Skincare - Elimite
What are Scabies?
Scabies is a highly contagious skin condition caused by microscopic mites called Sarcoptes scabiei. These tiny mites burrow under the skin and lay eggs, leading to intense itching and a pimple-like skin rash.
Scabies mites are spread through prolonged, direct skin-to-skin contact with someone who is infested. The mites can quickly spread to sexual partners, household members, and others who have close physical contact. Scabies outbreaks commonly occur in places where people are in close quarters, such as nursing homes, extended-care facilities, child-care centers, prisons, and homeless shelters.
When a female scabies mite burrows into the skin, it forms tiny tunnels where she deposits eggs. After hatching, the larvae climb out onto the skin's surface, molt into a nymphal stage, then develop into adult mites, which mate and continue the cycle. The burrowing and movement of the mites under the skin causes intense itching, which can be worse at night. A rash of small, raised bumps similar to pimples or hives also appears where the mites have burrowed.
Symptoms of Scabies
Scabies causes an extremely itchy rash that can look like many other skin conditions.
Rash - The scabies rash often appears as tiny blisters or bumps on the skin that may be very itchy or sore. The rash tends to appear in the webbing between fingers and toes, around wrists and elbows, under arms, on the stomach, lower back, buttocks, thighs, genital area, penis, and breasts. Babies may also develop a rash on the head, neck, palms, and soles of the feet.
Intense itching, especially at night - Scabies often cause the most intense itching at night because the mites tend to be more active in the evenings. The itching and rash can affect sleep and quality of life. Scratching may provide temporary relief but can also damage the skin.
Sore skin from scratching - The severe itching leads most people to scratch the affected areas aggressively, often while sleeping. This scratching can cause the rash to become raw, sore, and inflamed. Scratching also increases the risk of secondary skin infections.
Small burrows visible on skin - In some cases, small scabies burrows may be visible on the skin. These appear as tiny raised and crooked grayish-white or skin-colored lines on the skin surface. The burrows indicate the path the female mites took as they burrowed into the skin. Not all patients will have visible burrows.
Seeing a doctor can help diagnose scabies since the rash can resemble other conditions like eczema, hives, or allergic reactions initially. Getting an accurate diagnosis is key to receiving prompt and proper treatment.
Risk Factors for Scabies
Scabies are highly contagious and spread quickly between people through direct, prolonged physical contact. Understanding the risk factors for scabies can help prevent transmission.
The most common risk factor for contracting scabies is close personal contact with an infected person, such as holding hands, hugging, sleeping in the same bed, or sexual contact. Scabies easily spreads to sexual partners and household members of infected individuals.
Overcrowded living conditions also facilitate the rapid spread of scabies. Populations at highest risk include people in nursing homes, extended-care facilities, prisons, childcare facilities, and refugee camps. In these crowded settings, scabies can quickly reach epidemic proportions through person-to-person transmission.
Those with weakened immune systems have an increased susceptibility to scabies. Infants, young children, the elderly, malnourished individuals, and people with HIV/AIDS or taking immunosuppressant medications are at greater risk for severe symptoms and complications. Their weakened immune function makes it more difficult to fight off the mite infestation.
By understanding and mitigating these risk factors - avoiding close physical contact with infected individuals, maintaining good hygiene, and boosting immune function - the likelihood of contracting scabies can be reduced. However, scabies can still affect anybody, so prompt treatment is important if symptoms develop.
Dangers of Untreated Scabies
Scabies often lead to very itchy rashes that cause infected sores and scabs from constant scratching. The pruritic symptoms tend to worsen at night.
If scabies are left untreated, the infestation can spread across the body and the itch-scratch cycle can lead to bacterial skin infections. The constant scratching can also result in skin thickening and darkening called scabietic nodules.
Immunocompromised individuals are at risk of developing crusted scabies (also called Norwegian scabies), an aggressive form of scabies with thick crusty sores harboring high mite numbers. Crusted scabies is very contagious.
Scabies is easily transmitted through direct skin-to-skin contact and can quickly spread among families, roommates, nursing homes, daycares, jails, and other community living settings if left untreated. Even if one family member gets treatment, the mites can persist on infected clothing, towels, bedding, or furniture allowing reinfestation if proper cleaning is not done.
What is Elimite Cream?
Elimite is the brand name for a topical scabicide cream that contains 5% permethrin as its active ingredient. It is available by prescription only.
Elimite is classified as a scabicide, which means it is designed to kill scabies mites and their eggs. Permethrin is an insecticide that works by disrupting the function of the nerves in insects. When permethrin comes into contact with scabies mites, it causes paralysis and death.
As a topical medication, Elimite cream is applied directly to the skin. When used as directed, it is effective at killing the mites that burrow in the skin and cause the intense itching associated with scabies infestations. It also kills mite eggs, helping to stop the infestation and reinfestation.
