Best Treatments

As soon as you see the first signs of scabies, schedule an appointment to see your doctor.  The longer you wait, the more likely you are to spread the mites to others around you.  Scabies will not go away on its own, and can’t be treated effectively with non-prescription remedies. Fortunately, scabies is easy to treat with prescription medications, in most cases.  Once your doctor has diagnosed you, he or she can determine the best treatment for you.


The most common, and usually most effective treatment for scabies is a prescription cream called permethrine. One treatment cycle of this cream stops the scabies infestation for most people, and it is safe for use on infants as young as 2 months.  The cream is applied to the entire body, from the neck down, and left on for 8-14 hours before being washed off.  On infants, the cream is also applied to the neck, face and scalp, with care taken to avoid the eyes and mouth.

In most cases, treatment takes 1-3 days.  It is safe for children to return to school or daycare after treatment has been completed and all of the cream has been washed off. Check with your doctor to find out exactly how long treatment should be continued.

Some other topical ointments used in scabies treatment are lindane, which is considerably more toxic than permethrine and is used only when other treatment has failed. Because it can have harmful side effects, it is especially important to use lindane exactly as directed by your doctor. Incorrect or overuse can be dangerous, because it can cause permanent damage to the central nervous system. It is usually prescribed as a single application.  It is not recommended for those with a weakened immune system, those who weigh less than 100 pounds, children, and the elderly, or pregnant or nursing women.

A sulfur ointment is sometimes used to treat pregnant and nursing women because it is safe and mild.  It is also generally less effective than permethrine, however.  Crotamiton is another ointment used only rarely because it is less dependable in killing the mites and their eggs.


On occasion, a doctor may choose to prescribe an oral treatment for scabies. Invermectin is an anti-parasitic medication taken in pill form.  Its primary use is to kill roundworms, but has a secondary use in treating scabies and head lice.

Antibiotics may be prescribed only if a secondary skin infection develops. This usually doesn’t happen as long as you get treatment promptly.

Other Treatments

Even though the treatments listed above work well in the majority of scabies cases, there are some instances where more serious treatment is needed.  One such instance is if nodular scabies develop.  This happens when there is an unusually strong allergy to the mites, and results in hard, itchy reddish nodules, which sometimes remain long after the mites are dead. In cases like these, steroids might be injected into the nodules.  A less common treatment is the application of coal tar products to the affected area.

Another, more severe form of scabies is crusted or Norwegian scabies.  This is a highly contagious form because there are an unusually high number of mites found under the skin.  Norwegian scabies are usually found in people who have other infectious diseases or a weakened immune system.  In fact, scabies this severe can lead doctors to order HIV testing because it can indicate a severely compromised immune system.  Since Norwegian scabies often doesn’t respond to the usual treatments, doctors may try several in combination, such as a serious topical treatment like lindane together with invermectin pills.

Sometimes, steroid creams and even steroid pills can be prescribed for severe cases of scabies.  These however, just help to relieve the itch and don’t kill the mites themselves, so need to be used in conjunction with other medicines.

Even though over the counter treatments are not strong enough to kill scabies mites, there are some products that can help provide relief from the itch.  One popular anti itch remedy is Benadryl cream or spray.  Antihistamine pills, commonly used for cold or allergy relief, can also be effective in relieving the itching.  Be sure to check with your doctor before administering any of these to a child or infant.

There are a few other things to consider in conjunction with scabies treatments.  First of all, make sure that anyone in your household, or with who you are otherwise in close contact, receives treatment as well.  You don’t want to have family members and friends keep passing it around because one or two people didn’t receive proper treatment. Also, don’t hesitate to return to your doctor if your symptoms aren’t significantly better within 14 days of starting treatment.  If the first round didn’t work, the sooner you start on a second one, the sooner you will be free of the itching and irritation.

Scabies is fortunately easy to treat with a prescription cream, and in some cases, prescription pills. A few other methods are reserved for harder cases.

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