Scabies spreads from person to person
DEAR DR. DONOHUE: We have an outbreak of scabies in our area. Will you explain how one gets them? Is it by shaking hands or from pushing a grocery cart in the supermarket? How does one get rid of them? — D.S.
ANSWER: Scabies fills people with dread and disgust because they think it comes from poor personal hygiene. It doesn’t. It happens to the very rich, the very poor, the very persnickety, the somewhat hygienically laid-back, the elderly and the young — in short, to anyone. The scabies organism is a mite, a tiny insect. It’s so small that you really need a magnifying glass to see it.
It’s the female mite that causes all the trouble. She passes from infected person to uninfected through normal, daily person-to-person contact, like shaking hands. Off the human body, the mite lives for only 48 hours, so it’s possible but not highly probable to catch a mite from inanimate objects.
Once on the skin, the female mite burrows a tunnel beneath the skin to lay her eggs. The tunnel looks like a white or red thread below the skin. Larvae hatch in two to three days, and in two weeks they are adults capable of producing offspring.
Itching from scabies can be fierce. It comes from the infection and from an allergic reaction to the mite and its waste products. The finger webs (the skin between fingers), the backs of the hands, the wrists, elbows, underarms, buttocks and genitalia are the places where the mite most often makes its home.
Treatment with permethrin is effective. Directions have to be followed carefully. Oral ivermectin also works well. All family members should be treated. Antihistamines and lotions like Calamine control the itch. The itch often lasts for four weeks after the mite has been eradicated. It is not a sign of a need for retreatment.
Laundering bedding and clothes in the hot cycle of the washing machine and dryer gets rid of the scabies mite.
DEAR DR. DONOHUE: I am a 70-year-old man and have been on and off statins since my heart attack 11 years ago. Lipitor is one of the statins I used. When on these drugs, I get mild to moderate muscle pain. Short of taking Darvon Compound, I haven’t been able to find anything that eliminates the pain. Are you aware of any medications that can relieve my symptoms? — R.S.
ANSWER: Coenzyme Q10 might relieve statin-induced muscle pain. Have you tried all the statins — simvastatin (Zocor), pravastatin (Crestor), fluvastatin (Lescol) and atorvastatin (Lipitor)? Switching to a different statin can sometimes be beneficial. Or a reduction in dose might prevent pain.
Or, how about a different cholesterol-lowering medicine? Niacin works for some. Questran and Welchol also bring down cholesterol. So do gemfibrozil and TriCor.
I’m sure you are on a low-fat, low-cholesterol diet and doing some aerobic exercise, like brisk walking. These can reduce your cholesterol level.
DEAR DR. DONOHUE: I am seeking information about what happens after stripping of varicose veins (some 33 years ago). The veins were removed from ankle to groin. My question is: Then what? I am 83. — T.W.
ANSWER: Your question is: How does blood return from my legs after the veins have been removed? Is that correct? The varicose veins that were removed were “superficial” veins, veins that were right below the skin. You have another set of leg veins, the deep veins. They are buried in leg muscles. You can’t see them. Blood returns to the heart from the legs by way of those deep veins after the superficial ones are gone.
You’d be surprised at the variety of ways that varicose veins are treated these days. One procedure involves making a series of barely visible incisions through which the veins are removed in sections. Lasers, heat and injections of solutions that shrivel the veins are other techniques that were not in vogue 33 years ago.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.