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Scabies (cont.)

Scabies Medications

Follow all instructions from your doctor when using scabies medications. A package insert will provide added information.

  • Do not apply topical agents to eyes, face, or mucous membranes.
  • Discuss treatment with your doctor if you are pregnant, breastfeeding, or are treating your newborn or a toddler.
  • Common prescription agents for scabies
    • Permethrin 5% cream (Elimite) is the treatment of choice for scabies. Permethrin 5% cream is applied to clean, dry skin. For best results, clip and clean all fingernails and toenails. Permethrin is usually left on the skin for 10-14 hours and then washed off in the shower. It is best to apply permethrin at bedtime and then wash it off in the morning.
  • Less common prescription agents
    • Lindane 1% cream or lotion is an older medication that is rarely used because it is potentially toxic to the nervous system (leading to symptoms such as dizziness or seizures). Some scabies have become resistant to Lindane.
    • Ivermectin pill(s) (Stromectol) is an oral medication that is active against several parasites. It is not FDA-approved for use in scabies but has been used in cases with very heavy infestations. Ivermectin is not used in small children or in women who are pregnant or breastfeeding.
    • Malathion 0.5% lotion (Ovide) is usually used for head lice and is not approved by the U.S. FDA for the treatment of scabies. It is irritating to the skin. It must be used only as directed and should be kept out of the reach of children because ingestion may cause organophosphate poisoning.
    • Benzyl benzoate lotion is an older treatment for scabies. It can be irritating to the skin, especially in people who have eczema.
    • Crotamiton lotion or cream (Eurax) is approved for use in adults with scabies. Treatment failures with this drug are more common than with permethrin.
    • Sulfur-based lotions, creams, or soaps have been used, but are less effective than other options. They should not be used in people who are allergic to sulfa.

Follow-up

Itching can last for two weeks or more after successful treatment and does not necessarily indicate that the treatment failed. Repeat examination by a doctor in two weeks is recommended if there is persistent itching after treatment.

Medically Reviewed by a Doctor on 7/7/2014

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Read What Your Physician is Reading on Medscape

Scabies »

Human scabies is an intensely pruritic skin infestation caused by the host-specific mite, Sarcoptes scabiei var hominis.

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