How to Treat Scabies

My 9 year old granddaughter has contracted scabies. What is the appropriate medication to use for this problem? It is spreading all over her body.
Wanda – Ojai, California

How to Treat Scabbies

Dr. Greene’s Answer:

Scabies are tiny mites that commonly infest the skin. They are highly contagious. Children are the most vulnerable, but anyone can get them. Whenever a child develops intense itching, especially at night, the possibility of scabies should be considered.

The adult female mite is pinpoint in size, barely visible to the unaided eye. She has four sets of legs on a round body covered with brown spines and bristles. When she lands on someone’s skin, she burrows underneath the outer layer within 30 minutes — usually without being noticed. Every day she extends her burrow by up to 1/4 inch horizontally under the surface of the skin. Along the way, she lays little oval eggs, and also leaves many tiny fecal droppings. She will survive for about a month, and then die within the burrow.

The eggs hatch 3-5 days after being laid. The little larvae squirm through the burrow back towards the skin surface. They reach maturity in 2-3 weeks. They mate as soon as they find partners, and the pregnant females each start new burrows.

Scabies like to burrow in the web spaces of the fingers, the creases of the wrists, the armpits, the ankles, the feet, the genitals, and the nipples. They can occur anywhere on the body, although the face and neck are usually spared.

Usually the person doesn’t suspect any problem for about four weeks, while the mites burrow and reproduce, without causing any symptoms. Eventually, an allergic response develops in the host person. (If a healthy person has had scabies before, the allergic response begins within minutes, rather than weeks. On the other end of the time spectrum, if a new host’s immune system is supressed, the allergic response may take months rather than weeks). Itching is caused by this normal allergic reaction to the mites, the eggs, and the feces. Itching may be quite intense, and often appears before any visible sign of infestation.

Soon, 1-2 mm raised red bumps begin to appear (they often look like pimples). Sometimes they are crusted, scaling, or ulcerated. Occasionally there are blisters or hives. Threadlike burrows are sometimes visible under the skin. After several weeks or several months, though, a widespread eczema-like rash may camouflage the original problem. The scabies rash is sometimes confused with drug reactions, eczema, seborrhea, chicken pox, and other viral rashes.

Most cases of scabies are completely eradicated with a single overnight application of 5% permethrin cream (Elimite cream), available by prescription. It is the preferred agent to treat scabies all the way down to 2 months of age (more than 30% of scabies are now resistant to Eurax lotion, an earlier treatment). Elimite should be massaged into the skin from the scalp all the way to the soles of the feet. It should be thoroughly rinsed off 8-14 hours later. All family members, baby-sitters, and close physical contacts should be treated. Usually a 2-oz tube will treat one adult. Lindane is an effective alternative treatment, but I don’t recommend its use. It works and it is cheaper, but it is also far more toxic. In pregnant women and infants under 2 months, a smelly sulfur ointment is often used nightly for 3 to 5 days.

Spread of the mites is usually directly from person to person, but the mites can live with no host for 48 to 72 hours. For this reason, clothing and bedding should be washed in hot water. When this is not possible, items should be left in a sealed plastic bag for 7 to 10 days.

Even after successful treatment, the dead mites, dead eggs, and fecal material will remain in the skin for 2 to 4 weeks (until the skin grows out). Thus, intense itching is expected to continue. Antihistamines (especially at night), topical steroid creams, and the liberal use of moisturizers will often help. Sometimes antibiotics are needed, if scratching results in a bacterial infection. If the rash continues to spread after treatment, or if itching persists for longer than 2-4 weeks, reexamination and/or retreatment may be necessary.

Scabies infestations result from close physical contact, not from dirtiness or poor hygiene. Treat all contacts aggressively now, rather than waiting for the infestation to spread any further.

Dr. Alan Greene

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

  1. Londa

    I have just found out that I have scabies. After suffering with this for about a year. I have tried the permethim cream 4xs nd taken the pills but still no relief. Now my insurance has changed and I no longer have coverage….This is driving me crazy with the scaring and itching…they do travel to my face ears nose and everywhere else on my body. I really need help don’t know what else to do. I keep calling the Dr. to tell them I’m still breaking out but all they keep saying is use the cream which I know it’s not working or strong enough. Is there any help out there please help me….I don’t know how many ppl may have gotten this from me because I work in healthcare and suffered for at least a year before I even knew what I had….I have treated my son as well with this cream although he never showed any signs of this infection. I desperately need help please is there somewhere I can go get treatment that will work… Please Please help me… and Thank you.

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    • trubble56

      I bought the 10% permethrin liquid from Amazon. I mixed it 50/50 with lotion and used it after my shower for 3 nights in a row. It seems much better, but what helped even more was a 20 minute soak in the tub with borax and peroxide. It is such a relief. Now, I’m waiting to make sure it’s all cleared up.

