Specialized treatment for scabies is available and can cure the disease. You should know that home remedies have not been scientifically proven to be effective for scabies treatment, and that over-the-counter medicines for head lice are not strong enough to kill scabies mites.

Using over-the-counter medicines or home remedies for scabies treatment can make it more difficult for the doctor to diagnose scabies correctly.

Products used to kill scabies mites are called scabicides, and some may also kill mite eggs. For the treatment of scabies, the doctor may prescribe both skin cream treatments and oral medication.

Skin Cream Treatment for Scabies

It is important to follow the doctor’s prescriptions and instructions precisely for scabies treatment. The following skin creams are used to treat scabies and its symptoms:

• The medicine that is used most frequently to kill scabies mites is called 5% permethrin cream (like Elemite and Acticin). The 5% cream is much stronger than the over-the-counter permethrin which is used for head lice and that will not cure scabies.

The 5% permethrin lotion is applied on clean, dry skin over the whole body from the neck down and is left on for at least 10 to 14 hours (usually overnight) and then rinsed off. Permethrin is considered safe for children from two months of age. In infants, the cream should be applied to the forehead, scalp and temples too.

Only one application of the cream is often enough, but another application can be necessary if the symptoms continue after 2 to 4 weeks.

• If for any reason permethrin cream does not kill the scabies mites, other, generally less effective creams with more side effects are available for use. These include: Lindane 1%, Malathion lotion, Crotamiton lotion and sulfur-based lotions.

• Antihistamine creams or a cortisone cream may be prescribed to control itching, but will not cure scabies. It will only relieve the symptoms. It is important to follow the doctor’s prescription exactly, as some cortisone creams may make the itching worse.

Oral Medication Treatment for Scabies

There are a few oral medication treatment options available for the treatment of scabies and its symptoms:

• Ivermectin pills have been used to treat scabies, but it is not FDA approved for this use. Ivermectin for scabies is not considered safe to use in pregnant women and children younger than five. Ivermectin is mostly used in cases where the scabies infestation is severe (like Norwegian scabies or in crowded living conditions) or where permethrin creams were unsuccessful in killing scabies mites.

• Oral antihistamines or cortisone may also be prescribed to lessen the itching associated with scabies. Antihistamines with a sedative side effect can be useful at night to help with sleeping when itching is severe.

• Oral antibiotics may be prescribed if secondary infection of the scabies rash is present due to scratching.

It is important to remember that although the itching may lessen in one to two days, it can be present for up to two weeks after the mites have been killed. If the symptoms have not cleared up after two weeks, another round of treatment may be necessary.

It is generally not necessary to treat other family members until they show signs of scabies themselves, but in special cases a doctor may prescribe treatment for all those who have come into contact with the infected person.

How Can I Prevent Scabies?

It is hard to keep scabies from spreading. Try to avoid prolonged physical contact such as hugging and holding hands with someone who is being treated for scabies.

Scabies mites can live for 2 to 3 days without a host and it is possible that they can live in the clothes or bedding of an infected person while the treatment is going on.

To prevent re-infestation it is recommended that all clothes and bedding be washed in hot water and dried in a dryer with the setting on hot to kill any mites. Stuffed animals and other items that cannot be washed should be sealed in a plastic bag and left for seven days.

It’s not necessary to use pesticide sprays or fogs for scabies mites because they are not effective and can be harmful to the skin or poisonous if inhaled.

Remember that scabies treatment is effective if the prescription and instructions of the medicines are followed closely and if steps are taken to prevent re-infestation.

Centers for Disease Control and Prevention, Parasites – Scabies http://www.cdc.gov/parasites/scabies/
Kids Health, Scabies http://kidshealth.org/parent/infections/skin/scabies.html
MedicineNet.com – Scabies Index http://www.medicinenet.com/scabies/index.htm
Andrews, R.M., J. McCarthy, J.R. Carapetis, and B.J. Currie. “Skin disorders, including pyoderma, scabies, and tinea infections.” Pediatr Clin North Am 56 (2009): 1421-1440.
Heukelbach, J., and H. Feldmeier. “Scabies.” Lancet 367.9524 May 27, 2006: 1767-1774.