Which plants can cause itching and skin irritation. How to identify common itch-causing plants. What are the symptoms of plant-induced skin reactions. How to treat and prevent plant-related skin irritations. Why do some plants cause itching and rashes.

Common Itch-Inducing Plants: Nature’s Skin Irritants

Many plants in nature can cause skin irritation and itching upon contact. Some of the most notorious itch-inducing plants include:

• Poison ivy
• Poison oak
• Poison sumac
• Stinging nettle
• Giant hogweed
• Wild parsnip
• Manchineel tree

These plants contain various irritants that can cause reactions ranging from mild itching to severe rashes and blistering. Understanding which plants to avoid and how to identify them is crucial for preventing uncomfortable skin reactions while enjoying the outdoors.

The Science Behind Plant-Induced Itching: Urushiol and Other Irritants

Why do some plants cause itching and skin irritation? The primary culprit in many cases is a substance called urushiol. This oily resin is found in plants of the Toxicodendron genus, which includes poison ivy, poison oak, and poison sumac.

Urushiol triggers an allergic reaction in most people, leading to the characteristic itchy rash associated with these plants. When urushiol comes into contact with the skin, it penetrates quickly and binds to cell membranes. This process initiates an immune response, causing inflammation, redness, and intense itching.

Other plants use different mechanisms to cause skin irritation:

• Stinging nettle has tiny hairs that inject histamine and other chemicals into the skin
• Giant hogweed contains phototoxic sap that makes skin extremely sensitive to sunlight
• Wild parsnip causes phytophotodermatitis, a reaction that occurs when plant chemicals on the skin are exposed to sunlight

Identifying Itch-Causing Plants: Key Features to Look For

Recognizing potentially harmful plants is essential for avoiding skin irritation. Here are some key features to help identify common itch-causing plants:

Poison Ivy

Poison ivy is known for its clusters of three leaflets (“leaves of three, let it be”). The leaves are typically glossy with smooth or slightly toothed edges. The plant can grow as a vine or a shrub and may have white berries in late summer and fall.

Poison Oak

Similar to poison ivy, poison oak also has leaves in groups of three. However, the leaflets are more lobed and resemble oak leaves. The plant can grow as a shrub or vine and may have clusters of greenish-white or tan berries.

Poison Sumac

Poison sumac is a shrub or small tree with compound leaves containing 7-13 leaflets arranged in pairs. The leaves have smooth edges and a distinctive red stem. In late summer, it may produce clusters of white or gray berries.

Stinging Nettle

Stinging nettle has dark green leaves with serrated edges and tiny hairs covering the stems and leaves. The plant typically grows in dense clusters and can reach heights of 3-7 feet.

Symptoms of Plant-Induced Skin Reactions: What to Watch For

When exposed to itch-inducing plants, various symptoms may develop. These can include:

• Redness and swelling
• Intense itching
• Rash or hives
• Blisters or fluid-filled bumps
• Skin warmth
• Pain or burning sensation

Symptoms typically appear within a few hours to a few days after exposure, depending on the plant and individual sensitivity. In severe cases, additional symptoms may include fever, difficulty breathing, or widespread rash.

Treatment Options for Plant-Induced Skin Irritations

If you’ve come into contact with an itch-inducing plant, prompt treatment can help alleviate symptoms and prevent complications. Here are some effective treatment options:

Immediate Actions

• Wash the affected area thoroughly with soap and cool water
• Remove and wash any clothing that may have come into contact with the plant
• Apply a cool compress to reduce inflammation and soothe the skin

Over-the-Counter Remedies

• Calamine lotion to relieve itching and dry oozing blisters
• Hydrocortisone cream to reduce inflammation and itching
• Oral antihistamines to alleviate itching and allergic reactions

Natural Remedies

• Oatmeal baths to soothe irritated skin
• Baking soda paste to relieve itching
• Aloe vera gel for its cooling and anti-inflammatory properties

For severe reactions or symptoms that persist or worsen, it’s important to seek medical attention. A healthcare professional may prescribe stronger treatments such as oral corticosteroids or topical medications.

Prevention Strategies: Avoiding Contact with Itch-Inducing Plants

Preventing exposure to itch-inducing plants is the best way to avoid uncomfortable skin reactions. Here are some effective prevention strategies:

1. Learn to identify common itch-causing plants in your area
2. Wear protective clothing when hiking or working outdoors, including long sleeves, pants, and closed-toe shoes
3. Use barrier creams or lotions designed to block urushiol and other plant irritants
4. Stay on designated trails when hiking to avoid brushing against potentially harmful plants
5. Keep pets from running through areas where itch-inducing plants may grow, as they can carry the irritants on their fur
6. Remove any known itch-causing plants from your yard or garden (with proper protection)
7. Wash gardening tools and gloves after use to prevent indirect contact with plant irritants

By taking these precautions, you can significantly reduce your risk of encountering itch-inducing plants and experiencing uncomfortable skin reactions.

