Red dots and itching

[sgh49]

I have a similar question to one already posted.  I went to a massage parlor that was not very clean - now I don't think it was licensed.  The girl wanted to know if I wanted anything more than a massage.  I told her no but while I was there I started to feel something crawlilng on my hand.  That was yesterday and ever since I visited, I have quite an itch in my scalp, on my back, and on my stomach where my pants meet my waist.  I also see alot of small red dots that almost look like flat moles.  They don't itch, but it seem like I keep getting more of them.  I also treated myself with lice treatment (Rid shampoo) just in case - I can use benadryl to relieve the itching for a while.  I'm just afraid I might have brought something home and spread it in my house.  I washed the sheets I slept in last night.  If this were bed bugs, why do I seem to still be getting more red dots?  Do bed bug bites itch for an extended period?  If it were lice, would I be able to see them with a magnifying glass - although I don't see how I could have become so quickly infested with lice/crabs.    We did not have genital cotact - she had on clothes, and I had my underwear on.  Thanks for any advice you can give.

[Edward W Hook, MD]

Ectoparasites (crabs, bed bugs) are uncommon problems in the situation you describe.  The best way to address your concerns is to be seen be a knowledgeable health care professional.  Your local health department may actually have more experience with such situations than your private health care provider.

As for your specific situation, several comments which may prove helpful.
1.  The time course you describe is extraordinarily fast. As I understand it, the sensations you experienced occurred almost immediately after your massage.  As you know, this is uncharacteristic of such infestations.
2.  You might see crabs visible but they are not red
3.  Scabies are the lesions that most characteristically itch but they take days to get to that stage and are associated at that with small red bumps which itch intensely.  They may take several days to go away after treatment
4.   Washing your clothes and bed clothes, combined with the RID treatment would take care of scabies or crabs.
5.  Bed bugs do not come out in the light and they bite, leaving small blood spots on the bed sheets.  They do itch as well but once again, the time course you describe is really too rapid for a bed bug infestation.
6.  We are all suggestible and one of the easiest sensations to generate through the power of suggestion is itching.

As I have worked through the answers above, I find myself becoming more and more doubtful that you have an ectoparasite infestation but, as I've said the best way to be sure is with direct examination.  At the same time, had you had one, you've done the correct thing.  Hope this helps.  Please let us know what your health care provider says (BTW, many clinicians will treat such events out of concern, even if they do not see the ectoparasites, the treatment (once) is rarely harmful and they prefer to be safe rather than sorry- you've already done this)  EWH