Q: I have an intense itching on my body I think might be scabies. Right now I have outbreaks on the back of my neck into my hair, on my buttocks, calf of one leg, and on my stomach. I have been treated four times with Permethrin 5% cream that I left on 12 hours then washed off. Then I used another topical cream but that didn’t working either. I don’t seem to itch so much when I am busy but when I sit down or go to bed, the itching is horrible. No one else in my family has this. I sleep in the same bed as my husband.
My first symptoms appeared two months ago. When one spot clears up, I seem to break out elsewhere. My skin is very sensitive and has a prickly feeling. Do you think this could be something else?
A: There are countless causes for skin to itch that surprisingly enough may include medical conditions such as celiac disease, diabetes, fungal infections such as candida and ringworm, polycythemia, eruptive xanthomatosis (caused by diabetes),allergies, dry skin, eczema, scabies, bed bug bites medications, and still more. Having said this, most itching does not have an underlying, serious condition. A generalized itch is most often more difficult to treat than a localized itch. And, itches of any kind may occur with or without blisters, rashes, lesions, or abnormalities. Some itches may be psychological in nature and the result of stress and anxiety.
As you have considered, topical creams and lotions are commonly prescribed — some of which may be helpful and others which may not be. Any over-the-counter products may include such ingredients as diphenhydramine, camphor, benzocaine, or pramoxine. Keep in mind that some ingredients may cause drowsiness so thought should be given as to when to use them. While products that contain hydrocortisone may be promoted as reducing or controlling an itch, hydrocortisone only helps those itches caused by rashes that are responsive to cortisone such as eczema or seborrhea. The application of cold can often deaden an itch. Thus, placing a cold compress against the back of your neck or other areas of your body or taking a cool shower may lessen the degree of the itch. You may prefer a hot shower or compress that will feel good initially but can exacerbate symptoms later on. Thus, heat should be avoided.
The scabies to which you refer is a highly contagious skin disease that results from infestation of the itch mite known as Sarcoptes scabiei. Because you indicate no one else in your family suffers from your symptoms, you might be able to safely rule this one out, but to be certain, a simple exam with scraping and a microscopic exam might be performed. As a point of information, treatment commonly includes oral or topical drugs, since over-the-counter remedies are ineffective for scabies. Scabies are relatively common and often occur in such areas as nursing homes, schools, long-term care facilities, and in homeless populations.
Your itching and rash can only be diagnosed and hopefully prevented in the future when the underlying cause is determined. Therefore, in my opinion, you should be seen by a top notch dermatologist at the time of an outbreak when he or she can examine the lesions, perhaps take a scraping for analysis under a microscope, and hopefully zero in on whether the condition is from something mentioned or from something else not yet identified.
