Posted by Jenny on May 18, 2004 at 02:22:32:
In Reply to: scabies posted by scabies on May 17, 2004 at 19:11:56:
All topical scabies treatment should be head to toe.
Everything you put on your skin should be patch tested before use, ideally on your forearm for 24 hours. Allergy to sulfur is rare but will in those cases usually show up sooner, as lobster red skin or a hive-like rash (Voyajer).
I got rid of my scabies by treating with sulfur 10% in petrolatum 24/7. In exceptional cases 2-4 weeks may be required. I cut my hair really short and followed religiously the regimen described in the Scabies 101 posts.
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Sulfur 101
This post contains most of the sulfur info portion of Voyajer´s Scabies 101, with some additional suggestions mostly on how to mix your own sulfur cream and where to get the sulfur powder for this purpose, plus updates on where to buy pre-made sulfur ointments. Voyajer´s 'Scabies 101' needs to be studied carefully in addition to the below.
From a post from Voyajer
"Now if you want to make an ointment to use during the day, then I would buy the "Flowers of Sulfur" powder (called also precipitated sulfur or sublimed sulfur) and mix with a plain cold cream. You need to mix in a blender or with a mixer to make an even consistency. 1 part sulfur powder to 9 parts cold cream. If you buy a cold cream that isn't too greasy, but more like a lotion, then the ointment won't be as greasy under your clothes. I used Adult Acnomel (8% sulfur--but a little expensive to use full-body), I used this flesh-colored acne medication on my face once in awhile. (I didn't actually do the whole above the neck treatment, because I live in dry weather and felt it wasn't necessary.) The Adult Acnomel seems to dry on the skin and isn't sticky, but seems also to dry out the skin more. It's great for acne.
The pre-mixed sulfur ointments aren't as thick as vaseline or as sticky. They are technically made with petrolatum. This is a type of petroleum jelly, but Vaseline brand seems thicker to me and more sticky. You can cut the pre-made ointments with mineral oil to make them less sticky, but this also makes them slightly less effective so you possibly might need to use them a couple days longer.
Doctors prescribe the topical pesticides for this very reason, that is, that the sulfur ointment does take longer and is messier. But if you ask me, it is worth it not to use pesticides and rather to use something non-toxic.
There are too many bad side-effects with the pesticide use."
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To mix your own sulfur ointment
Make sure the sulfur powder is 100 % precipitated sulfur, also kalled sublimed sulfur, or brimstone, or flowers of sulfur, or milk of sulfur. These are different names for pure elemental sulfur, natural and non-toxic. It is a relatively fine crystalline powder, light lime colour, with a faint pleasant lemon fragrance (will not stink).
Keep tightly sealed as the powder attracts moist. The powder, undiluted, will burn your skin. I got it in a paint store, it was referred to as 'pure sulfur' meaning 100% pure native (or elemental) sulfur, which will always be processed in one of the above ways.
For treatment of scabies, 10 weight % of sulfur powder is mixed with to 90 weight % petrolatum (see below for details).
Where to buy sulfur powder
1.
Your pharmacy
Ask for milk of sulfur which is somewhat easier to mix than the other varieties.
Some pharmacies will compound the sulfur ointment for you, see below.
2.
http://www2.eckerd.com
http://catsearch.atomz.com/search/catsearch/?sp-q=sulfur&sp-
a=sp10025a53&sp-t=cat_search
Sublimed Sulfur Powder
4 oz $3.19
Standard Shipping $3.95
2-Day Shipping $9.95
Overnight Shipping $19.95
3.
www.medichest.com
www.medichest.com/sulfurpowdersublimed-5276. html
12 0z for %7.18 + shipping
4.
Paint supply stores
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Which base to use
Any petrolatum base: Petroleum jelly (vaseline), or mineral oil, or cold cream.
Here's how you can make your own cold cream base
Basic Cold Cream
Ingredients
1/2 cup mineral oil
1 ounce beeswax
1/4 teaspoon borax
1/4 cup plus 1 teaspoon distilled water
essential oil scent, if desired
Instructions
Heat oil and wax in double boiler. Dissolve borax in water and boil. Add to wax in a thin stream, stirring vigorously in one direction. When mixed remove from heat and check temperature. At 140º, add scent. At 120º,
pour into jars.
Makes one cup of cream.
How to mix the sulfur cream or ointment
The sulfur powder is very hygroscopic and will always be lumpy. Use the back of a spoon to work the powder through a very fine sieve. This can be done directly onto the petroleum/vaseline base. Add and mix little by little to avoid lumping.
