Pay attention to your body
I want to write a bit about my own personal experience so people who are struggling mentally with either infestation or the aftermath can have it as a reference. I started developing a widespread itch about two months ago. At first I thought it was just seasonal allergies. Got an allergy test done and came back positive for dust mites (this is going to be important later). Later on boyfriend noticed some burrow marks in my wrist. He was the one who suggested it might be scabies, since he’s had it before himself.
Went to a doctor, got diagnosed and prescribed with ivermectin. Itch subsided pretty quickly after the first dose but kind of came back the day before my second dose. Again, subsided quickly after my second dose and came back roaring a week after. At that point I became obsessed with treatment failure and reinfection. Started coming to this subred, which reinforced my anxiety around it.
Meanwhile there were NO objective signs of infestation. My boyfriend, with whom I share a bed regularly but not every day, remained asymptomatic. I had no visible physical signs of reinfection (no burrows, no papules). Itch was pretty widespread (scalp, face, even inside my tongue) rather than localized to classical areas. And yet, I was convinced I had an active infestation. Reading post here led me to disregard all of the objective signs pointing to something else.
Then I came around this scientific paper: https://www.sciencedirect.com/science/article/pii/S1477893923001126. Small study, but it shows more than 50% of patients end up presenting with persistent itch even after successful treatment. It even discusses how there can be allergic cross-reactivity between dust mites and scabies! The paper suggests treating with steroids might help with this post-scabies hypersensitivity. So I went to the doctor, and discussed this possibility.
Got prescribed methylprednisone, and after a couple of days taking it, symptoms improved considerably. Couple of weeks later, itch did not come back, nor there were any signs of infestation. I’m fine now.
All this to say, make sure you separate the subjective experience (itch or skin lesions that aren’t characteristic of scabies) from the objective facts (are you showing new lesions, new burrows, are close contacts becoming itchy). Try to approach treatment based on the objective findings. If I had followed the discussions here, I’d have treated again instead of trying the steroids.
Good luck!