For most people the Seven year itch is an intriguing term- denoting an almost immoral urge to stray out in search of clandestine extra marital affairs. The seven year itch as the pseudonym for infidelity got its share of fame after the release of the 1955 blockbuster film starring Marilyn Monroe and Tom Ewell. The film was directed by Billy Wilder and the original play on which the film was based was written by George Axelrod.
The plot of the film revolves around the amorous fantasies of a publisher who is about to publish a new book that emphasizes that many men have extra-marital affairs after about seven years of marriage – called the “7-Year Itch”. The film is also famous on another count. Its uncensored version contains one of the most famous images in cinema history – Marilyn’s dress blowing up over a subway grating. The phrase seven year itch now is often extended to refer to an urge to escape from any situation, not necessarily of seven years’ duration either!
George Axelrod, who wrote the play on which the film was based, is not the author of the phrase either.
The real seven-year itch is not even connected in any way with the wedding lock and lovers. And it was not a condition that began after seven years, but one that lasted for seven years, for want of an effective treatment till the early 20th century. It is well known as Scabies and is caused by an itch mite.
The real seven year itch has been known for centuries. Aristotle probably came across the mite that causes the seven year itch or scabies as it is well known today, who used the term ‘akari’ to describe a wood mite. But he did not make the association of the mite with the itch. Though the disease was described throughout the centuries, it was thought to be of humoral origin and due to ‘bad’ blood or constitution. It was Giovan Cosimo Bonomo in 1687 that first identified the parasitic origin of scabies and assigned it to the Sarcoptes scabei mite, though many controversies surround the discovery. French called scabies ‘gale’, the English “the itch’, and the Germans ‘kratze’.
The seven year itch was so annoying (even now is, without appropriate treatment) that it was used as an imagined punishment for antisocial behavior- ” he should be given the seven-year itch and not be allowed to scratch!
With effective cure available, the seven year itch is no more the chronic irritant it used to be, but is still highly prevalent among those who live in crowded, unhygienic conditions.
Scabies can affect people of any age but is most common in children and young adults. It is highly contagious and is spread by close physical contact, especially in overcrowded living conditions. There are sometimes outbreaks in schools and residential or nursing homes. It can also be passed on by sexual contact.
The scabies mite can burrow into any part of the skin, but is most commonly found around the hands in the web spaces, feet, inside the wrist and elbows, below the breast fold and, in males, the genitalia. It does not usually affect the neck and head, although it may in infants, the elderly and in those who have deficient immunity.
Managing the Seven Year Itch
With effective treatments available, the pseudonym seven year itch is no more applicable to scabies. Once you are diagnosed with scabies, your physician may prescribe any of the following, depending upon your country of residence, as some of the medication are not available in certain countries:
1. Permethrin 5% cream or lotion: Most effective and easy to apply: Apply for 8-12 hours
2. Malathion 0.5% aqueous liquid: Not so effective as permethrin: Apply for 24 hours
3. Gama Benzene Hexachloride 1% lotion: Apply overnight: Neurotoxin, hence cannot be used in children and in pregnancy and lactation and in those suffering from certain diseases.
4. 25% Benzyl Benzoate: Apply daily for 3 days.
5. 6% Precipitated Sulphur: Effective and safe for use in infants
6. Crotamiton cream/lotion: Relieves itching, and a weak antiscabies effect.
7. Systemic antibiotics: If secondary infection present
8. Antihistamines: To relieve itching
9. Systemic Therapy :Ivermectin is a new drug indicated in treating severe types of scabies. Only to be used under medical supervision.
Helpful Hints to get rid of the Seven Year Itch in 7-14 days:
1. Confirm the diagnosis with your doctor.
2. Follow the doctors’ advice on the medication prescribed.
3. Treat the whole family even if they do not have any symptoms. Those afflicted with scabies mite start itching only after about 2-3 weeks.
4. Do not take hot water bath before applying the medication. This will cause the medication to be absorbed deeper into the skin, while the mite and its larvae remains in the upper layers of the skin. This will reduce the effectiveness of the application and increase the side effects. The skin should be cool, clean and dry before applying the medication.
5. Treat the dresses, bed sheets, linen, blankets etc also! The mites survive on these for 3-5 days. Either machine wash with hot water or keep in closed cupboards for 5 days .
6. Apply the medicines all over the body including neck in adults and face in the infants. Take care to apply liberally into the nail folds and cuticles, after taking food.
7. Always repeat the application of medication after one week to cover the new larvae and mites being hatched out of the eggs laid the week before.
8. Itching can persist up to 3 weeks after successful treatment, hence anti-itching medication may be required. Remember that these medications(called antihistamines) can cause drowsiness. Driving and handling of machinery should be avoided while using such medications.
9. Crusted scabies, or Norwegian Scabies, the severe form of scabies seen in weak minded and bodied individuals, needs special care and treatment from a specialist.
10.Finally, never use over the counter products without first consulting your physician or dermatologist. Medicines used for the treatment of scabies are mild insecticides and should be used with caution in children and in the pregnancy and lactation.