These are several quotes from Voyajer, who posted on this board:
"Make sure the sulfur is precipitated (which is also called'sublimed' or 'flowers of sulfur' and many other names). You can mix your own because it is really cheap that way, but be sure to mix it well with an electric mixer or in a blender. 10% of the sulfur powder and 90% cold cream or vaseline...Don't breathe in any of the sulfur powder. Use a face mask. If you have protective goggles this would be good too...Just in case the sulfur powder flies into the air by accident. It will burn the heck out of eyes, nose and mouth. Be careful. Also see that the powder does not get on your skin. And clean the blender really well afterward...Some people are allergic to sulfur ointment. It is very important to get the percentage right. An 8% mixture might not make a person react when a 10% mixture does make them react. Also, anything over 10% sulfur if mixed incorrectly can make almost anyone have an allergic reaction. It has to be made correctly."
If you use a blender, add the powder little by little - by the spoonful, take care to avoid dusting - and slowly as you would when making a mayonnaise.
For children, use 6 %, If necesserary go down to 5 %, although at that ratio, Voyajer suggested prolonging treatment. For a grown up person, at the 6% ratio, 14 days of treatment was suggested. See more about the length of treatment below.
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Pre-made sulfur creams
1.
Some pharmacies will compound the sulfur ointment for you.
For compounding pharmacists in your area, go to
http://www.iacprx.org/referral_service/index.html
2.
From this board:
"Some U.S. pharmacies do not carry sulfur ointment but will compose them foryou on demand, I guess they have the powder or order it for you, and mix it with petroleum jelly. One poster said it takes them an hour to do this."
"The Medical Shoppe mixed up a batch for me. The pharmacist used sublime sulfur which he said was better and less gritty than precipitated. It also doesn't have that aweful sulfur smell. The first Medical Shoppe I called said they still needed the doctor to call it in to the pharmacist, but the second one I called said no problem. So sometimes you just have to call around, they can do it for you without a prescription if they want to. Also from talking with the pharmacist I gather that (as one pharmacist put it) it is a tedious job, and they are usually fond of doing it anyway. So, I think they prefer you to buy more, like a lb. or something, to make it worth their while. I got one pound for $30.00. The Medicine Shoppe has franchises. You could go on line and find the closest one to you.
www.medicineshoppe.com "
3.
Pomada de Azufre, Debbi found it in the Dollar General store for $2.50 a jar.
4.
Unguento Azufre and Pomada de Azufre can be found OTC at Walmart and CVS
Pharmacies
-From a poster on this board:
"Not all Walmarts carry Unquento Azufre 10 %. Where I live, 2 out of 5 walmarts stocked it. I found it over by the first aid items (bandaids, chigger ointment, itch/burn creams.) Look for small 2.5 oz. container with yellow label runs about $3.80. Every Walmart I've been to I've found it on the top shelf. Don't call around to each Walmart. You MUST go in and check for your self. I found some stores told me they didn't have it when they did. I asked the pharmacist to give me the OTC stock managers extension# just so I could call him & get an idea when he restocked that item. Kinda crazy, but every time I went there, there would be but 1 container left! Must be a Hot Item!"
Earlier posters found it in 'the hispanic pharmacy section' at Walmart. "they have a 10% sulfur ointment. It's a small white jar with a yellow/orange label made by De La Cruz POMADA DE AZUFRE. It is a 2.6 OZ jar - it's use on the front says it is 'Acne Medication'..."
"...Sulfur ointment I found at a southwestern USA Walmart, in the Mexican body products section, which was in the aisle with hair colorings, brushes & combs:
Brand name 'De La Cruz Pomada De Azufre' Acne Medication, Sulfur Ointment 10%, 2.6 oz-- White plastic jar with orange label. Distributed by DLC Marketing Co., Paramount, CA
90723.
Ingredients: Specially processed microcrystalline sulfur 10% in an oil-free, water-washable base. It feels very greasy to me, like vaseline. IMHO it's too greasy for a good acne med. & my teenagers won't use it...."
5.
Buy on the web:
http://www.germa-drugs.com
Sulfur Ointment 2 oz
'SULFUR OINTMENT. USP 10%
Use: Great for affections of the skin, fungus, spots, acne, ect.
Directions: Apply twice daily during the day for a total of 7 days.
Formula: Sulfur Precip. 10g., Petrolatum 90g.
Buy 6 for $3.84 ea.'
