What's in this article?
- Scabies is an itchy, highly contagious skin disease caused by an infestation by the itch mite Sarcoptes scabiei.
- Direct skin-to-skin contact is the mode of transmission.
- A severe and relentless itch is the predominant symptom of scabies.
- Sexual contact is the most common form of transmission among sexually active young people, and scabies has been considered by many to be a sexually transmitted disease (STD), although not all cases are transmitted sexually.
- Signs and symptoms of scabies include a skin rash composed of small red bumps and blisters that affects specific areas of the body. Other symptoms can include tiny red burrows on the skin and relentless itching. The itch leads to frequent scratching, which may predispose the skin to secondary infections.
- Treatment includes oral or topical scabicidal drugs.
- Over-the-counter remedies are not effective in eliminating scabies
How do dermatologists diagnose scabies?
A dermatologist can often diagnose scabies by visually examining a patient’s skin from head to toe.
To make sure that a patient has scabies, a dermatologist may scrape off a tinybit of skin. This is painless. Your dermatologist will put the skin on a glass slide and look at the slide under a microscope. If your dermatologist sees scabies mites or their eggs, it is certain that you have scabies.
Treatments and drugs
Scabies treatment involves eliminating the infestation with medications. Several creams and lotions are available with a doctor’s prescription. You usually apply the medication over all your body, from your neck down, and leave the medication on for at least eight hours. A second treatment is needed if new burrows and rash appear. Because scabies spreads so easily, your doctor will likely recommend treatment for all household members and other close contacts, even if they show no signs of scabies infestation. Medications commonly prescribed for scabies include:
- Permethrin cream, 5 percent (Elimite). Permethrin is a topical cream that contains chemicals that kill scabies mites and their eggs. It is generally considered safe for adults, pregnant women, and children ages 2 months and older. This medicine is not recommended for nursing mothers.
- Lindane lotion. This medication also a chemical treatment is recommended only for people who can’t tolerate other approved treatments, or for whom other treatments didn’t work. This medication isn’t safe for children younger than age 2 years, women who are pregnant or nursing, the elderly, or anyone who weighs less than 110 pounds (50 kilograms).
- Crotamiton (Eurax). This medication is available as a cream or a lotion. It’s applied once a day for two days. This medication isn’t recommended for children or for women who are pregnant or nursing. Frequent treatment failure has been reported with crotamiton.
- Ivermectin (Stromectol). Doctors may prescribe this oral medication for people with altered immune systems, for people who have crusted scabies, or for people who don’t respond to the prescription lotions and creams. Ivermectin isn’t recommended for women who are pregnant or nursing, or for children who weigh less than 33 pounds (15 kg).
Although these medications kill the mites promptly, you may find that the itching doesn’t stop entirely for several weeks. Doctors may prescribe other topical medications, such as sulfur compounded in petrolatum, for people who don’t respond to or can’t use these medications.
Home Remedies for Scabies
Although you cannot cure a case of scabies without prescription medication from a doctor, there are certain things you can do at home to keep from reinfesting yourself or your family.
- Wash all clothing, towels, and bed linens that you have used in the last three days. Use hot water. You should use the dryer at high heat rather than air drying. Since the mites can survive on nonliving objects for several days, place the objects that are not machine washable (such as coats and stuffed toys) into a bag and store for a week.
- Cut your nails, and clean under them thoroughly to remove any mites or eggs that may be present.
- Thoroughly vacuum carpets, furniture, bedding, and car interiors, and throw the vacuum-cleaner bag away when finished.
- Try to avoid scratching. Keep any open sores clean. Itching may be treated with antihistamine medications such as diphenhydramine (Benadryl), hydroxyzine (Atarax), cetirizine (Zyrtec), and promethazine (Phenergan). Topical measures to reduce itching such as cool baths or calamine lotion should not be given while the prescription cream is being used because it will wash the cream off or prevent it from getting into the skin.
Home remedies such as neem or tea tree oil, hydrogen peroxide, Borax, bleach, olive oil and lemon, Lysol, and clove oil are largely untested and are not recommended as a substitute for prescription medication.