When to Seek Medical Attention: Recognizing Severe Reactions

While most plant-induced skin irritations can be managed at home, some situations require medical attention. Seek help from a healthcare professional if you experience:

• Severe or widespread rash covering a large portion of your body
• Difficulty breathing or swallowing
• Fever or signs of infection (increased redness, warmth, or pus)
• Rash on sensitive areas such as the face, eyes, or genitals
• Symptoms that persist or worsen after a week of home treatment
• History of severe allergic reactions to plants

Medical professionals can provide stronger treatments and ensure that complications are addressed promptly. In rare cases, severe allergic reactions may require emergency care.

The Impact of Climate Change on Itch-Inducing Plants

Climate change is altering the distribution and potency of many plant species, including those that cause skin irritation. Here’s how climate change is affecting itch-inducing plants:

Expanded Ranges

Rising temperatures and changing precipitation patterns are allowing some itch-inducing plants to expand their ranges. For example, poison ivy is now found in areas where it was previously unable to thrive, potentially exposing more people to its irritating effects.

Increased Growth and Toxicity

Higher levels of carbon dioxide in the atmosphere can stimulate plant growth and increase the production of irritating compounds. Studies have shown that poison ivy plants grown in high-CO2 environments produce more potent urushiol, potentially leading to more severe reactions.

Longer Growing Seasons

Warmer temperatures are extending growing seasons for many plants, including those that cause itching. This means that the risk period for encountering these plants is becoming longer in many regions.

Changes in Plant Communities

As climate change alters ecosystems, it may favor the growth of certain itch-inducing plants over others, potentially changing the composition of plant communities and the risks associated with outdoor activities in certain areas.

Understanding these changes can help individuals and communities adapt their prevention strategies and be more aware of potential risks when spending time outdoors.

Itch-Inducing Plants Around the World: Global Diversity of Skin Irritants

While poison ivy and its relatives are well-known in North America, itch-inducing plants are found worldwide. Here’s a look at some notable examples from different regions:

Australia

• Gympie gympie (Dendrocnide moroides): Known as one of the most painful plants in the world, its sting can cause intense pain lasting for months
• Bull nettle (Urtica incisa): A relative of stinging nettle with similar irritating properties

Europe

• Giant hogweed (Heracleum mantegazzianum): Native to the Caucasus but invasive in many European countries, causing severe phytophotodermatitis
• Wood nettle (Laportea canadensis): Found in woodlands and causing stinging sensations upon contact

Asia

• Chinese nettle tree (Urtica thunbergiana): A large tree with stinging hairs that can cause intense itching and pain
• Manchineel tree (Hippomane mancinella): Native to tropical areas of southern Asia and the Caribbean, all parts of this tree can cause severe skin reactions

South America

• Poisonwood (Metopium toxiferum): Found in tropical areas, causing reactions similar to poison ivy
• Cow itch vine (Mucuna pruriens): A climbing vine with pods covered in irritating hairs

Travelers and outdoor enthusiasts should research local plant hazards when visiting new areas to avoid unexpected encounters with itch-inducing species.

Itch-Inducing Plants in History and Culture

Throughout history, itch-inducing plants have played various roles in human cultures, from medicinal uses to warfare. Here are some interesting historical and cultural aspects of these plants:

Traditional Medicine

Despite their irritating properties, some itch-inducing plants have been used in traditional medicine. For example, stinging nettle has been used to treat arthritis, with the theory that the sting might distract from joint pain or stimulate anti-inflammatory responses.

Warfare and Defense

In some cultures, the irritating properties of certain plants were harnessed for defensive purposes. Native Americans reportedly used crushed poison ivy leaves to coat arrow tips, adding an extra deterrent to their weapons.

Folklore and Superstition

Many cultures have developed folklore around itch-inducing plants. In some Native American traditions, it was believed that only those with pure hearts could handle poison ivy without developing a rash.

Modern Research

Today, scientists are studying the compounds found in itch-inducing plants for potential medical applications. For instance, research is being conducted on urushiol’s potential use in developing new adhesives and its possible applications in cancer treatment.

Understanding the historical and cultural significance of these plants adds depth to our knowledge of their impact on human societies beyond their irritating effects.

The Ecological Role of Itch-Inducing Plants

While itch-inducing plants may be a nuisance to humans, they play important roles in their ecosystems. Here’s a look at some of their ecological functions:

Wildlife Food Sources

Many animals are unaffected by the irritants that bother humans. For example, deer and other mammals often eat poison ivy leaves, while birds feed on the berries of poison ivy and poison sumac.

Erosion Control

Some itch-inducing plants, like poison ivy, are effective at preventing soil erosion due to their extensive root systems and ability to grow in various conditions.

Habitat Creation

The dense growth of plants like stinging nettle can provide shelter and nesting sites for small animals and insects.

Pollinator Support

Many itch-inducing plants produce flowers that support pollinators. Stinging nettle, for instance, is an important food source for several butterfly species.

Ecosystem Indicators

The presence or absence of certain itch-inducing plants can indicate environmental conditions. For example, stinging nettle often thrives in nitrogen-rich soils, potentially signaling over-fertilization in agricultural areas.

Recognizing the ecological importance of these plants helps balance our approach to managing them, especially in natural areas where they fulfill crucial roles in the ecosystem.