5% sulfur cream and 10% sulfur cream (for an adult, use the 10%,for children try
the 5%)'
Also
http://www.herbsofmexico.com/ointment.asp
O1005 Pomada de Azufre 2.6 oz $5.50
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How to use the sulfur cream
Patch test for 24 hours before you start the treatment. If your skin turns "lobster red" under the patch there is an allergy and the treatment should be reconsidered.
A hive-like rash under the patch would mean the same thing.
Allergic reaction to the sulfur is not very frequent and does not mean that sulfur is in any way toxic.
The sulfur may be itchy by itself which isnormal. All remedies for scabies are likely to cause some itch.
"Application should be made from top of head to tips of toes, all nooks, crannies, creases and crevices. Don't forget under finger and toe nails, belly button, etc."
How long to treat for
From Voyajer´s Scabies 101
"As regards the sulfur treatment, what I read was that in an orphanage in Mexico, 10% sulfur in cold cream (which I believe they mixed together themselves) was applied once a day at night for 3 days straight to every child (total 58 were treated this way). I believe that the cold cream spread in a thinner layer than would the vaseline ointment normally used. Three days were let pass then one additional night of ointment was applied.
Nothing was applied during the day. Clothing and bedding were changed on the 3rd day. So in total the treatment was carried out only 4 times at once a day. All those treated with this cold cream mixture were evaluated on the 10th after initial treatment began and considered free of scabies by the researchers in the study. However, if you are an adult with scabies that was misdiagnosed for several months, I would suggest doing sulfur every day for a week if you find it comfortable. If not, then 3 days on, 3 days off, 3 days on, 3 days off, 3 days on. This will ensure a kill. Reapply sulfur each day after bathing.
If you were exposed to someone with scabies but show no signs, you could have one or two or no scabies mites on you. I think it might be sufficient in this case to only go for a 3 day treatment and then wait and see. A three day treatment is what you will find most manuals recommend."
Bathing/showering is not mandatory for the treatment, but reapplication is. Bathing helps for the treatment though, especially a gentle scrub bath. Use the mildest soap or preferably a soap-free shower gel.
The petroleum ointment seals the body heat in and may make you feel warm and sweaty. This is part of the treatment, as is a certain amount of itchiness.
Voyajer: "The reason sulfur works best in petrolum (Vaseline) or cold cream is the coverage. Vaseline leaves an airtight film on the skin. Many recent studies suggest that the mites need to breathe...Scabies burrows show small holes in the roof denoting the need for air. The vaseline in the sulfur ointment forces them out to breathe.
This makes them burn in the sulfur. It is a good system to cure them."
"Sulfur ointment causes skin dryness. It dries out the pores and causes the mites to die. Petrolatum doesn't really have moisturizing properties.
It doesn't add moisture to the skin because it doesn't contain water. The main purpose of Petrolatum or petroleum jelly (Vaseline) is to make an air-tight protective seal on the skin. So although petrolatum is made from crude oil, it has little moisturizing properties and is more of a skin sealant. "
Another poster: "Suggestion - wrap yourself in CLINGWRAP after applying ointments ....makes for better penetration of medication (my derm suggested that)."
- Not necessary, but gives you a feel for the underlying principle. And, protects night clothes and bedding.
From the web, some general info on topical sulfur
from an acne site (please note that some of the brands mentioned here are good for acne treatment but not for scabies treatment.)
Sulfur Topical
Brand Name(s):
Cuticura Ointment, Finac, Fostex Regular Strength Medicated Cover-Up, Fostril Lotion, Lotio-Asulfa, Sulpho-Lac
Drug Class:
Acne drug
Available OTC?: Yes
Available Generic?: Yes
Available In
Cream, lotion, ointment, bar soap
Why Prescribed
To treat skin conditions including acne,
seborrheic dermatitis, and scabies.
How It Works
Topical sulfur is lethal to various strains of bacteria (which are a primary cause of acne), fungus, parasites, and other types of microorganisms. It also promotes softening, dissolution, and peeling of hard, scaly,roughened, or irregular surface skin.
Range and Frequency
For acne, lotion, cream, or bar soap: Use on skin as needed. To use the soap, work up a rich lather using warm water. Wash the affected area, rinse thoroughly, apply again and rub in gently for a few minutes. Remove excess lather with a towel or tissue, without rinsing. Lotion: Apply 2 or 3 times a day. Ointment: Apply the 0.5% ointment as needed. Wash the affected area with soap and water and dry thoroughly before application. For seborrheic dermatitis: Use 1 or 2 times a day as directed on the package instructions. For scabies: Apply the 6% ointment every night for 3 nights. The ointment should be applied to the entire body from the neck down. You may bathe before each application and should bathe 24 hours after the
last application.
