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Thank you for the information. In recent onset itching without an obvious cause (e.g prescription medicines), which is severe and without a skin rash scabies
must always be ruled out first. This is even more so when the itching becomes worse at night. In people with good hygiene scabies hardly has any skin manifestations aside from the itching.
Another reason for ruling out scabies first is that the workup for unexplained pruritis (itching) is extensive
and includes looking for an infective focus anywhere in the body, a blood exam along with a peripheral smear, urine and stool tests and a lastly if everything else is negative a skin biopsy to rule out rare conditions like prebullous bullous pemphigoid.
Lastly scabies is often picked up from communal areas like a gym.
Here is what I would recommend as treatment as of now:
- 5% Permethrin cream to be applied all over the body barring the face and scalp once now and once 7 days after the first application. The cream must be left on the body for 12 hours and then washed off
- Tab Allegra 180 mg once a day + Tab Atarax 50 mg once at night for 2-4 weeks depending on itching
- Tab Ivermectin 12 mg (if body wt>60 kgs), 9 mg (if body wt<60 kgs) - taken once now and once 7 days later (take on empty stomach)
- Wash all the clothes and linen in boiling water or the hot cycle of the washing machine.
All family members or people living with her must be treated with permethrin as advised above even if they are asymptomatic, as usually everyone in the family is affected but only one or two people develop itching.
All of the above will require a prescription and I would recommend discussing my recommendation with your GP. Till you can see the GP take Tab Claritin 10 mg twice a day and apply Sarna sensitive lotion all over the body. Both of these are over the counter products.
The itching in scabies takes 2-4 weeks to subside. If it has not gone even after 4 weeks of taking the treatment detailed above then an alternative cause has to be looked for and the tests I had mentioned earlier will be required.