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  2. Kona

    My son has contracted scabies when he was 8 month old. doctor prescribed antibiotics, itching syrup (I forgot the syrup name) and after completing antibiotics have to use permethrin lotion to my son & all of my family members, have to clean cloths with hot water. we used it & worked good. we had relief from it but my son still has on his hand & leg. doctor prescribed to use fucicort cream (streiod) but I read in internet using streiod much is not good. what can I do now? my son feels very uncomfortable at night. I am again pregnant now. I will again affected with scabies? please suggest me…..

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  3. FRANK

    I CONTACTED SCABIES IN A HOMELESS SHELTER.. NEVER HAD IT BEFORE AND A GUY NAMED LARRY HAD IT THERE. I SAT NEXT TO HIM FOR 2 MONTHS. I GOT IT A MONTH LATER WHEN HE LEFT. THANKS FOR THE SCABIES TO REMEMBER YOU BY.I TOOK THE PEREMWITH NP MONEY FOR MEDICINETHRIN LOTION TWICE A WEEK APART. IT WORKED GREAT AND I THOUGHT IT WAS ALL OVER TILL A MONTH AND A HALF LATER I SEE THE RASH AGAIN. I HAVE NO INSURANCE NOW THAT I STARTED WORKING AND NO EXTRA MONEY TO SPEND ON THE 120.00 BOTTLE OF PERMETHRIN. WHATS A POOR MAN TO DO.

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    • FRANK

      i contacted scabies at a homeless shelter. A guy named larry had it, so sitting in his presence every day is the way I had contacted it. Seen the doctor when i had the medicaid card. I took two treatments of the permethrin 5 % lotion a week apart. it worked great. the rash started disappearing ,. The itching started getting less and less the whole month. Seemed I was cured by the end of the month completely. No more itching, rash gone, but wait. The bad news is the eggs left by the now dead mites hatch and start your scabies all over again. So the eggs have to be killed as well as the adults or you will only be cure for a few weeks till it starts all over again. i thought i was cured till another rash appeared 6 weeks later. I have no insurance now and only work 3 days a week. I am screwed. If the government was smart they’d give away the medicine free before it’s an epidemic

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  4. sahil

    I am suffering from scabies for 6 month .I take medicine like permethrin lotions and clobetasol propionate and gentamicin cream but no improvement .

    Sir
    Give me a advice and medicine .

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    • joey

      try sulfer ointment it works great ! Just dont put to much on and over use it or it will make your skin itch a little bit , apply once im the morning this ointment last about 12 hours, but this stuff does miracles on those lil bastards, and be sure to take baths with some bleach or borax with a little tea tree oil in it .

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  5. Greg

    Dr. Greene…I was introduced to debriding soap by a friend. It’s all natural..you use it in the bath and soak in it. The debriding soap draws everything out of your skin. I also added peppermint oil to the bath to kill any live scabies or eggs that would find their way to the bath water. This is after one treatment with permethren..I have seen no mention of this debriding soap anywhere on the internet but http://www.parasitestore.com…I swear by it and it makes total sense to draw the garbage out of your skin. Your thoughts?

    Thanks
    Greg

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  6. Mari

    Hi Dr. Greene,
    I’ve had this for a few months, unfortunately too many incorrect diagnoses. Now I’m treating with permethrin and ivermectin. They seem to work great the day I use them, but then about 3-4 days later I start having the crawling pinch/bite feeling gradually increasing. And now I’m noticing more and more tunnels. I have no symptoms in any crevices. Just under breasts primarily, buttocks and I feel them in my hair, ears, nose, eyebrows and lashes…
    I disabled with limited income… I’ve already maxed out $ on the medication. I see a lot of clove garlic bleach ideas. What I think would help is knowing exactly what is happening each day. And yes, I clean all bedding everyday in hot, clean clothes each day, I stopped using towels and use paper towels and throw them out. There has got to be a realistic solution. What can I add to my routine?

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  7. Brianna

    I have a 19 month at home we did the treatment and the rash just seems to keep spread in getting worse and more red. My daughter wakes up to scratch and cry saying ouch. It breaks my heart I don’t know what to do

