Home > Scabies > How to Treat Scabies

Table of Contents

• Causes
• Symptoms
• Diagnosis
• How to Treat Scabies
• Removing Scabies from the Home
• Free Brochures

" “Learning how to treat scabies and get rid of scabies mites can be confusing.  There are over the counter product available as well as prescription options (recommended) from your doctor that contain pesticides known to kill mites such as permethrin cream such as Elimite. Because the condition spreads easily, all family members are treated, even if a family member shows no symptoms." 

Scabies Causes

What are scabies?

Scabies is contagious and caused by a mite you can only see under a microscope. It survives up to a 30 days when living under the skin of a  human host. It lays eggs in the first skin layers, which hatch and grow into adults, which starts the cycle of burrowing, laying eggs and itching all over again. Symptoms may last for months or years, unless you thoroughly clean your infested home to halt re-infestation.

This mite, the Sarcoptes scabiei, tunnels into your skin, making itself at home. It spreads rapidly with person-to-person contact such as hugging, sleeping together, sharing bedding, sharing towels and wearing another’s clothing and it may also be spread by sexual contact. 

If this is the first time you have had scabies, you may not know it until four to six weeks later, when symptoms begin to show. The secretions the mite produces while under your skin cause the relentless itching, which will drive you to find out quickly how to treat scabies.

How Long Does Scabies Last?

Scabies can continue as long as there are female mites laying eggs under the skin. Scabies scabicide creams will kill any mites with itching continuing for 2 to 4 weeks after being treated.

What are the Symptoms of Scabies?

You will usually see small zigzag blisters and a red rash, located in your armpits, between the webs of your fingers or toes, under your nails, around the waist, the inner elbow, the nipples, the penis, on wrists, the groin area or your buttocks. The blister is the female mite laying her eggs, as she moves under your skin. 

When Do Symptoms of Scabies Appear?

Scabies symptoms appear 2 to 6 weeks after being infested. Scabies can be spread even before symptoms appear.

Diagnosis

Scabies is challenging to diagnose.

Typically, your doctor will swab a suspicious inflamed area and take a skin scraping to look for mites, eggs and feces. There is no blood test needed to diagnose this disease. The other test you may have is when the doctor uses a black felt pen on the blisters. The skin is wiped off and the burrow should be seen when the ink sinks into it. 

How to Treat Scabies

Scabies is very contagious Follow these steps as indicated for scabies treatment of close contacts (family etc.):

1. For each person in the household get a set of underwear, pajamas and sheets.
2. Wash all of the above in hot water (highest setting). Add bleach to water to ensure clothes are clean.
3. Wash all clothes in hot water that were worn over the past 3 days or isolate in a sealed plastic bag (tie wrap or plastic bin with lid). Mites may have dropped into these items.
4. Return washed sheets to bed. 
   
   For remainder of steps, do it before going to bed if easier:
   
   
5. Everyone in household should take a warm bath or shower and dry off.
6. Apply either an over the counter scabies topical such as All Stop Micatin Skin Spray or treatments prescribed by your Doctor to the entire body from the neck down.  Be sure to apply between your toes, in all creases and in the navel. Put some of the cream under your finger nails. All skin areas should be covered. For infants, consult with your Doctor.  In most cases, infants under age 2 have applied topical rinsed off after 6 hours.  If pregnant consult with your Doctor as not all products are appropriate.
7. After skin topical is applied, put on the underwear and pajamas.  
8. Go to bed in clean sheets.
9. When awake in the morning, wash off cream in shower or bath.
10. Put on new underwear and clothes.
11. Scabies treatment may be needed again in 1 week.

Note that the rash and itching can continue for several weeks (2 to 4) after treatment.  To stop itchy areas consider using a Hydrocortisone 1% cream such as Aveeno.

If itch persists for more than 1 months, see your Doctor to see if there are other causes.

Scabies Medications

In most cases, you will need a scabies medication prescription from your doctor, but there are alternatvies you may also use as described below.

How to treat scabies with an over-the-counter product:

If you prefer to treat scabies naturally and avoid the use of chemicals such as permethrin (an insecticide and possible carcinogen), then we suggest trying AllStop Mitactin Skin Spray. The product penetrates the skin interrupting the mites ability to breathe and feed, causing them to die. 

NOTE: No over the counter products have been tested and approved to treat scabies.

Antihistamines, such as, Phenergan, Zrytec, Atarax or Benadryl can help with itching.

If you see no improvement, or if itch becomes intense, call a Doctor.

Prescription medications:

Your Doctor will prescribe products that contain insecticides known to kill parasites such as scabies mites.  These include;

• 5% permethrin cream is applied after bathing. The cream is left on the skin overnight and then washed off in the morning.
• Prescription pill with Ivermectin
• Malathion .05% lotion
• Antibiotics for infections
• Benzyl benzoate

Warnings

Tell your Doctor if pregnant or if infants live in the house. Modifications may be needed to prescribed medications.

Removing Scabies from the Home

Scabies mites can live for up to 3 days off of a host, which is why it is a good idea to wash all linen and clothes in hot water that were used at least 3 days prior to treatment.  It's a good idea to also disinfect floors with a product formulated to kill scabies mites such as Benzarid.

Scabies is spread through direct skin contact or contact with items that have come in contact with an infected person.

Brochure

References

Johns Hopkins Guide to Symptoms and Remedies

American Academy of Dermatology

CDC