity. Females are active only at night and are dormant during the day. At night, the female feeds intensively; for each egg she gnaws a deep transverse egg knee, and above it in the roof of the passage she makes a hole that serves as an exit for the larva. As daylight approaches, the female stops and freezes. This daily program is carried out synchronously by all females [1, 5].

The clinical picture of scabies is characterized by polymorphism of rashes. Both primary and secondary morphological elements are usually observed. Primary elements are represented by small papules, vesicles, and scabies. Secondary elements can often be the only ones on the skin and include excoriations and hemorrhagic crusts. Therefore, any scratching on the skin, regardless of its cause, during the initial examination of the patient requires the exclusion of scabies. To make a diagnosis, it is important to take into account medical history, the localization of rashes on the skin of the interdigital folds, the lateral surfaces of the fingers, the flexor surface of the wrist joints, elbows, in the navel and lower abdomen, buttocks, on the penis, in the nipple area in women, the presence of skin complaints itching, especially worse at night. In accordance with regulatory documents, the final diagnosis of scabies must be confirmed in the laboratory [1, 4, 6].

There are several methods for laboratory diagnosis of scabies, which are based on light microscopy of a preparation prepared in various ways [1]:

scraping method with mineral oil;
scraping method using alkali;
scraping method using lactic acid;
removing the tick with a needle;
alkaline skin preparation method;
scraping method without blood;
scraping method until blood appears;
superficial cyanoacrylate biopsy (SCAB) [7].

The latter method appeared relatively recently and is widely used abroad. The affected skin is degreased with an alcohol-containing disinfectant, then a small drop of cyanoacrylate glue is applied to a glass slide, which is immediately pressed to the area of typical rashes. After about 30 seconds, the glass is quickly separated from the skin with a quick movement. This procedure is repeated in the same way on other suspicious areas of the skin. The resulting glasses are then examined using a conventional microscope. Instead of a glass slide, special adhesive tape is also used [7].

Results are available from a comparative study of dermato-, scrape microscopy and adhesive tape testing in 125 patients with suspected scabies in endemic settings with limited resources, poor communities, and low-income countries. It was found that although dermatoscopy is not specific, its sensitivity was 0.83, while the sensitivity of skin scraping was very low - only 0.46, with a specificity of 1. The sensitivity of dermatoscopy was also much higher than the sensitivity of adhesive tape - 0.68. The authors recommend using dermatoscopy to diagnose scabies, and if this is not available, the adhesive tape test [8].

Treatment of a patient with scabies is carried out mainly with external anti-scabicides - scabicides. Before starting treatment for scabies, the patient should take a shower with soap and change his underwear and bed linen. In adults, the entire surface of the skin is treated, except for the face and scalp. The drug is applied in a thin, uniform layer, paying special attention to the treatment of the hands, feet, skin of interdigital folds, armpits, genitals, and perineum. Rubbing in the drug should be carried out in the evening, which is due to the nocturnal activity of the scabies pathogen and the fact that overnight exposure to the skin of the drug is sufficient for the complete death of active forms of scabies mites. To avoid the development of contact dermatitis and folliculitis, rub the drug in the direction of hair growth. As part of the specific treatment of scabies, antihistamines are prescribed to relieve itching [1].

The key to successfully treating scabies is identifying and treating all contacts, especially family members. Depending on the agent used, specific treatment is continued for an average of 3 to 7 days, for example on the 1st and 4th days of treatment. After completion of treatment, the patient should also take a shower and change his underwear and bed linen.

Traditionally, sulfur preparations are used to treat scabies in children and adults. For men use 33%, for women – 20%, for children 10–15% sulfur ointment. Treatment is carried out daily for 6–7 days [1, 4].

Benzyl benzoate has been used to treat scabies since 1900. It is preferred by 37% of doctors. It has been experimentally proven that after a single treatment with benzyl benzoate, all active stages of the mite die. Taking into account the maximum period of stay of formed larvae in the egg (58 hours), a water-soap suspension or benzyl benzoate ointment is rubbed once a day at night on the 1st and 4th days of the course of treatment. It is recommended to wash and change linen on the 5th day [4].

