Seeking Clarity on Possible Scabies or Bug Bites: A 33-Year-Old’s Dilemma
Hello, everyone. I am looking for some advice regarding my current health situation. - **Demographics**: 33-year-old male - **Region**: Pacific Northwest, USA - **Health Background**: Not on any medications or supplements; no known allergies - **Recent Travels**: Within the last month, I have visited Hawaii, Oklahoma, Missouri, and Upstate New York. - **Lifestyle and Exposure**: I travel frequently for work, often finding myself in rural or natural settings such as forests and fields. **Symptom Timeline**: - Four weeks ago, I discovered insect bites on my ankles and initially assumed they were from chiggers or fleas. I checked my bedding but found no evidence of bed bugs. - Following a week with no improvement and the emergence of new bites further up my legs, my primary care physician assessed the situation visually and diagnosed me with scabies. He prescribed permethrin, Zyrtec, and cefadroxil. After requesting a skin scraping, he conducted it gently, without using mineral oil, magnifying equipment, or performing a burrow test. The results turned out to be negative. - I underwent two treatments with permethrin spaced a week apart and conducted a thorough cleaning of my home, including washing linens and clothes at high temperatures and vacuuming my mattress and sofa. Initially, the symptoms seemed to lessen following the treatment. - However, one week post the second permethrin application, I noticed new itching in areas close to the original bites on my ankles. - A visit to a dermatology assistant involved the use of a dermatoscope connected to an iPad, leading to images being sent to a dermatologist. Their report stated “favor bites, uncertain insect identification.” They recommended clobetasol ointment and suggested that if the problem persists, I might need to consider pest control services. They declined to do additional skin scraping. **Questions and Concerns**: - I’m unclear about the term “favor bites” and what it indicates (does it imply that the condition appears more like insect bites rather than scabies?) - Am I receiving adequate care, or should I insist on more thorough testing, like a scraping or biopsy, to definitively rule out scabies or identify any other underlying issue? - Is it appropriate for the dermatology team to recommend pest control when the source of the issue has not been pinpointed? - What actions do you suggest I take next to avoid stagnating in this situation? I appreciate your insights in advance!
Answers (1)
8/21/2025, 5:41:57 PM
OpenHealth AI
It sounds like you've been dealing with a frustrating situation regarding your skin issues. Based on what you've described, it appears you're caught between the possibility of insect bites and scabies, and you've taken many appropriate steps already. Let's clarify your concerns and outline actionable next steps.
Main Points:
- "Favor bites" likely indicates that the lesions appear more consistent with insect bites rather than scabies.
- Your care has included necessary treatments, but additional exploration might be warranted.
- Pest control suggestions without a clear identification of the issue might feel premature.
Explanation:
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The term "favor bites" suggests that the characteristics of your skin lesions are more indicative of insect bites rather than scabies, particularly since you’ve had examinations that have found no definitive signs of scabies. This could mean that the new symptoms might be due to other insect bites or reactions rather than an ongoing scabies infestation.
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Given your extensive travel history and exposure to natural environments, it’s possible that another insect, like mosquitoes or fleas, could be involved. The treatment with permethrin targets scabies specifically, so while you've followed proper treatment, it may not affect other types of insect bites or skin reactions.
Next Steps:
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Monitor Symptoms: Keep a detailed diary of your symptoms, noting any new lesions, areas of itching, and any patterns you see (like worsening after exposure to certain places or activities). This could help identify potential triggers.
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Consult with Your Dermatologist: Request a follow-up appointment with your dermatologist, particularly to discuss the recurring symptoms. You can ask for a more thorough examination or consider other testing options such as a biopsy if warranted.
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Consider Alternative Treatments: Since clobetasol is a potent topical steroid, it can help reduce inflammation and itching. Continue using it as directed, while also monitoring its effectiveness.
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Pest Control Evaluation: If you continue to develop new bites despite following cleaning protocols, consider a professional pest inspection to rule out infestations, particularly if the source remains unclear.
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Allergen Testing: If insect bites continue or worsen, it may be wise to discuss with your healthcare provider about allergy testing to rule out any allergic reactions to insect bites or environmental factors.
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Lifestyle Adjustments: In your upcoming travels, consider using insect repellent and wearing protective clothing to minimize the risk of bites.
Your situation is indeed complex, but by taking these steps, you should be able to move closer to clarifying the cause of your symptoms and seek the most effective treatment. Please keep me updated on your progress, and let me know if you have more questions!
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