How Scabies Is Treated

Show Article Table of Contents

Scabies is treated with a topical or oral medication, such as Permethrin cream or Ivermectin, that kills the mites and their eggs. Your doctor may also recommend other treatments, such as pain or anti-itch medications, to help ease related discomfort. Taking steps to eradicate the mite from your surroundings is important for avoiding re-infection, so it will be considered part of a treatment plan. Close contacts, like family members, may even be treated for scabies whether they are showing signs or symptoms of infection or not—partly to get ahead of a potential future diagnosis, partly to protect you all from passing the mite back and forth.

Prescriptions

Several prescription treatments are available and approved for treatment of scabies infection. These treatments help clear up the scabies rash and reduce the risk of complications. 

Scabies is treated with either topical pesticide creams or an oral medication. The Centers for Disease Control and Prevention (CDC) recommends the following treatments:

  • Permethrin 5% cream applied to all areas of the body from the neck down (not just those with rash) and washed off after 8 to 14 hours; a second treatment may be needed a week later
  • Ivermectin: 200 ug/kg orally, repeated in two weeks; not for use in children who weigh less than 15 pounds
  • Crotamiton (Eurax) lotion: approved for topical use for scabies in adults, but not for children 
  • Sulfur ointment: appropriate for all ages
  • Lindane 1% lotion or cream applied in a thin layer to all areas of the body from the neck down and thoroughly washed off after 8 hours. This medication is only recommended if you cannot tolerate the other treatments because of its high risk of toxicity. Resistance to Lindane treatment has also been reported. Lindane should not be used by people with skin problems, and it should not be used directly after a bath or shower. In addition, lindane is not approved for infants and children under age 10. 

Sometimes, scabies does not improve with the therapies that are approved for its treatment. If that is your experience, your doctor might consider off-label options—topical therapies not approved by the FDA for scabies—including benzyl benzoate or allethrin (pyrethrin topical spray). 

It is imperative that you take your medication as prescribed, finishing the full course of treatment. The parasite is not considered dead until treatment is complete. So, though your symptoms may seemingly resolve ahead of schedule, ending treatment early may cause them to return.

Topical corticosteroid creams can decrease inflammation and help reduce the itching sensation, but they do not destroy the parasite or shorten the duration of infection. 

OTC Therapies

Over-the-counter treatments can't treat the actual infection, but they can help make you more comfortable as it resolves.

Lotions

Creams and lotions can help soothe your skin as your scabies clears up. Some creams—such as over-the-counter hydrocortisone cream, Benadryl cream, and Caladryl lotion—also have anti-itch ingredients that can diminish itching for hours. 

Anti-itch Medication

You can take oral (by mouth) pills to reduce your itchiness. Even when taking an over the counter pill for itching, it is best to check with your doctor if you have never taken anti-itch pills before. 

Pain Medications and Anti-Inflammatories

If you have pain from your scabies, you may experience some relief with over-the-counter pain medication. Non-steroidal anti-inflammatory medications, like Advil (ibuprofen), can reduce pain as well as the inflammation caused by scabies infection, but other options can also provide comfort. 

Home Remedies and Lifestyle

Like over-the-counter options, home remedies can only reduce discomfort, not wipe out the mite from your body. However, some home-based approaches do offer the additional benefit of helping to prevent the transmission of the mite within the family and to others with whom you may come in close contact.

Soothe Discomfort and Itchiness

You may find relief by applying wrapped ice packs on your skin or bathing in cool water. You might also notice that the itching sensation is worse in warmer temperatures, so cooling your body with air conditioning or a fan can help.

Avoid Scratching

If you think you might be infected with scabies, try not to scratch your skin. Scratching may cause wounds and open sores that can become infected by other bacteria and lead to further problems. 

That, however, is often easier said than done (especially for children). Some strategies that can help reduce scratching include covering the skin with soft, padded clothes, using bandages to cover particularly itchy areas, trimming nails short, and wearing mittens.

Decontaminate Personal Items

In addition to treating your infection, it's important to clean fabrics and soft surfaces that you have come in contact with to avoid re-infection. This includes using special detergents to kill mites on clothing and sheets, and washing them in hot water. Items that cannot be washed, like stuffed animals, can be placed in a plastic bag for at least 72 hours, according to the CDC.

CAM Therapies

There are no alternative therapies recommended for the treatment of scabies. Studies show that tea tree oil may show promise, but its effectiveness still needs further study.

How to Prevent Scabies
Was this page helpful?
Article Sources
  • Centers for Disease Control and Prevention. Scabies Treatment.
  • Fischer K, Holt D, Currie B, Kemp D. Scabies: important clinical consequences explained by new molecular studies. Adv Parasitol. 2012;79:339-73. doi: 10.1016/B978-0-12-398457-9.00005-6.
  • Khalil S, Abbas O, Kibbi AG, Kurban M. Scabies in the age of increasing drug resistance. PLoS Negl Trop Dis. 2017 Nov 30;11(11):e0005920. doi: 10.1371/journal.pntd.0005920. eCollection 2017 Nov.
  • Thomas J, Carson CF, Peterson GM et al. Therapeutic Potential of Tea Tree Oil for Scabies. Am J Trop Med Hyg. 2016 Feb;94(2):258-66. doi: 10.4269/ajtmh.14-0515. Epub 2016 Jan 19.