Onset of Effect
Unknown.
Duration of Action
Unknown.
Dietary Advice
Topical sulfur can be used without regard to diet.
Storage
Store in a tightly sealed container away from heat and direct light. Keep the cream, lotion, and ointment forms from freezing.
Missed Dose
Resume your regular dosage schedule with the next application. Do not double the next dose.
Stopping the Drug
If you are using sulfur by prescription, the decision to stop taking the drug should be made by your doctor. If you are using it without prescription, you may stop taking the drug when your skin has cleared; however, it is likely that the condition will recur.
Prolonged Use
If prescribed, do not use sulfur for longer than your doctor recommends.
Over 60
No special precautions required.
Driving and Hazardous Work
No special precautions are necessary.
Alcohol
No special precautions are necessary.
Pregnancy
Sulfur has not been shown to cause birth defects or other problems during pregnancy. Before you use sulfur, tell your doctor if you are pregnant or plan to become pregnant.
Breast Feeding
Topical sulfur has not been reported to cause problems in nursing infants. Consult your doctor for specific advice.
Infants and Children
Use and dosage for children must be determined by your pediatrician.
Special Concerns
Anyone with a history of allergy to sulfur and other ingredients in the medication should not use this product.
Keep sulfur away from the eyes. If you accidentally get some of the medicine in your eyes, flush them thoroughly with water.
Overdose Symptoms
Excessive application of topical sulfur may lead to more-severe irritation of the skin.
What to Do
If topical sulfur is accidentally ingested, call your doctor, emergency medical services (EMS), or the nearest poison control center immediately.
Drug Interactions
Consult your doctor for specific advice if you are using abrasive soaps or cleansers,alcohol-containing preparations, any other acne agent, any preparation
containing a peeling agent such as benzoyl peroxide, salicylic acid, alpha hydroxy acids, sulfur, or vitamin A, or soaps, medicated cosmetics, or other cosmetics that dry the skin. Also tell
your doctor if you are using any other prescription or over-the-counter drug for a
skin condition.
Food Interactions
No known food interactions.
Disease Interactions
You should not use sulfur if you have had a prior allergic reaction to it.
Side effects
Serious
No serious side effects have been reported.
Common
Mild redness and peeling of skin.
Less Common
Skin irritation or allergy with redness, peeling, burning, stinging, itching, or rash.
Contact your doctor.
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A note about Adult Acnomel
Voyajer : 'Adult Acnomel8% sulfur 2% resorcinol (specifically for acne, but will work) This is flesh colored and you can wear it on your face all day.'
'Adult Acnomel
8% sulfur 2% resorcinol (specifically for acne, but will work)--good for face in humid or damp climates or in demodex. Available at Sav-on A little pricey but worth it. No disturbing odor.'
From the web
The most effective over-the-counter acne medication you can buy. Acnomel fights break-outs before and during occurances, eliminating existing blemishes and helping to prevent future breakouts. *Deep cleans pores and absorbs excess oil* to let clear, clean, healthy skin show through. Cleanse the skin thoroughly before applying medication. Cover the entire affected area with a *thin layer*
http://www.medichest.com/acnomelacnemedicatio.html
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Warnings & Precautions
Warnings: For external use only. Apply to affected areas only. Do not use on broken skin or apply to large areas of the body. Do not get into eyes. If excessive skin irritation develops or increases, discontinue use and consult a physician.
Using other topical acne medications at the same time or immediately following use of this product may increase dryness or irritation of the skin. If this occurs, only one medication should be used unless directed by a physician. Keep this and all medication out of the reach of children. In case of accidental ingestion, seek professional assistance or contact a Poison Control Center immediately.
Active Ingredients
Resorcinol 2% , Sulfur 8%
Inactive Ingredients
Alcohol 15% W/w, Bentonite, Fragrance, Iron Oxide, Potassium Hydroxide, Propylene Glycol, Titanium Dioxide, Purified Water
Where to get adult Acnomel on the web
http://shop.store.yahoo.com/buyinprivate/acacmedcream.html
http://www.medichest.com/acnomelacnemedicatio.html
http://www.numarklabs.com/OTC.html
http://www.walgreens.com
http://hardtofindbrands.com/cf/products_detail.cfm?ItemNum=116