COMMON CONDITIONS: SKIN, HAIR, AND NAIL PROBLEMS

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Scabies
Scabies is an infestation caused by a mite that burrows just under the skin surface. At first you will have intense itching, which is worse at night. You may then notice little bumps and tiny, pencil-like lines (burrows); these usually develop between the fingers and toes and on the elbows and wrists, but may occur anywhere on your skin. Scabies is troublesome rather than serious. Anyone can catch it, regardless of age and personal hygiene, through any type of skin-to-skin contact or simply by sharing bedding, towels, or clothing.

Scabies infestation on a hand and fingers

See your doctor first

Make an appointment to see your doctor if you think that you have scabies. He or she will check if you have the condition and prescribe the appropriate medication.

DRUG REMEDIES Scabies lotions usually contain the antiparasitic drugs lindane or permethrin. Your doctor will prescribe an appropriate preparation. Usually, the treatment is applied to your entire body (but not your head and face). Trim your nails short and apply it under your nail tips. Babies under 2 years and elderly people may need their face and scalp to be treated as well. The preparation is usually left on overnight and then washed off in the morning. A second application may be necessary, depending on the type of lotion used and your symptoms. Antihistamines (see p.178) can help relieve itching. Sedative types make you drowsy, and are particularly useful at night. Calamine lotion (see p.179) helps relieve the itchiness that occurs in scabies.

What you can do yourself

For best results, start scabies treatment as soon as the symptoms appear. This may be anything up to 8 weeks after infestation, and the itching can last for several weeks. Use a prescription cream or lotion for treating scabies (see DRUG REMEDIES, right).
G

You can relieve itching with calamine lotion and/or take an antihistamine if itching is making it difficult for you to sleep (see DRUG REMEDIES, right).
G

Make sure other people in the home and close friends are treated, even if they are not showing signs of scabies. Ask your physician to provide enough treatment for all household members.
G G Scabies mites can live for 12 days in clothes and bedding. To kill the mites, wash clothes, bed linen, and towels in hot water and dry in a tumble dryer if possible. Wash personal items such as hairbrushes as well. G Vacuum carpets, rugs, furniture, and cushions because they may harbor the scabies mites. Use a disposable bag in your vacuum cleaner and discard the bag afterward. If you have a bagless vacuum cleaner, empty it and wash it out after use.

Relieving itching Itching can persist for several weeks after the infestation has cleared up, so you may need to continue using calamine and/or an antihistamine.

Seek further medical advice

Arrange to see your doctor if:
G You are still itching more than 2 weeks after finishing your course of treatment G The rash becomes sore and starts to ooze

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COMMON CONDITIONS: SKIN, HAIR, AND NAIL PROBLEMS

Urticaria
Urticaria, or hives, is an intensely itchy rash of white or yellow swellings (wheals) surrounded by red, inflamed skin. It is usually caused by an allergic reaction, which can be triggered by a range of factors, such as certain foods or medicines, insect bites, or stings. People with hay fever or asthma are more susceptible. Hives can also be caused by stress, or have no obvious cause.
See also Anaphylactic shock, p.159.
WARNING

Seek immediate medical help if you have urticaria and:

G You become breathless or hoarse, or start to wheeze G Your lips or tongue swell and/or you have difficulty swallowing

See your doctor first

Make an appointment to see your doctor to confirm that you have urticaria and/or to check whether you are taking medication that could be triggering the attack.

DRUG REMEDIES Antihistamines (see p.178) control allergic

swelling and itching. You may need to try several types to find out which works best for you. The drug may need to be taken regularly for a prolonged attack of hives. Ask your pharmacist for advice.

What you can do yourself

Urticaria is extremely uncomfortable, but the following measures will help relieve irritation and soothe the skin. Attacks are usually short-lived, but some people have persistent symptoms. Take an antihistamine to reduce itching and swelling (see DRUG REMEDIES, right).
G

Calamine lotion (see p.179) is a soothing

preparation with a cooling effect. Using a cotton ball, dab it onto the rash 23 times a day.

NATURAL REMEDIES Oatmeal products (see p.187) are often effective for soothing itchy skin. Add oatmeal oil to lukewarm bath water and soak for 1020 minutes.

Take a cool shower to reduce the redness and heat of the rash. Alternatively, hold a cool compress (a clean washcloth soaked in cool water and wrung out) against the rash for a few minutes at a time. Keep reapplying for about 30 minutes.
G

PREVENTION Preventing urticaria If you have

recurrent attacks, try these measures of prevention. Keep a diary of attacks, and try to identify any foods, medicines, or other factors that may trigger them. Once you find a trigger, you can try to avoid it. G If you think stress is a contributory factor, try self-help techniques (see STRESS, pp.2021).
G

You can also relieve itching with calamine lotion (see DRUG REMEDIES, right).
G

Try an oatmeal bath oil (see NATURAL REMEDIES, right) to relieve itchy skin.
G G Minimize irritation by wearing loose-fitting, lightweight clothes made of natural fibers.

Seek further medical advice

Arrange to see your doctor again if:
G

Urticaria is not responding to treatment