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Scabies (cont.)

What Are Scabies Treatment Options?

The first question affected people ask is how to get rid of scabies. Prescription medications (see below) are available, which kill the scabies mite and thus are known as scabicides.

  • Household members and sexual partners should be treated at the same time regardless of whether or not they have symptoms. Anyone who has had skin-to-skin contact with the patient in the past month should be treated. If a child with scabies attends day care or the affected person is institutionalized (such as in a nursing home or prison), then staff and others in close contact with the person should be treated. It is best to treat everyone simultaneously to minimize the risk that untreated people will re-infest treated people.
  • Occasionally, the scratched skin may become infected, and sores may contain pus or become red and warm. This is a separate condition from scabies and is usually a bacterial infection that develops due to scratching or irritation of the infested skin. If this occurs, it may be treated with an oral antibiotic or an antibiotic ointment applied to the area.
  • The itching and rash may last for up to two weeks after treatment. If the symptoms last longer, it is possible that the person has been re-infested or that the cream was not used appropriately. In some cases, the treatment is repeated after two weeks if symptoms have not gone away.

What Medications Treat Scabies?

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.
Last Reviewed 8/30/2017

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

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