Innovations in Protection and Treatment

As our understanding of itch-inducing plants grows, so do the methods for protecting against and treating their effects. Here are some recent innovations in this field:

Advanced Barrier Creams

New formulations of barrier creams are being developed that not only block contact with irritants but also help neutralize them on contact. These creams often incorporate natural ingredients known for their soothing properties.

Urushiol-Binding Compounds

Researchers are working on developing compounds that can bind to urushiol and other plant irritants, potentially preventing them from causing skin reactions or reducing the severity of reactions.

Early Detection Tools

There are ongoing efforts to create portable devices or smartphone apps that can help identify itch-inducing plants using image recognition technology, allowing hikers and outdoor enthusiasts to avoid these plants more effectively.

Improved Treatment Protocols

Medical professionals are refining treatment protocols for severe plant-induced skin reactions, including the use of systemic treatments and light therapy for persistent cases.

Plant-Derived Remedies

Ironically, some plants are being studied for their potential to treat reactions caused by other plants. For example, compounds derived from the jewelweed plant are being investigated for their ability to counteract poison ivy reactions.

These innovations offer hope for better prevention and more effective treatment of plant-induced skin irritations in the future, making outdoor activities safer and more enjoyable for everyone.

Plants that can make you itch

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Poison Ivy, Poison Oak, and 7 Other Plants That Can Give You a Rash

Poison ivy is found across the United States. You can come into contact with it while hiking in the woods, but it grows virtually everywhere — along roadsides, on fences, in backyards. Poison ivy leaves grow in clusters of three on vines that can grow up into trees or trail along the ground. Every part of the plant contains the compound called urushiol, which causes poison ivy’s notorious rash — the vine, the roots, the leaves, the flowers, and the berries.

A poison ivy rash typically appears a few days after exposure, and can even take a week or two if this is your first time in contact with the plant. When it does, you’ll know it: You’ll see very red skin, swelling, and blisters, and you’ll feel a serious itch. A strong corticosteroid skin cream or ointment can help with the inflammation. Your doctor may prescribe other medication if the inflammation is severe, to either suppress your immune system or to help further reduce the reaction. Anti-itch topical creams may also help.

RELATED: How to Treat Poison Ivy and Reduce Discomfort

2. Poison Oak: Not Related to Oak Trees

Stinging nettle is the best-known member of the nettle family. It grows throughout the United States as well as in Europe, Asia, and North Africa. The plant tends to grow in dense patches near streams, along hiking trails, in ditches, and around farmland, often where the earth has been disturbed.

The stems of stinging nettle are singular, with few branches, and can grow 6 to 8 feet tall. The stems may be green or purple and may or may not have stinging hairs. The petioles (stem parts of the leaf) and undersides of the leaves also have stinging hairs.

The leaves of stinging nettle are longer than they are wide, and dark green, 2 to 4 inches long, with a tapered tip. Clusters of whitish flowers grow at the base of each pair of leaves along the stem.

Coming into contact with stinging nettle causes a sharp, painful sting, followed by a burning sensation and sometimes itching. The irritation can linger for several hours and cause hives near the site of contact which can last up to 24 hours.

Stinging nettle is sometimes gathered for food or to make into tea. It has long been a folk remedy for joint pain, eczema, arthritis, gout, and anemia. Cooking deactivates the stinging properties of stinging nettle.

6. Baby’s Breath: Irritating When Dried

If you’ve ever gotten roses from a florist, chances are they were clustered with sprays of tiny white or pink flowers known as baby’s breath. You might also see baby’s breath in cultivated perennial gardens.

Baby’s breath generally isn’t an irritant while it’s still alive, but when it’s dried, it can irritate the eyes, nose, and sinuses, as well as the skin. It can additionally cause asthma in people who touch it frequently, such as floral industry employees.

The skin irritation caused by baby’s breath is usually minor and temporary.

People who have become sensitized to baby’s breath and are having asthma reactions ideally should stop handling it.

Interestingly, double-flower varieties of baby’s breath tend to cause fewer reactions than single-flower varieties, so if you’re planting it in your garden or have a choice when ordering a bouquet, go for the double-flower option.

7. Leadwort: Look but Don’t Touch

Giant hogweed is an invasive plant in Europe and North America and, according to the New York Department of Environmental Conservation, a “federally listed noxious weed” in the United States.

Contact with the sap of giant hogweed can cause serious skin and eye irritation, blistering, scarring, and even blindness if the sap gets in the eye. The skin rash may look like a second-degree burn and can leave you with long-lasting scars and sensitivity to sunlight.

Giant hogweed sap is phototoxic, which means it requires exposure to ultraviolet light to cause a reaction. If you touch giant hogweed — or think you might have — keep the exposed area away from sunlight for 48 hours, and wash it with soap and cold water as soon as possible. If you get sap in your eyes, rinse them with water and wear sunglasses. See a physician if you have a reaction.

You can recognize giant hogweed in part by its size: It can grow to 14 feet high or higher and has hollow, rigid stems 2 to 4 inches in diameter. Its deeply lobed, compound leaves can grow up to 5 feet across, and its white, umbrella-shaped flower heads, can be up to 2.5 feet across. The stems of giant hogweed are green with purple splotches and coarse, white hairs.

