Scabies Treatment: Top Medications, Creams & OTC Options

Scabies is a skin infection caused by the Sarcoptes scabiei mite and characterized by intense itching, a bumpy rash, and sometimes tiny burrowing marks in the skin. Any part of the body may be infected including the genital area, face, wrists, between the fingers, and along the waistline.

Although the scalp is vulnerable to the infestation, this mostly only occurs in very young children. A person who has scabies may develop a secondary bacterial infection because of the damage caused by the mite cause when it burrows into the skin and the constant scratching from the intense itching.

Although it takes anywhere from two to six weeks for symptoms to manifest, this infection is highly contagious from day one. If you suspect you have an infestation of the scabies mite, it’s critical that you get diagnosed and start treatment as soon as possible. Everyone in your household or who you’ve recently had close bodily contact with will also need to be treated to eliminate the risk of infection recurring.
Scabies Treatment

How to Diagnose Scabies

When you have a scabies infection, your skin may start to develop insect-like bites. The lesions may appear as a rash of pimples or blisters. There may also be S-shaped tracks left behind when the organism burrows into the skin.

Most of the time, a doctor or dermatologist will be able to diagnose your condition by visually inspecting the affected areas and talking to you about your symptoms. However, the doctor may take a few skin scrapings and view them under a microscope to verify the scabies mites or eggs are present.

Treating Scabies

Scabies is a treatable disease, but you must be diligent about applying the medication as directed. There are a number of medicines your doctor may prescribe depending on your medical history and the severity of the infestation.

Permethrin cream – The most common one is 5% permethrin cream, which contains a synthetic chemical used in insecticides. It’s safe enough for most everyone to use including pregnant women and children as young as 2 month old. However, it can cause burning or irritation of the skin. Permethrin cream is applied once every seven days. It should be slathered on the body starting at the neck, left on overnight, and then completely washed off the next day.

Crotamiton – Another type of medication that may be prescribed is 10% crotamiton, which is available in lotion or cream form. In addition to killing the mites, it also has antipuriritc properties that alleviate the itching associated with scabies. The medication should be applied every 24 hours after bathing. It’s essential that you avoid using it on mucosal tissues in the mouth or vagina or on broken or inflamed skin as there is a high risk of poisoning. To ensure the mites die and do not infect you again, change all clothing, bedding, and towels every morning and wash them in hot water and dry on high heat.

Sulfur – Sulfur has been used for a long time to treat scabies. It is usually combined with a substance called petrolatum and available as sulphur soap, shampoo, cream, or ointment. While it is safe for use during pregnancy and on babies, it’s generally only prescribed with other medications fail to eradicate the infestation. Currently, it’s not approved by the FDA for use as a scabies treatment, though it is very effective at getting rid of the bugs.

Lindane – Another treatment that’s often prescribed when other medications fail to work is 1% lindane. The lotion or cream is applied to skin from the neck down, left on for eight hours, and washed off. It’s not approved for pregnant or nursing women, and should not be used on skin that is inflamed, wet, or covered in a rash. The reason is the medication can get in the blood stream and cause seizures. Additionally, the scabies mites can build up a resistance to the medication, so it’s essential that you use it exactly as prescribed.

Benzyl Benzoate – Benzyl benzoate is an inexpensive treatment that contains a variety of pesticide elements that’s good for getting rid of the organisms causing the infection. Be careful to use the medication as directed, however, as using too much of it can cause ataxia, convulsions, respiratory problems, and hyperexcitation.

Ivermectin – These lotions and creams are generally good for treating mild to moderate cases of scabies. More severe cases may require stronger medication, especially if the immune system is compromised as in the case of people suffering from HIV/AIDS or going through chemotherapy.

In this situation, the doctor may prescribe two or three doses of ivermectin (stromectol), which is an antiparasitic medication that can be administered in pill form or used as a lotion. While effective against scabies, it can cause problems in the central nervous system if used for too long. Typically, the medication would be administered every two weeks and in doses of 200 micrograms per kilogram of body weight.

Antibitocs/Antihistamines/Steriods – The doctor may also prescribe or recommend medications to treat the symptoms associated with the skin disorder such as itching and inflammation. This may include the use of:

  • Antibiotics to clear out any bacterial infections that develop
  • Antihistamines like Benadryl to provide relief from itching
  • Steroid creams to minimize redness and swelling
  • Pramoxine lotion to control itching

Your symptoms may worsen the first week of treatment, but should heal completely within 4 weeks. In addition to treating the disease, be certain to diligently wash all bedding, clothing, and other items that have come in contact with your body to prevent reinfection.

With all of the medications, preventing them from being absorbed into the skin is paramount because of the possible side effects associated with them. Additionally, quick absorption means the medication won’t stay on the skin long enough to nix the scabies bugs.

Before applying the lotion, cream, or ointment, make sure your skin is dry and cool. Be certain to get it on your back, the bottom of your fee, between your fingers and toes, and other hard-to-reach or easily forgotten areas. You should even work the medication under your fingernails or toenails using a Q-tip or old toothbrush (place in a sealable bag afterwards and throw away).

Most medications must be left on the skin for anywhere from 8 to 24 hours. Therefore, you’ll need to reapply it to any areas you wash during that time period such as your hands.

Although these medications will kill the bugs and eggs, you may continue to experience itchiness afterwards. However, it should lessen more and more over time. If it doesn’t improve within 14 days after you treat your scabies, contact your physician for assistance.

How Long Does Scabies Last

Without treatment, scabies can live on the skin for 1 to 2 months. However, without a human host, the organisms will die anywhere from 48 to 72 hours. If you follow your doctor’s treatment plan and are diligent about preventing reinfection, you should be rid of the infestation in 1 to 2 weeks.

Prevention and Control After Exposure

Scabies is highly contagious, and the critters can continue infecting you and your loved ones if you don’t take adequate steps to keep them from hanging around.

  • Avoid close (skin-to-skin) contact with other people until you all have been treated. Everyone should be treated at the same time; otherwise, the scabies mites will simply jump from one host to another.
  • All bedding, clothing, towels should be removed and washed daily in hot water and dried on the highest temperature setting possible. If the items can’t be washed right away, store them in a large plastic bag that can be sealed.
  • For items that cannot be washed, get them dry cleaned or place in the dry at the highest temperature. Place in a sealed plastic bag for a minimum of 7 days. The mites cannot survive without a host for that long.
  • Clean the surfaces in your home with a strong disinfectant such as bleach during and after the treatment period to kill any mites or eggs that may be left behind.
  • Vacuum all parts of the home thoroughly throughout the treatment period, beginning on the first day you start using the medication. If your vacuum uses bags, throw it away after each session. For vacuums with canisters, discard the contents away from the home and wash the canister in hot and soapy water. If you can’t remove the canister, spray a mix of bleach and hot water into it and wipe it out with a paper towel. Throw the towel away.

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