Dei'ah veDibur - Information & Insight

A Window into the Chareidi World

15 Kislev 5764 - December 10, 2003 | Mordecai Plaut, director Published Weekly









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Shema Yisrael Torah Network











Home and Family

Your Medical Questions Answered!
by Joseph B. Leibman, MD

Diplomate, Board Certification of Emergency Medicine

We continue on evidence-based medicine. Everyone has heard about head lice and we have written many times on the terrible Mediterranean louse which is resistant to almost everything.

There is another disease that can cause a wealth of misery called scabies. This is an infestation of an almost invisible mite that likes to burrow into skin folds, especially the wrist and between fingers, causing an intensely itching rash. This commonly affects people in close contact in less-than- sanitary environments such as day care centers and nursing homes. People who are weakened by disease and have impaired disease fighting ability are also commonly affected. Many medications are available to treat these pests, but I will focus on three.

Ivermectin works very well, and as well kills our pesky lice, but is unavailable in Israel. It is safe in children and I arranged for some pills to be brought to me from the USA. Malathion works well here as well. This is also used for lice. It is a powerful insecticide that is short-acting. Lindane used to be used and is effective but side effect fears limit its use.

Herbal preparations may or may not work. There is no concrete evidence of any success with these products for this disease. However, petroleum jelly -- with or without sulfur -- does seem to suffocate both bugs, but it is messy.

While we are on skin disorders, let's speak about eczema which also likes skin creases. It is often found in kids and is probably due to allergic causes. Most cases do resolve by the early teens. This condition is unsightly and bothersome.

Evidence definitely exists for steroid creams; usually the most mild is the best. Indeed, Glaxo has products in this area, of which Betnovate is the mildest. Seven days of a mild steroid may be equal to three days of a strong steroid. There are no ill effects from these creams. Other beneficial actions include control of dust in the house and emollients, which are moisturizing skin creams, may help. There is no evidence that exclusion of milk or eggs, either by pregnant mother or by baby, nor avoidance of certain fabrics or use of wet wraps, helps. Antibiotic creams add nothing.

Write me in care of the Yated.

GlaxoSmithKline is the sponsor of this column.


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