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Modern approaches to the diagnosis and treatment of scabies | #05/12

Scabies is a contagious parasitic skin disease caused by the scabies mite Sarcoptes scabiei, accompanied by itching, worse in the evening and at night, and papular-vesicular rashes.

Currently, scabies remains one of the most common parasitic dermatoses in our country.

An increase in the number of patients with scabies usually accompanies wars, natural disasters, social upheavals, due to population migration, economic recession, and worsening social and living conditions.

As mentioned above, the causative agent of scabies is the scabies mite – Sarcoptes scabiei . This species belongs to the family Sarcoptidae, group Acaridiae, suborder Sarcoptiphormes, order Acariphormes. Representatives of the genus Sarcoptes are currently known as parasites of more than 40 host animal species belonging to 17 families of 7 orders of mammals.

The morphological appearance of scabies mites of the Sarcoptidae family is extremely peculiar and is due to deep adaptations to intradermal parasitism. The structure of scabies itch, like most mites, is characterized by a strict constancy of the microstructures of the external skeleton, which is associated with their microscopic size.

The female scabies mite looks like a turtle. Its size is 0.25–0.35 mm. Adaptations to intradermal parasitism are represented by multiple setae, triangular outgrowths of the cuticle on the dorsal surface, spines on all tarsi that serve as stops during gnawing, gnawing-type chelicerae, and long elastic setae on the tarsi of the hind pairs of legs to maintain the direction of travel only forward. Devices for ectoparasitism are sticky pneumatic suction cups on the front legs, waxy bristles on the body and limbs, which create an extensive mechanoreceptor sphere around the tick and allow one to navigate by touch without eyes. The rate of movement of the female during the course is 0.5–2.5 mm/day, and on the surface of the skin 2–3 cm/min. Scabies mites are characterized by sexual dimorphism. The main function of males is fertilization. They are much smaller in size – 0.15-0.2 mm, have dense bristles on the body to protect against mechanical stress and suction cups also on the IV pair of legs for attaching to the female during mating. The ratio of females and males in scabies mites is 2:1.

The life cycle of the scabies mite is clearly divided into two parts: short-term cutaneous and long-term intradermal. Intradermal is represented by two topically separated periods: reproductive and metamorphic. Reproductive is carried out by the female in the scabies she gnaws through, where she lays eggs. The hatching larvae emerge from the passages to the surface of the skin through holes made by the female above the site of each clutch, settle on it and penetrate into the hair follicles and under the scales of the epidermis. Here their metamorphosis (molting) takes place: new individuals (females and males) are formed through the stage of proto- and telenymph. Females and males of the new generation come to the surface of the skin, where they mate. Daughter females migrate to the hands, wrists, feet, penetrate the skin and immediately begin to make passages and lay eggs. In rare cases, the introduction of females is possible in other areas of the skin (buttocks, axillary regions, abdomen, etc. ) due to mechanical pressing. Clinically, this corresponds to scabious lymphoplasia of the skin. Only females and larvae are invasive stages and participate in infection. At room temperature and relative humidity, at least 60% of females remain mobile for 1–6 days. Even at 100% humidity, females on average withstand up to 3 days, larvae – up to 2 days.

Scabies mites are characterized by a strict daily rhythm of activity. During the day, the female is at rest. In the evening and in the first half of the night, she gnaws through one or two egg knees at an angle to the main direction of travel, in each of which she lays an egg. Before laying an egg, she deepens the bottom of the passage, and makes an exit hole in the roof for the larvae. In the second half of the night, the female gnaws the course in a straight line, intensively feeding, during the day she stops and freezes. The daily program is performed by all females synchronously. As a result, the itch course on the patient’s skin has a convoluted shape and consists of segments of the course, called the daily element of the course. The back part of the course gradually exfoliates, and during a clinical examination of the patient, it simultaneously consists of 4–7 daily elements and has a constant length of 5–7 mm. During life, the female passes 3–6 cm in the epidermis; the revealed daily rhythm of activity is of great practical importance. He explains the increase in itching in the evening, the predominance of the direct route of infection by contact in bed in the evening and at night, the effectiveness of prescribing anti-scabies drugs at night.

Clinical picture

The clinic of scabies is due to the characteristics of the pathogen and the reaction of the host organism to its introduction.

The incubation period for scabies has a different duration and depends on whether an adult female or a larva has hit the skin. In the first case, it is extremely short, and in the second it is 2 weeks. Itching, as the main symptom of scabies, appears in terms that range from 14 days to 6 weeks with a primary infection and can be extremely short, limited to a few days with reinfection. It has also been shown that reinfection at the same time can occur more difficult in already sensitized individuals, and the number of detectable scabies mites in such patients is often minimal [7, 9].

A typical form of scabies is characterized by the presence of skin itching, which is most pronounced in the evening and during sleep. However, itching can be permanent. It can be localized in separate areas of the skin or spread throughout the body, with the exception of the skin of the face and scalp. An extremely important sign is the presence of itching in family members or collectives.