Elimite requires a prescription from a doctor, who can confirm the diagnosis of scabies and provide instructions for proper use. It is not approved for the prevention of scabies, only as a treatment. The 5% permethrin concentration in Elimite has been shown effective in clinical trials for treating scabies.
How Elimite Cream Works
Elimite cream contains 5% permethrin as its active ingredient. Permethrin is an insecticide that kills the Sarcoptes scabiei mites that cause scabies.
When applied to the skin, permethrin paralyzes and kills both the adult mites and their eggs. Elimite works by disrupting the function of the mites' nervous system through blockage of sodium ion exchange.
To effectively treat scabies, it is essential to apply Elimite cream thoroughly over the entire body from the neck down.
Elimite is left on the skin for 8-14 hours before washing off. This extended contact time allows the permethrin to fully penetrate the layers of skin and maximally kill all mites and eggs. Typically only one application is required to fully eliminate a scabies infestation.
Leaving Elimite cream on overnight helps ensure it has sufficient time to penetrate burrows and kill all mites hiding in the skin. The next morning, patients should shower or bathe to wash away dead mites and eggs.
Effectiveness of Elimite
Elimite cream is highly effective at curing scabies, usually requiring only 1-2 treatments. This makes it more effective than over-the-counter remedies like permethrin which often fail to fully eliminate the infestation in a single application.
Compared to other prescription scabicides, Elimite often works more quickly to kill the scabies mites. In clinical trials, a single application of Elimite resulted in cure rates of over 90% after 2 weeks. Other prescription treatments may take up to 4 weeks to fully cure scabies.
The active ingredient in Elimite, permethrin, is a powerful insecticide that rapidly paralyzes and kills mites. A thin layer of Elimite cream can penetrate deep into the skin and continue working for several days after application. This helps ensure that any newly hatched mites emerging from eggs are also destroyed.
While oral prescription pills are also available, Elimite is often preferred as the first-line treatment due to its balance of safety, effectiveness, and speed. Just a few applications spaced 7-14 days apart can provide relief of symptoms and ensure no mites remain alive long enough to reproduce and re-infest the skin.
Proper Application of Elimite
When using Elimite cream to treat scabies, it is important to apply it properly in order to get the full benefit of the treatment. Here are some tips for applying Elimite:
Apply a thin layer of Elimite cream over all areas of the body from the neck down. It is important to treat the entire body, not just the obviously affected areas.
Pay close attention to the areas between the fingers and toes, under the nails, and on the palms of the hands and soles of the feet. Scabies mites can hide in the skin folds and crevices of the hands and feet. Applying Elimite thoroughly to these areas is key.
Take a shower or bath before applying the cream. This removes excess oils from the skin and allows the Elimite to absorb better.
Apply the cream to cool, dry skin. Do not apply it immediately after a shower or to moist skin.
Do not take a shower or bath again for 8-14 hours after applying the Elimite. This gives the medication time to kill the mites before washing it off.
Be sure to apply the cream to all members of the household at the same time. This prevents re-infestation.
Properly applying a thin layer of Elimite cream over the entire body and leaving it on overnight allows its active ingredient, permethrin, to fully penetrate the skin and kill the scabies mites. This provides the best chance of completely eliminating the infestation with a single application.
Safety Considerations
Elimite cream is generally safe when used as directed, but there are some precautions to be aware of:
Not for use in eyes. Elimite cream should never be applied inside or around the eyes, as it can cause irritation. Be careful to only apply it to affected areas of skin.
Avoid mouth and nose. Do not allow Elimite cream to get inside the mouth or nose. Contact with mucous membranes can result in irritation.
Can be mildly irritating if left on too long. It's important not to leave Elimite cream on the skin longer than prescribed. Usually, it should be washed off after 8-14 hours. Leaving it on too long can cause mild skin irritation in some people.
Repeat after 1 week if live mites are still present. If signs of a scabies infestation persist after the first application, it's recommended to repeat the treatment after 1 week. This ensures any eggs that may have hatched are also eliminated.
When using Elimite cream, be sure to follow the instructions carefully. While generally safe when used as directed, taking the proper precautions can help avoid potential side effects. Let your doctor know if any worrisome reactions occur after using this medication.
When to See a Doctor
Even after properly applying Elimite cream, your scabies rash may persist in some cases. You should follow up with your doctor if your rash has not improved after 2 treatments with Elimite.
It's also important to make an appointment if you experience severe itching or signs of skin infection like oozing blisters, crusting skin, pain, swelling or fever. Scabies that spread to the face or scalp region can indicate a more aggressive infestation as well.
People with weakened immune systems are at higher risk for complications from scabies. If you have a condition like HIV/AIDS, are undergoing cancer treatment, or take immunosuppressant medications, contact your doctor promptly if you suspect a scabies infection. Your doctor may prescribe additional treatments beyond Elimite to fully eliminate the mites.
Seeking prompt medical attention is advised if your scabies are severe or persist after properly using Elimite. Your doctor can provide further evaluation and prescribe alternative medications as needed to relieve your symptoms and address the underlying mite infestation.