The combination drug Spregal is very popular, which is available in the form of an aerosol for the treatment of scabies in adults, infants and older children. One bottle of the drug is enough to treat a family of 3–4 people [1, 4].

Aerosol A-steam was created specifically for the preventive disinfection of premises, clothing, furnishings and bedding. Antiparasitic treatment with A-par is recommended to prevent re-infection after the main treatment has been completed [1, 4].

The most common drug for treating scabies in the world, including in children, is permethrin. In our country, permethrin is sold in the form of a 5% emulsion, from which, according to the instructions, a 0.4% aqueous solution should be prepared to treat scabies. The drug is used daily for 3 days. On the 4th day, the patient takes a shower and changes his underwear and bed linen. It should be noted that permethrin also has an anti-pediculosis effect.

Pediculosis is a specific parasitism of a person by lice that feed on his blood. Lice belong to the category of wingless insects from the order of false proboscis. As is known, three types of lice parasitize humans: head, body and pubic. Their names depend on the areas of the skin surface where these insects primarily parasitize. Interestingly, human lice have been used as a forensic tool. In the sucked blood of a louse that has parasitized two hosts, the DNA of the attacker and the victim can be detected [1, 9].

Pediculosis is transmitted to humans through close physical contact or through passive transmission through combs, clothing, hats, and bedding. Overpopulation, poor hygiene, and sexual promiscuity contribute to the spread of lice. The body of the louse is a vector for typhus and relapsing fever, bartonellosis, the causative agent of infective endocarditis and other diseases in homeless people. Therefore, the spread of head lice in a population leads to many other potential problems [1, 10].

The main clinical symptoms of pediculosis [1]:

itching accompanied by scratching, in some people - allergies;
roughening of the skin from massive lice bites and exposure to insect saliva on the skin;
melasma - skin pigmentation due to tissue hemorrhages and the inflammatory process caused by exposure to saliva;
tangle - formed by scratching the head, the hair becomes tangled, stuck together with serous-purulent discharge, which dries into crusts, under which there is a weeping surface.

Diagnosis of any type of lice is based on examination of the skin and its appendages. Pediculosis is confirmed when eggs (nits), nymphs or mature lice are detected. Using a magnifying glass and knowing where to look for lice based on the biology of the species helps with diagnosis. Wetting the hair with a 5-10% solution of acetic acid and using a comb with a fine, fine comb helps remove nits and lice.

In the treatment of lice, like scabies, there are two aspects. This is the use of specific medications and disinfection. To treat head lice, in some cases, the hair is cut short with a clipper, and mechanical removal of nits and lice is used by combing. For moderate to severe infestation (10 or more specimens, including insects and eggs), pediculicide insecticides are used, for example permethrin in the form of shampoo, lotion or emulsion. The drug is used according to the instructions for use. However, for most products it is recommended to repeat the treatment after 7–10 days [1].

Permethrin and many other pediculicides are neurotoxic. In this regard, their use has limitations, for example in young children.

An alternative to neurotoxic pediculicides is occlusion agents, which block the lice's spiracles. Thus, in the USA, benzyl alcohol in the form of a 5% lotion, which inhibits lice by closing the spiracles, has been approved for the treatment of head lice in children 6 months and older [11].

As an occlusive agent for the treatment of lice pubis, regular petroleum jelly can be used 2 times a day for 7-10 days. Dead lice are removed mechanically, for example using tweezers. To treat pubic lice, the same pediculocides are used as for the treatment of head lice.

To treat body lice, pediculocides do not need to be used, because the pathogen lives on clothing. Clothes are processed by hot washing, ironing or hot drying. Dry cleaning is also an effective way to remove nits and lice from clothing. Thus, disinfection comes first in the treatment of body lice. It is recommended to carry it out using disinfection stations [1].