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  8. Jaytrees

    I hate scabies! I would not wish this on anyone except a child molester, given too much faith in the doctors already. Me and my fiancée have been infected for two months now and her son 17 yrs old who lives in the main house away from us has had it and treated with permetherin to be clear and not itch for weeks now. I have a low immune system not because I am HIV or have cancer but for some other reason.she has used permetherin and gotten rid of them but I keep giving it back since we started treating ourselves. I have been to 3 ER’S 4 urgent cares and have used permetherin and iivermectum together and 2 other times just permetherin, also 1 eurax to only find out it won’t cure me 100%. This is my 2nd time going through this hell. 10 years ago I had it and used lindane after 6 months of hell. Now I’m scared to use it again, does anyone know if it stays with you forever or is it safe to use since its been so long? I used a baking soda paste allow it to dry and spray vinagar and borax and its crazy how the scabies come pouring out of my body! Tea tree oil after the rinse in shower, and borax dusting of clothes and body before bed. If I bathe the surface of water in tub has tiny floating jelly things seen only at a angle view of the tub water. Be sure to wear plastic bags on feet and do not allow jelly to touch u or anyone else u can soak n hot water ,vinagar ,and borax use scrub glove and tea tree oil and mint shampoo on glove and sulfur bar of soap to help fight the numbers of them neem oil after you dry off all over to keep the itch from keeping u awake. I have read a lot and yes they do live on your face sometimes, mine are at the corners of my mouth chin and behind ears earlobe and can watch them retreat into my mouth when pressed or poked. Tip of my nose had something and neck bottom of my feet hand’s arms wrists and legs ankles calfs shoulder and shaft of my #$%&%.!! I used a horse fly spray on my interior of my car and the next morning was shocked at the nasty dead things on window switch’s dash and seats. If you have scabies don’t be a socialite and spread it to ur friends or family warn the people you come into contact with don’t be ashamed and keep quiet with them. Good luck . my doctor was set on pyrosiss and that I was diabetic, After the dermatologist PA made me into a face picking meth head and not listen to what I tried to say was happening and condensed me about what was the matter with me. I am hanging in there .where can I get the lindane from.?

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    • ry

      Try clove oil! You can also make a spray from it! My mother caught it from my brother, she swears by it. Hope it helps

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  9. rahul

    I am face scabies in my private part i have done lotsoff checkup but there is no any solution. my life is about deadbi can’t live on this stage my age is 23.if you have any solution please help me after than i gona to suside my self.

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    • Rahul,

      I am so sorry for your condition. Please let us know what you’ve already tried.

      Best,
      @MsGreene
      Co-Founder DrGreene.com

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    • Judith Reyes

      i found this thing called all stop for scabies i havent tried it yet but im gonna order it my mom feels like killing her self too i just recently caught this on my winter break:/ god bless you hope we get cured!

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  10. JamesT

    I thought I had scabies on my penis, but it turned out to be severely dry skin. While this was a major relief, it still hurt and itched like hell. I started using a penis health creme per my doc’s suggestion and everything went away pretty quickly. I still use the creme actually because it keeps my skin down there nice and smooth…. my girlfriend loves it. Keep these cremes in mind guys.

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  11. Vicki Podjan

    I have been fighting facial outbreaks for about 8 yrs now. After many docs (dermatologists too) and lots of $ spent with no solution, my arm and face finally presented with a new pattern. They now look like linear raised burrows. My doc prescribed permethrin 5 percent cream and Ivermectin oral tabs. I have used this treatment 4x now and things are starting to clear up a little. When I thought back to when I first started suffering from this horrible skin condition, I realized it was shortly after I returned from New Orleans 9th Ward one year after after hurricane Katrina. I was there for one week as a volunteer with my church. We gutted houses and I did a lot of broom sweeping to clean up dried mud and dirt and there was visible mold on the wood we gutted. I’m wondering if this is where I contracted scabies. I’ve read that many people have scabies that worked and lived there. Is this possible? If so, no wonder I have had terrible insomnia and intense itching among many more devastating symptoms. What type of doc could help me most, infectious disease doc, a parasitologist, or another specialist? I’ve practically been a recluse because the sores are so unsightly and embarrasing. Please advise, I don’t want to live like this anymore.

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    • Vicki,

      This is certainly not the re-payment you deserve for your kindness!

      Perhaps consider a second opinion from another dermatologist. Or call your local health department and ask them who they recommend in your area.

      So sorry you’re going through this!

      @MsGreene
      Mom, Co-founder DrGreene.com, not a doctor

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    • Johnk

      I saw several MDs including a dermatologist regarding my skin condition that was diagnosed as idiopathic dermatitis until it was finally diagnosed as scabies. I used very expensive $37 permethrin with no results. I then tried salt/borax bath, tea tree oil/olive oil but it made my skin sting worse than the itch…finally I am using sulfur soap in the shower followed by a sulfur ointment

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      • rose

        Is it working?

