What causes scabies?
Patient: We were just moving into a new apartment and my girlfriend's daughter's boyfriend was helping us move things in for several days.  About 76 hours ago, before my girlfriend took him home for the night I remember him telling me he was itchy.  about 15 hours after that, 67 hours ago she saw him at a local store picking up medication.  When she asked what it was he apparently said, "oh, my doctor said I've got chiggers or something" and she looked at the medicine he was prescribed and called me at work to look it up.  The medication was Permethrin Cream, 5%.  I looked it up and found out it was for scabies treatment.  Within the next day, he was apparently very badly broken out; within the next day and a half following that his girlfriend, my girlfriend's daughter with whom he's had considerable contact with, was broken out and my girlfriend  had complained the night before had an itchy bump on her hip.  That evening my girlfriend and her daughter went to the doctor and were tentatively diagnosed with also being infested with scabies. A skin scrape was done on each but the labs haven't come back yet as it was a Thursday and they were told it would be at least 3-4 days before the lab results came back.  Both have lived in the same apartment since the news and have been in contact with many things in the apartment.  Since it was immediately after/during the move-in many thing were still yet unpacked.  A lot of the large furniture had been moved around (many times to see how it looked) by the boyfriend and two other people at the same time, as well as me and my girlfriend separately on the last occasion (the one he told me he itched badly as he left).  For three nights I slept with my girlfriend there.  The night before they went to the doctor we had about 20 minutes contact where she manually stimulated me with lubrication and held each other off and on throughout the night.  I was home very little after the initial move to help move things around and touched very few things after I got home late at night after waking up, but I did move the furniture (suede-like cover) and only wore clothes that the original infested person did not touch.  There were, however, things (clothes and otherwise) in our bedroom he did carry that were on the carpet.  I showered in a hot shower, as I always do, every morning before and after this became evident.  As soon as I found out I have never returned to the apartment, have not had any physical contact with my girlfriend or anyone else for that matter.  I am still showing no signs and used about a quarter tube of Permethrin cream on myself the day we all found out.  I'm staying at my parents' house at the time, as the doctor my girlfriend saw advised, for a week or longer.  I still can't really tell any signs but am getting ready to give myself a second treatment of the Permethrin cream as I was not aware I should wear full covering clothing and not wash it off for 24 hours.  I applied the cream fairly thinly except my hands, arms, feet, ankles and genitals (as we had had prolonged contact at that point the night before).  My girlfriend has sprayed things in the apartment down with anti-lice spray after vacuuming but has just nearly three days later gotten to wash all the clothes that were on the floor in bunches of hangers because they were not yet put away.  Mine have been washed in hot water and dried on high heat, as hers have (considering neither of all have been done yet); mine have been delivered to me without her ever touching them (had her wear long rubber gloves) and I have also washed and dried them at my parents' house without me ever touching them.  I have never had scabies before and read that symptoms may take 4-6 weeks to manifest.  My girlfriend and her daughter have both had them within the last year for the first time and have manifest symptoms soon after exposure.  What are my chances of being infested, infesting my immediate family (with which I've had fairly minimal contact now) and what is my best course of action?  --  Thank You for Your Advice -- Travis Doctor: Hello ,Thank you for your question .  (Scabies )Scabies is a condition of very itchy skin caused by tiny mites that burrow into your skin. The itching is caused by an allergic reaction to the mites.Scabies spreads very easily from person to person. It can affect people of all ages and from all incomes, social levels, and living situations.With treatment, the scabies mites die and the itching goes away over a period of days to weeks. Without treatment, the mites continue to reproduce under the skin, causing more sores and itching.Scabies has two main symptoms:Severe itching that is usually worse at night. Small children and older adults tend to have the worst itching.A rash with tiny blisters or sores . Children tend to have worse skin reactions than adults.How is it treated?you need to use a special cream,These products contain permethrin.Permethrin 5% cream (Elimite) is the treatment of choice for scabies. Permethrin 5% cream is applied to clean, dry skin. For best results, clip and clean all fingernails and toenails. Permethrin is usually left on the skin for 10-14 hours and then washed off in the shower. It is best to apply permethrin at bedtime and then wash it off in the morning.Lindane 1% cream or lotion is an older medication that is rarely used because it is potentially toxic to the nervous system (leading to symptoms such as dizziness or seizures). Some scabies have become resistant to Lindane.Ivermectin pill(s) (Stromectol) is an oral medication that is active against several parasites. It is not FDA-approved for use in scabies but has been used in cases with very heavy infestations. Ivermectin is not used in small children or in women who are pregnant or breastfeeding.Malathion 0.5% lotion (Ovide) is usually used for head lice and is not approved by the U.S. FDA for the treatment of scabies. It is irritating to the skin. It must be used only as directed and should be kept out of the reach of children because ingestion may cause organophosphate poisoning.Benzyl benzoate lotion is an older treatment for scabies. It can be irritating to the skin, especially in people who have eczema.Crotamiton lotion or cream (Eurax) is approved for use in adults with scabies. Treatment failures with this drug are more common than with permethrin.Sulfur-based lotions, creams, or soaps have been used but are less effective than other options. They should not be used in people who are allergic to sulfa.Most creams or lotions are applied to the entire body from the neck down. In most cases, you leave the medicine on for 8 to 14 hours and then wash it off. Be sure to read and follow all instructions that come with your medicine.To make sure that all the mites are killed:Wash all clothes, bedding, and towels that you used in the 3 days before you started treatment. Use hot water, and use the hot cycle in a dryer. Another option is to dry-clean these items. Or seal them in a plastic bag for 3 to 7 days.Clean and carefully vacuum the room or rooms used by the person who had scabies.After treatment, the itching usually lasts another 2 to 4 weeks. It will take your body that long to get over the allergic reaction caused by the mites. Antihistamines (such as Benadryl), steroid creams, or, in severe cases, steroid pills can help relieve itching.If you still have symptoms after 4 weeks, you may need another treatment. and visit doctor.I wish was helpful for  youBest regardsDr. Ahmed Habib