When scabies and pediculosis are detected, it is necessary to carry out anti-epidemic measures. For each patient, an emergency notification is drawn up in the prescribed form in two copies, which are sent to the disinfection department of the territorial Sanitary and Epidemiological Surveillance Center and the disinfection department of the disinfection station. Each identified patient with head lice is subject to registration in the infectious diseases register. The observation period for a lice outbreak is 1 month, for a scabies outbreak – 1.5 months. When scabies or pediculosis is detected in an organized group, an epidemiological investigation should be carried out with the involvement of an epidemiologist, a sanitary doctor in charge of this institution [1].

Diagnostics

Scabies is a contagious disease. Therefore, it is necessary to diagnose it as quickly as possible and begin proper treatment. Laboratory diagnostic methods, skin scrapings, and dermatoscopy are used. Making an accurate diagnosis will not be difficult for a dermatologist who has already had experience working with patients who have the symptoms described above.

However, the disease caused by a microscopic mite should be distinguished from other similar pathologies - these are urticaria, allergic dermatitis, pruritus.

Top 3. Zinc ointment

Rating (2021): 4.54

138 reviews from resources were taken into account: Yandex.Market, Otzovik, Protabletky

The best remedy for healing the skin Zinc ointment will not help directly get rid of scabies, but it is one of the best and often prescribed remedies for healing and restoring the skin after it has been damaged by scabies mites.

Characteristics
Average price: 45 rub. (30 g)
Manufacturer: Biosynthesis (Russia)
Active ingredient: zinc oxide

Zinc ointment is often mentioned as a remedy for treating scabies. In fact, the drug can only have an auxiliary effect. This ointment will not get rid of the parasite, but it will alleviate the consequences of its effects on the skin. After use, itching is reduced, redness disappears, and the skin recovers faster. It is optimal to use Zinc ointment for scabies as part of complex therapy, but not as an independent remedy. This inexpensive, odorless and colorless medicine is perfectly absorbed, does not leave marks on the skin or clothes, and receives many positive reviews.

Advantages and disadvantages

Budget cost
Relieves itching and speeds up skin recovery
Odorless and colorless, absorbs well into the skin

Does not cure scabies, but only relieves symptoms

Complications

Scabies must be treated from the first day the disease is detected. Otherwise, it can cause many unpleasant complications, which will be very difficult to get rid of. For example, pyoderma, or purulent skin lesions, as well as dermatitis, are very common. It is possible to develop microbial eczema and urticaria, but this is not very common.

With prolonged course without treatment, the likelihood of developing deep folliculitis and impetigo increases. Then you will have to contact a surgeon for treatment. As purulent lesions spread, the lymph nodes may become enlarged, the temperature may rise, and the skin may become sore.

Prevention of scabies

If scabies in one of the family members, it is necessary to use preventive measures to prevent subsequent infection. The patient needs to organize a separate sleeping place and personal hygiene items.
Carpeted surfaces and upholstered furniture must be vacuumed. Wash the garbage bag in a soda solution.
The clothes of an infected person are soaked in a soda solution or boiled in a washing machine with a large amount of powder. Washed items are ironed and steamed using an iron. Outerwear and furniture are treated with a disinfectant.

Needs steaming

Children who spend a large amount of time in groups require parental supervision with periodic examination of the skin surface.
Young people should take into account that infection with scabies mites is possible through promiscuity. Contraceptive methods do not protect against infection.
Treatment of scabies in humans in combination with preventive measures takes no more than a week.

Treatment and prevention

Scabies treatment is usually carried out at home. It is important to eliminate the cause of the disease – scabies. This is done by applying special ointments to the skin - benzyl benzoate, spregal, permethrin, crotamiton. Treatment continues until complete recovery and complete destruction of the scabies mite. Traditional methods of treatment for this disease are absolutely useless.

With proper and timely treatment, complete recovery occurs.

