Treatments Your Provider May Prescribe
Your physician may be able to diagnose scabies simply by examining your skin for typical lesions, such as burrows. Your doctor may also diagnose scabies by gently scraping some skin onto a slide and looking with a microscope for mites, eggs, or mite feces.
In most cases of scabies, your doctor will prescribe a medicated cream or lotion to kill the infestation, such as:
- Permethrin 5% cream (Elimite®) – This is the first choice for treatment because it is very effective and safe. It is safe even for children and pregnant women. Rinse the cream off after 8–14 hours, and repeat in 7 days to kill recently hatched larvae.
- Crotamiton 10% lotion or cream (Eurax®, Crotan®) – This is not as effective as permethrin and can be irritating to the skin. Apply once daily for 5 consecutive days.
- Precipitated sulfur (5% or 10%) – This is prepared with petroleum jelly and is applied nightly for 3 consecutive nights. This is often the best choice for children aged younger than 2 years and for pregnant and lactating women because it is very safe to use. Unfortunately, it is greasy, has an odor, and can stain clothing.
- Lindane 1% solution – Lindane can be toxic to the nervous system. Therefore, avoid using it for young children, pregnant or lactating women, or people with diseases affecting the nerves (neurological diseases). Apply to the body, rinse in 8 hours, and repeat in 7 days.
When using a topical cream, lotion, or ointment, be sure to follow these steps (unless your physician gives other instructions):
- For adults, apply to the entire body except for the face and scalp.
- For children, apply to the entire body, including the face and scalp, as these areas are commonly infested.
- Smear the product beneath the fingernails and toenails.
- Apply to body folds, including inside the navel, in the buttocks crease, and between the fingers and toes.
In more severe cases of scabies, your doctor may prescribe oral medications:
- Ivermectin (Stromectol®) pills – Take once and then repeat 1–2 weeks later. Do not give to children aged younger than 5 years or who weigh less than 15 kg (about 35 lbs), or pregnant or lactating women.
- Antibiotic, if any scratched areas appear to be infected with bacteria.
After treatment, the rash and itching may take up to 4 weeks to go away, as your immune system continues to react to the dead mites. However, new burrows and rashes should stop appearing 48 hours after effective treatment. If you see new burrows or bumps, or if the itch continues for more than 4 weeks, you may need to be treated again.
Your doctor may also recommend steroid creams or antihistamine pills to relieve the itching. In severe cases, oral steroids may be required to decrease symptoms.
Because it may take up to 6 weeks after exposure to develop symptoms, people may be unaware that they are infested. Therefore, household members, sexual partners, and anyone else with prolonged skin-to-skin contact with an infested person should also be treated. Ideally, everyone should be treated at the same time in order to prevent reinfestation.
Self-Care Guidelines