Examination reveals specific lesions. The main clinical symptoms of scabies are burrows, polymorphic rashes outside the burrows, characteristic sites of rashes, as well as symptoms named after the authors of Ardi (the presence of pustules and purulent crusts on the elbows and in their circumference), Gorchakov (the presence of bloody crusts there), Michaelis (the presence of bloody crusts and impetiginous rashes in the intergluteal fold with the transition to the sacrum), Cesari (detection of scabies in the form of a slight elevation on palpation).

Characteristic places of localization of rashes are mainly the flexor surface of the joints (wrist and elbow), as well as the anterolateral surface of the abdomen, lower back, buttocks, genital area, while they are absent on the upper half of the back. Scabies and rashes are well expressed in the interdigital and axillary folds, on the areola circles of the breasts of women, in the navel. Rashes are represented by paired papules and vesicles, itchy burrows, eczematous pseudovesicles (pearl vesicles) on the skin of the lateral surfaces of the fingers and palms; scabious ulcers, with crusts on the surface; as well as scabious nodules.

Atypical forms of scabies , often encountered in recent years, it seems to us appropriate to classify and present as follows:

• scabies without damage to the skin;
• urticarial scabies;
• scabies on the background of corticosteroid therapy;
• nodular (with postscabious nodules) scabies;
• eczematized scabies;
• scabies complicated by pyoderma;
• Norwegian scabies;
• infant and child scabies.

The first two forms are due mainly to allergic reactions.

Scabies without skin lesions can be an incipient form of the disease in people who follow the rules of body hygiene, but more often manifests itself as an allergic reaction to mite antigens during the period of the disease or after its treatment. This form of the disease is more often detected during active examination of persons who have been in contact with a patient with scabies.

Urticarial scabies is represented by small blisters caused by sensitization to both mites and their waste products. They occur more often on the front surface of the trunk, thighs, buttocks and forearms.

Scabies secondary to topical corticosteroid therapy, also called occult scabies, leads to a loss of the specific symptoms of scabies as a result of suppression of the skin’s immune responses. The disease acquires papulosquamous, papulovesicular, and sometimes even hyperkeratotic rashes.

Nodular scabies (scabious lymphoplasia) is characterized by the appearance of itchy nodules that are red, pink, or brown. On the surface of new nodules, scabies can be found. Typical localization: penis, scrotum, axillary and intergluteal folds, areola. Nodules are usually few. Sometimes they are the only diagnostic sign of scabies [2, 4].

Eczematized scabies occurs, as a rule, in people with an allergic predisposition. In places of scratching, foci of lichenification may appear. However, eczematous lesions usually come to the fore and the diagnosis of scabies cannot always be suspected. Rashes appear on the hands, in the armpits, shins, hands. In advanced cases, rashes can become disseminated, up to the development of erythroderma.

In persons with reduced body resistance, a secondary bacterial infection in the form of impetigo or ecthyma may join eczematized lesions at the sites of scratching, staphylococcal folliculitis, boils and abscesses may occur.

Norwegian scabies (crustous, crusty) in the initial stages is presented as ordinary scabies or disguised as atopic dermatitis, psoriasis, seborrheic dermatitis. Characterized by keratinization, the formation of scales or thick crusts. With severe immunodeficiency, the process can be generalized, with neurological diseases it can manifest itself as a limited area of ​​sensory impairment.

Infant and child scabies is characterized by rashes resembling hives or baby pruritus in the form of a large number of combed and crusted blisters with predominant localization in the perineum on the scrotum, in the axillary folds. Characteristic scabies can be found on the soles.

Diagnostics

Diagnosis of scabies, in addition to clinical data, is based on microscopic confirmation of the diagnosis. However, this procedure requires considerable skill, an experienced microbiologist, and is not feasible in some clinical forms. Minimal clinical manifestations of scabies also make it difficult to obtain sufficient biological material for research. The technique has advantages in specialized institutions. There are several methods of laboratory diagnosis of scabies: removal of the mite with a needle, the method of thin sections, scrapings, alkaline preparation of the skin.

Treatment

For the treatment of scabies, various preparations of sulfur, benzyl benzoate, Peruvian balsam, etc. were previously proposed. In recent years, new drugs have been used, such as Spregal, crotamiton, lindane, malathion, permethrin, Prioderm, Tetmosol, thiobendazole, prescribed in the form of ointments, creams, solutions , shampoos, emulsions and aerosols. The main requirements for anti-scab preparations are the speed and reliability of the therapeutic effect, the absence of an irritating effect on the skin and contraindications to the appointment, ease of preparation and use, stability during long-term storage, availability for mass use, hygiene and low cost [8, 9]. In addition, various forms of scabies, such as post-scabious, eczematized or urticarial, require the addition of pathogenetic therapy.

