Scabies is a common skin condition. It happens when microscopic mites burrow into the skin and lay their eggs. A prescription-strength cream is the only way to cure it.
In this article, we explain what scabies is, look at how doctors treat it, and suggest over-the-counter (OTC) products that might help ease the symptoms.
The microscopic human itch mite, which scientists call Sarcoptes scabiei var. hominis, causes the skin infestation scabies. The mite burrows into the top layer of skin and lays its eggs there. People can catch scabies through prolonged skin-to-skin contact with someone who has the infestation.
The symptoms tend to include severe itching and a rash that looks a little like tunnel-shaped pimples. The itching may get worse at night, and some people can develop sores from scratching the skin.
According to the Centres for Disease Control and Prevention (CDC), there are no OTC scabicides, which are products that kill scabies mites or eggs.
Some OTC medicines claim to be able to treat scabies, but the regulatory bodies have neither tested these nor approved them for use in humans.
The only way to treat scabies is to ask a doctor for prescription medication.
The CDC have warned people never to use scabies treatments that the manufacturers intended for use in domestic or farm animals.
Doctors prescribe a class of medicines called scabicides to kill the mites and their eggs. The most commonly used scabicide drug is a cream that contains 5% permethrin.
People can buy OTC products that contain permethrin, but these are not strong enough to treat scabies. They only contain 1% permethrin, and people use them to treat head lice.
People using permethrin should:
- read the package carefully
- wash and dry the skin thoroughly
- massage the cream into the skin, starting at the neck and moving down to the soles of the feet
- leave the cream on for 8–14 hours
- shower or bathe to remove the cream
- put on clean clothes
If an infant or a young child has scabies, parents or caregivers should also apply the cream to their head.
Usually, people only need to use this treatment once. The itching tends to get less severe within about 24 hours, but people might still be itchy for up to 4 weeks after using the cream. If someone spots mites in their skin 14 days after using the cream, they should speak to a doctor.
Scabies is contagious. When someone has it, they should make sure that everyone in their household and any sexual partners treat themselves for the condition. Where possible, everyone should use the treatment at the same time to stop scabies from coming back.
Other ways to prevent scabies from returning include:
- washing all clothes, bedding, and towels that a person with scabies has used in hot water, and then drying them on a hot cycle
- taking items that it is not possible to clean in this way to a dry cleaners
- avoiding touching any unwashable materials, such as carpets or couches, for 72 hours after treatment
Prescription creams are the only way to treat scabies. These products will kill the mites and their eggs on contact.
While the treatment usually works within 24 hours, people are often still itchy for a few weeks afterward. Ways to ease the itching at home include:
- placing a cold, wet cloth or ice pack on the itchy skin for about 5–10 minutes
- adding uncooked oatmeal to a cool bath and soaking in it
- moisturizing the skin using a product that is free of additives, fragrances, and perfumes
- using an anesthetic cream that contains pramoxine
- using calamine lotion
Anyone who suspects that they have scabies should see a doctor. The infestation is highly contagious, meaning that it spreads easily to other people. Without treatment, scabies will only get worse.
One round of treatment is usually enough to treat scabies. If someone spots mites or a new rash on their skin 14 days after they have used the cream, they should go back to the doctor before treating themselves again. They might need stronger medication.
Scabies can sometimes lead to bacterial skin infections. Skin infections might be red and painful, or they may resemble crusted sores. Anyone who thinks that they might have a skin infection should speak to a doctor as they might need antibiotics.
People will usually make a full recovery from scabies if they use the cream correctly. The best way to ensure this is to follow the instructions on the packaging exactly.
While the itching should ease within 24 hours of treatment, some people will still experience an itch for some weeks afterward.
People can get another infestation of scabies if they become exposed to the mites again. To avoid this, it is important to make sure that everyone in the household treats themselves.