One of the most common questions/comments I get on this site is about symptoms persisting after treatment.
Perhaps you have done your permethrin/ivermectin/scabies mask following all the guidelines, but two or three weeks pass and you’re still getting signs of scabies.
For example, you may have spots still appearing after scabies treatment, or the itch is still there, or you just have a “crawling” feeling on your skin.
The good news is, these are all perfectly normal symptoms.
It is very normal for you to have persisting scabies symptoms up to four weeks after treatment.
There are several reasons for this.
First, if you’ve treated properly, you should have killed all the mites and eggs under your skin. However, these dead mites and eggs are still under your skin.
It will take some time for your body to expel them.
This is where the itch comes from.
Sometimes, it can take 1-2 months before your body has managed to expel all the dead matter.
The second reason is, these dead mites and eggs are an irritant, and this can cause rashes to break out on your skin.
If you have rashes that look like scabies rashes/eczema/allergies, that’s likely what is happening. Your body is reacting to having foreign matter under your skin’s surface and is flaring up.
This is no different to when your skin is exposed to other allergens and you break out in hives or rashes.
The third reason is, the treatments you use for scabies can indeed be quite harsh on the skin.
For example, permethrin is insectiside. This is technically a poison. If you’ve used permethrin properly, you’ve coated your entire body in it. Obviously lathering your body in a poisonous substance and leaving it on for eight hours is not good for your skin, and when we use permethrin we need to do this twice in seven days!
Your skin is not used to this, and obviously doesn’t like it. It is normal for your skin to react while it’s trying to normalise.
The final reason you might notice scabies symptoms after your treatment is your mental state.
Scabies is very stressful and mentally taxing! Imagine having parasites under your skin that you can’t even see affecting your sleep, your relationships, your day-to-day life for weeks on end!
What this can do is make you very paranoid about your skin condition, to the point where every little rash or bump on your skin gives you anxiety or worry.
A small rash on your hand that you wouldn’t even think twice about on a normal day, can almost give you a panic attack after you’ve just been through scabies.
“Oh my goodness are they back? Did I not get rid of them!?”
All of these factors above can lead to your body having rashes and scabies symptoms persisting for some weeks after your treatment.
Some people call this “post scabies syndrome”, or “post scabies anxiety”.
Just remember that if you’ve done the treatment properly, you almost certainly have nothing to worry about.
Try not to stress, the mites and eggs are dead. If you need to, you can do a body mask again just for peace of mind.
You’ve done the hard work. Just let your body find equilibrium again and come back to normal.