General principles: rubbing anti-scabies preparations into the skin, especially carefully in the places of the tick’s favorite localization. After each forced washing of hands, it is necessary to re-treat them with an anti-scabies agent. In the presence of complications (primarily pustular skin lesions), lubrication is not performed, but lubricated. Before starting treatment, it is advisable to take a hot shower or bath, using a washcloth and soap to mechanically remove mites from the surface of the skin, as well as to loosen the surface layer of the epidermis, which simplifies the penetration of antiscabiosis drugs. In the presence of phenomena of secondary pyoderma, water procedures are contraindicated. Regardless of the method of therapy with an anti-scabies drug, the entire skin is treated. Avoid getting the drug in the eyes and mucous membranes. The dosage of the acaricidal agent should not be too high, and other skin preparations should not be used at the same time. The patient should be given clear and concise advice.

Medicines used to treat scabies:

1. Preparations containing sulfur

It has long been used to treat scabies. Examples of such agents are: 10–33% sulfuric ointment, 10% sulfuric petroleum jelly, Demyanovich’s method, Wilkinson’s ointment, 5–10% polysulfide liniment, Sulfodecortem, Helmeric’s ointment, Milian’s paste.

Currently, the use of such drugs is limited, since the therapeutic effect of some of them has been questioned. In addition, they have a number of undesirable properties: drugs have an unpleasant odor, stain clothes and underwear, and have an adverse effect on the skin (dermatitis, eczematization).

Sulfur ointment – for the treatment of adults, a 33% concentration is used, for the treatment of children, 10-15%. The ointment is rubbed daily, preferably at night, for 5-7 days on the entire skin. On the 6th or 8th day, the patient washes, changes underwear and bed linen.

Sulfodecortem is a drug containing 10% precipitated sulfur and hydrocortisone acetate. Apply after washing for 5-7 days. Repeated washing and change of linen are made after the end of the course of treatment.

The Demyanovich method was widely used in our country. It is based on the acaricidal action of sulfur and sulfur dioxide released during the interaction of sodium thiosulfate and hydrochloric acid.

A 60% solution of sodium thiosulfate (solution No. 1) and a 6% solution of concentrated hydrochloric acid (solution No. 2) are successively rubbed into the skin of the trunk and extremities, for children the concentration is 40% (No. 1) and 4% (No. 2). Apply solutions for 3 days. Before use, solution No. 1 is slightly heated and rubbed into the skin with hands in a certain sequence: starting with the simultaneous rubbing of the drug into the skin of both hands, then the limbs, then the skin of the body (chest, abdomen, back, gluteal region, genitals) and, finally, into the skin of the lower extremities to the toes and soles. Rubbing into each area lasts 2 minutes, the whole procedure should take at least 10 minutes. The second rubbing is performed with the same solution, similarly to the first. After a 10-minute break, they start rubbing solution No. 2 in the same sequence, 1 minute for each area 3-4 times with 5-minute breaks for drying. At the end of rubbing and after the skin has dried, the patient puts on clean underwear and does not wash for 3 days, but rubs it in the hands again after each wash. After 3 days, the patient washes and changes clothes again.

Solution No. 1
Rp.: Natrii thiosulfatis 120.0
Aq. Destil. 80.0
M.D.S. rub into skin
Solution No. 2
Rp.: Ac.hidrochlorici puri 12.0
Aq. Destil. 200.0
M.D.S. rub into skin

To date, the use of this drug is limited due to the ever-dwindling number of pharmacies that have production departments. In addition, this method is very time consuming and is accompanied by the release of an unpleasant smell of sulfur and sulfur dioxide.

2. Balsam of Peru

This balm is made from an extract of one of the plants of the legume family (Miroxylon Periferum). One of the active principles is cinnamein, containing benzyl benzoate, which, apparently, gives the antiparasitic effect to the drug. Side effects include local allergic reactions, eczema. When the drug is applied to a large area of ​​the body surface, resorptive effects with the phenomena of renal intoxication are possible.

3. Preparations of benzyl benzoate

Benzyl benzoate. It is used in the form of a 20% water-soap suspension, children under 3 years of age are prescribed a 10% suspension. The suspension is rubbed into the skin of the whole body, except for the head, and for children under 3 years old and into the skin of the face. Rubbing is carried out in a certain sequence (see the Demyanovich method). The course requires two treatments with an interval of 3 days to affect the mobile forms of ticks and larvae. Linen is changed twice after each treatment. The cost of the drug is 100 ml per treatment and 200 ml per course. Treatment with benzyl benzoate is contraindicated in pregnant women and during lactation. Freshly prepared preparation has the greatest efficiency. When stored, benzyl benzoate loses its effectiveness, which explains the failures in its use.

It is also possible to use benzyl benzoate in the form of a 10–20% ointment. In this case, the consumption of the drug is 30–40 g per rubbing and 60–80 g per course.

Askabiol is a drug containing an equal amount of benzyl benzoate, solid soap and ethyl alcohol.

Benzoseptol is a preparation containing equal amounts of benzyl benzoate, mild soap and isopropyl alcohol.

Novoscabiol – a preparation containing benzyl benzoate – 30.0, methylester – 1.0, paraffin oil – 69,0.

Nbin is a drug containing benzyl benzoate – 68 parts, tween-80-14 parts, anestezin – 12 parts, DDT (insecticide – trichloromethyldi (p-chlorophenyl) methane)) – 6 parts.

