How do you approach patients who continue to experience pruritus and ongoing concern for persistent scabies despite having completed appropriate treatment?  

Pruritus can not uncommonly continue in patients for 6 weeks or more after infestation is managed. High-dose antihistamines may be of some benefit. Consider if there is an ongoing untreated exposure that the patient has not thought of or cannot/will not share with you. Not all people infested with s...

The combination of dilute bleach baths, mid-potency steroid ointment, and hydroxyzine works great. I counsel patients to use topical steroid Monday through Friday and take weekends off. Use dilute bleach solution in a spray bottle and/or pramoxine lotion stored in the refrigerator for breakthrough i...

@Gil Yosipovitch had an awesome case like this treated with nemolizumab after failing many things.

Although pruritus may continue for 4-6 weeks after effective treatment of scabies, I would recommend doing a full skin exam to rule out any evidence of persistent infestation and certainly ask about exposure to close contacts who might still be infested. If no evidence of infestation, I agree that ...

Agree, scabies is contact dermatitis to mites. Expect only gradual improvement in the first month, with complete resolution of symptoms in 2-3 months. Anti-histamines don’t benefit contact dermatitis, but topical steroids will help after infestation is fully eradicated. I don’t see a rol...