As preventive measures, it is recommended to wash your hands more often, regularly examine the skin of children attending kindergarten and school, wet clean rooms with a disinfectant solution once a week, and wash bedding at maximum temperature.

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Scabies doesn't go away

Julia

December 9, 2021

Hello. In September, itchy nodules began to appear. For a long time I didn’t understand what it was. The location and shape of the rash did not indicate scabies. The dermatologist stubbornly ran away that these were insect bites. The treatment didn't help. Neither antihistamines nor glucocorticosteroids worked. I took a course of dexamethasone. The result only relieved the itching. I went to another dermatologist. They did tests. They diagnosed scabies. Discovered. Sulfur ointment was prescribed for 5 days. The day after application there was a rash all over my body. Tender areas are uniformly red. Don't touch. The ointment didn’t work(((. I bought Medifox. I applied it for 3 days. There was an effect. No itching, the post-scabiosis nodes became gray and even. But a day later new tracts began to appear. In new places. Already just tracts. I tried the sulfur ointment again. I was convinced that that intolerance is evident. Again, terrible satiety and raspberry spots under the weight. I bought benzyl benzoate emulsion. I rubbed it in for 5 days. Terrible burns on the body. Plus an allergic reaction throughout the body. Most likely to the products of the death of mites. Already at the end of treatment with benzyl benzoate, new passages appear again. Treatment again. I returned to Medifox. It relieves itching well. Plus, if the itching is from allergies, I use Akriderm. The itching is unbearable and with allergic rashes over a large area. The entire apartment is treated. I sleep separately. The towels are disposable. Everything is treated 24 hours at a temperature of - 20 - wash at 60 degrees - ironing with steam on all sides to the maximum. I iron everything. Underwear, socks. Phone, remote control, etc. are processed with Medifox. But moves appear. Localization is the outer sides of the arms and shoulders and forearms, the inner surfaces and outer thighs. Hands and feet are clean. The family doesn't itch. We underwent preventive treatment with sulfur ointment once. About treatment with Medifox. After identification. Together with me. 3 days. As per instructions. Very tired. I do not know what to do. It’s confusing that moves appear. Could it be that they are manifesting themselves? And these are old moves? Now I’m on a three-day treatment with Medifox again. Is it possible to increase the concentration of the working solution? Not 0.4%, but more. Does this make sense? Is it worth repeating the course right away? Help me please!!!!!! There is no doubt that this is scabies. Laboratory confirmed. Plus characteristic features. Moves. And I'm afraid to sleep because of the itching. The treatment has been going on for a long time. Almost three weeks. With rare and weak relief. Neurosis, breakdowns. I'm afraid of infecting my family.

Age:

39
Chronic diseases:
Ait

The question is closed

scabies

Top 2. Simple sulfur ointment

Rating (2021): 4.67

154 reviews taken into account from resources: Otzovik, Otabletkah, Protabletky

The most popular ointment Simple sulfur ointment is the most popular product presented in the rating. We found more reviews about it than about other medicines for scabies.

Characteristics
Average price: 45 rub. (25 g)
Manufacturer: Tula Pharmaceutical Factory (Russia)
Active ingredient: precipitated sulfur

Simple sulfur ointment is an inexpensive antimicrobial and antiparasitic agent that will help you completely get rid of scabies in five days. The product has a specific smell, is not always well absorbed into the skin, and can stain clothes. But he copes well with the tasks assigned to him. In addition to getting rid of scabies mites, the ointment can be used for other purposes, including to combat acne and the effects of post-acne. Sulfur ointment receives only positive reviews. All those who tried it to treat scabies were satisfied with the result and were ready to endure discomfort in order to get rid of the disease.

Please note that the drug must be prescribed by the attending physician; use without consultation is unacceptable!

Advantages and disadvantages

Time-tested drug
Affordable price
Getting rid of scabies in 5 days
Can be used to combat acne and post-acne

Unpleasant smell
Leaves marks on skin and clothes