4. Lindane or gammabenzenehexachlorane

This organochlorine insecticide is applied as a 1% lotion, which is applied once to the entire surface of the body and left for 6 hours, then washed off. In hot climates, lindane powder may be used. The drug can also be used in the form of a cream, shampoo and ointment. The drug is not used during pregnancy and lactation, in infancy, as well as in patients with eczema and atopic dermatitis, as it can cause exacerbation (Latin exacerbo – irritate, aggravate) of the process.

5. Crotamiton (Yurax)

It is used as a 10% cream, lotion or ointment. The active substance crotamiton, in addition to its acaricidal action, has the ability to relieve itching, which is very important for patients with scabies. Apply the drug after washing 2 times a day with a daily interval or four times in 12 hours for 2 days. The drug is interesting because it does not cause side effects, it can be used to treat children, pregnant women and patients with allergic dermatosis. At the same time, its effectiveness is not absolute.

6. Permethrin preparations

The mechanism of action is based on a violation of the permeability for cations of the membranes of nerve cells of insects, which has an acaricidal effect. Affects adult larvae and eggs.

Medifox is a 5% concentrate of synthetic pyrethroid permethrin in alcohol and castor oil. Available in ampoules of 2 ml, glass bottles of 24 ml, polymer containers from 0. 1 to 5.0 liters. It is applied externally in the form of a freshly prepared 0.4% emulsion. To do this, 8 ml of a 5% solution of factory packaging should be added to 100 ml of water. Rubbing is done once a day at night for 3 days. Shelf life of the working emulsion 8 hours

Nittifor is a solution for external use in a 60 ml vial containing permethrin and cytylperidinium bromide.

Rubbing the drug is carried out 1 time per day at night for 3 days. On the fourth day, the remnants of the drug are washed off with cold water and bed and underwear are changed.

7. Pyrethrin group

Aerosol Spregal (esdepalletrin) – a synthetic pyrethrin (a neurotoxin for small arthropod parasites), reinforced with piperonyl butoxide (an enzyme inhibitor that helps to remove pyrethrin from the parasite), is used as the active principle of the aerosol anti-scabies agent Spregal. The excipient (auxiliary substance) specially developed for it allows the solution to be applied to the entire surface of the skin and ensures the penetration of active substances into the skin and scabies, followed by the destruction of the female mite and her eggs.

However, when using Spregal, some caution is sometimes required, for example, in the presence of a large number of excoriations, since in this case there may be some increase in skin itching and the appearance of dermatitis in patients with individual intolerance to one of the components.

The question of choosing a drug for the treatment of scabies is a major one for the practitioner.

The choice of the method of therapeutic action in atypical forms of scabies is based on modern knowledge of its immunopathogenesis. Accession to the basic etiotropic therapy of differentiated pathogenetic therapy increases the effectiveness of the treatment of these torpid forms of scabies.

As a special problem in the treatment of scabies, one can single out severe itching that does not disappear after treatment. The reasons for this phenomenon can be varied:

• allergy to the applied medicinal preparation, especially in suspicious patients who use it too often;
• a state of physiological hypersensitivity, which manifests itself in the fact that severe itching does not disappear within 8–10 days after treatment;
• misdiagnosis;
• improper treatment or secondary invasion;
• psychiatric problems: acarophobia (fear of scabies) or parasitosis mania.

Thus, persistent itching can be due to various reasons and needs medical supervision, the patient should not self-medicate.

Scabies prevention

The most important link in the prevention of scabies is early diagnosis and active detection of patients. They are carried out during preventive examinations of decreed groups of patients. It is very important to establish foci of scabies and work to eliminate them. Identification and simultaneous treatment of all contact persons. Timely and thorough disinfection of clothes, underwear and bed linen. The control of cure is carried out 3 days after the end of treatment, and then every 10 days for 1.5 months. Linen is boiled, dresses and other clothes (if it is impossible to process in a disinfection chamber) are carefully ironed or aired in the air for 5 days, and in the cold for 1 day. Carries out wet cleaning with a 5% solution of chloramine. Upholstered furniture is treated with the same solution. In order to disinfect the epidemiological focus, the A-PAR aerosol agent is recommended, which allows for high-quality disinfection at home.

A-PAR is an anti-scabies preparation, the excipient of which, safe for humans, allows you to disinfect clothes and bedding without leaving stains on clothes and, in addition, is intended for the treatment of furniture, hard surfaces, door handles, children’s toys, shoes.

Final disinfection is carried out after the end of treatment, in children’s groups twice: after identifying the patient in the group and at the end of treatment. In large, long-term, intensively operating teams, it is advisable to carry out the final treatment of the premises using Medifox (0.2% aqueous emulsion), Medifox-super (0.2% aqueous emulsion), Cyfox (0.5% aqueous emulsion) preparations.

Literature

1. Gebra F. Guide to the study of skin diseases: Per. with him. Ed. A. A. Polotebny. St. Petersburg: O. I. Bakst, 1876. T. 1.
2. Daria J. Fundamentals of dermatology: per. from French Ed. A. A. Sakhnovskaya. M. –L.: State. publishing house, 1930.
3. Demyanovich M. P. Scabies. M.: Medgiz, 1947.
4. Korotkiy NG Modern external therapy of dermatoses. Tver: Provincial medicine, 2001.
5. Savchak V., Galnikina S. Practical dermatology. K.: Ukrmedkniga, 1998. S. 14–22.
6. Samtsov AV Infectious dermatoses and venereal diseases (modern methods of treatment). St. Petersburg: Special Literature, 1997, pp. 30–33.
7. Sergeev Yu. V. Modern clinical and immunological features of scabies and new approaches to its diagnosis and therapy // Immunopathology, allergology, infectology. 2000, no. 4, p. 102–107.
8. Sokolova T. V., Fedorovskaya R. F., Lange A. B. Scabies. M.: Medicine, 1989.
9. Sokolova TV, Lopatina Yu. V. Parasitic dermatoses: scabies and tick-borne dermatitis. M.: Binom, 2003.
10. Fedorov S. M., Selissky T. D. Scabies. In: Skin Diseases. M.: Medicine, 1998. S. 164–172.
11. Belyab P., Jean-Pastor M. Zh. Scabies. SCAT. 1996 Marseille. R. 22–26.
12. Ackerman B. Histopathology of human scabies. Ed. Lippincott Compagny, 1997, Philadelphia. R. 88–95.
13. Saurat J. A. Risques systemiques des medicaments topiques chez l’enfant // Sem. Hop. Paris. 1982, 58, 26–27, 1643–1649.
14. Shacter B. Tretment of scabies and pediculosis with linden preparation: an evalution // J. Am. Acad. Dermatol. 1981, 5, 517–527.
15. Van Neste D. Immuno — allergological aspects of scabies: a comparative study of spontaneous blastogenesis in the dermal infiltrates of common and hyperkeratotic scabies? Allergic contact dermatitis and irritant dermatitis // Arh. Dermatol. Res. 1982, 274, 159–167.

I. V. Verkhoglyad, Doctor of Medical Sciences, Associate Professor
I. Ya. Pinson, Doctor of Medical Sciences

GBOU DPO RMAPO Ministry of Health and Social Development of Russia, Moscow

Contact information about the authors for correspondence: [email protected]

Arpimed

Always use the drug exactly as recommended by your doctor or pharmacist. If you have any doubts about taking the drug, consult your doctor or pharmacist.

To open the tube, remove the cap from the tube, turn it and place it on the threaded end of the tube, then turn it to pierce the seal.

Apply cream to clean, dry, cool skin. Do not take a hot bath or shower immediately before applying the cream.

Apply a small amount of cream in a thin layer to the affected areas of the skin (see “How and when to take Permethrin cream”).

Treatment of scabies

Adults and adolescents over 12 years: apply up to 30 g of cream (corresponds to 60% of the cream in the tube) .

Children aged 6 to 12: apply up to 15 g of cream (corresponding to 30% of the cream in the tube).

Children aged 2 months to 5 years: apply up to 7.5 g of cream (corresponds to 15% of the cream in the tube).

Newborns and children under 2 months of age: there is not enough experience with the drug in this age group and therefore the required dose has not been developed. Accordingly, the use of the cream is not recommended in patients of this age group.

The above dosing information is a guide only. The dose may be adjusted according to the needs of the individual patient and body surface area. For example, sometimes some adult patients require more cream.

Treatment of pediculosis pubis

Adults over 18 years: apply up to 30 g of cream (corresponding to 60% of the cream in the tube).

How and when to use Permethrin cream

Permethrin is for skin use only.

Avoid contact with eyes or contact with mucous membranes (nasopharynx, genitals) or open wounds. In case of accidental contact with these surfaces, rinse thoroughly with water.

Adults should apply the cream all over the body, including the neck, palms of the hands and soles of the feet. On the head and face, you can not apply if these areas are not affected by scabies (scabies mites).

When applying the cream to the areas between the fingers and toes (also under the nails of the fingers and toes), wrists, elbows, armpits, genitals and buttocks, they must be carefully prepared.

Treatment of pubic lice in adults: any facial hair (beard, mustache) and eyelashes should be checked for lice and nits. The cream should be applied to the scalp on the face, avoiding contact with the eyes. If lice or nits are found on the eyelashes, they should be carefully removed with tweezers. The cream should not be applied to the eyelashes because it may cause moderate eye irritation.

Children: children should apply the cream evenly over the entire body, including the palms of the hands, soles of the feet, neck, face, ears and scalp. The skin around the mouth (because the cream can get into the mouth) and the eyes should be protected from application.

Do not let your child lick cream off their hands. If necessary, children should wear gloves during treatment.

There is not enough experience with the drug in infants and young children. Therefore, treatment of children under the age of 23 months should be carried out only under close medical supervision.

Elderly: Elderly patients (over 65 years of age) should apply the cream in the same way as adults, but in addition, the cream should also be applied to the face, ears and scalp. Care should be taken to avoid getting the cream on the skin around the eyes.

How long to use Permethrin cream

One application of Permethrin is usually sufficient.