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    • Lovemuffin

      This is exact ally how I feel about myself with this problem, I’ve been hiding it for so long and now it’s getting on my hands and face where I can’t hide it and I avoid people, I used to be outgoing and have friends but I’m alone now picking the eggs out with tweezers and nail clippers I’ve bled lots, but everytime I pick out many eggs within one sore all the time, I’ve destroyed my body and soul. I used to bd happy but not any more. I look horrible I stay in my room picking picking picking all the time. I need help to take this scabie crap away sooooo bad, I want my life back

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  12. Anna

    I have baby kittens of 6weeks old that i have rescued they and all the family have scabbies o need for the cat some type of med i read on sulfure creams for them. Which one do you reccomend. I rescued 6 from getting eatten by ants and gave the others away to people who needed kittens, i kept 2 and they got me infected,i want to save them and keep them. Need to do it before its too late.

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    • Gala

      Hi,

      For scabies ,you can try out Durvet Nu-Stock Ointment, 12-Ounce (actualys its for animal but people use it and they are cured with scabies).It containsm 73% sulphar, and other substance.

      Thanks.

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  13. Denise

    i need some help with my son he’s only 2 had scabies everything the Dr. give me didn’t work at all.

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    • Anna

      I was told to clean house super clean !thow away or move away clutter ,use foggers in the house first ,then use doctors meds,im not throwing away my 2 recued cats Salt &Pepper are theyre names,they are my main concern to heal for now!

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  14. Sana malik

    Plz help me i am falling scabies from last 5 years i used many mediicine and tblts but its no working::::plzzz telll me de name of medicine which can effect fast plzz help me

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    • Lynn

      I have been suffering for a year & six months now. I have used about 50 bottles of permithine lotion to no avail, spent thousands of $$$ I’m not kidding. I am contemplating taking that horse past that people are using online, but I’m terrified to try it because it says right on the tube, not for human consumption. They do not prescribe ivermectin in Canada. Could someone give me the name of a doctor in the United States that I can travel to see that will help me with this😟 Desperate in Canada, willing to travel wherever I have to go!

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      • Hi Lynn,

        I can only imagine what you’re going through and I’m so sorry. This may be a silly question, but have you seen a doctor about this and has he or she determined that it is indeed scabies? Have you told him or her how much permethrin lotion you’ve used? I’m concerned you’ve gotten toxic levels.

        Are there others here who can help with a recommendation for a US doctor? How about recommendations for other scabies treatments?

        Cheryl
        Executive Producer, DrGreene.com

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      • Anna

        I have used the pig one and it was too mild for me ,but the horse really works, I live in the RGV Rio Grande Valley Edinburg Tx 78539 theres many Vets but Tandys is a pet supply and they have them there, they will prepare your dose for you,all Vet techs take that med ,since they have to deal with sick animal with scabbies I was told to clean house super clean !thow away or move away clutter ,use foggers in the house first ,then use doctors meds,im not throwing away my 2 recued cats Salt &Pepper are theyre names,they are my main concern to heal for now!

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  15. Josh

    HI! i just had this crappy scabies and my very good brother brought me this (we both have it). This is very wrong timing and i hate it a lot especially i’m a college student and trying to apply for a part time job.
    Now, I’m using Dr. Kaufmann (a sulfur soap), sulfur ointment and Permethrin Lindell Lotion.
    Are these enough to kill those evil mites and their eggs?
    I think my scalp is infected too? what should i do?
    Should i also use anti-scabies for dogs to my body?
    I’m sorry but i’m very desperate to be fully cured ncluding my brother. We badly need help and guide.

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  16. Lu

    My sister, her 4 children and mom now have scabies. They’ve had it for more than 6 months. They only have medicaid and the dr has now told them that he can no longer prescribe them medication because they should have healed by now. I’m in desperate search of help to buy something over the counter to help them all. Does dr scabies really work? It’s a lot of money for the whole family package. Please help

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  17. Nagendra

    Sir, my one year and six month old baby(son) has scabies. After getting medicine he was fine, but after some time (or when we moved one place to another) the problem once again persist. Please recommend a medicine or tube for baby.

    He is also having some stomach problem. I mean after some days he meet to loos motion again and again.

    I have also taken him to skin doctor. After getting medicine he become fine, but not for always.

    Also suggest some important vaccination required.

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  18. allie

    Is there any ointment I can buy from Walmart or something bc my husband has scabies…

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  19. michelle

    What about a natural product like Dr. Scabies I saw it on the web. Do you think that will work? I have no money to go to the doctor. Please help !!

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    • Jennifer

      I am writing this on the basis of my personal experience, I was suffering from scabies from almost 2 months on per prescription of my dermatologist I had used Permethrin, Lindane and other natural products like Sulfur, Neem oil and Turmeric etc. But nothing worked. I changed Dermatologist and her prescription I have had used Dr. Scabies, You will not believe that worked amazingly. I had recovered from scabies within 10-12 days. Though I was taking lot of precautions like bathing and washing in hot water, eating natural vegetables and fruits etc and was keeping my cloths and bedding separate. It helped me a lot.

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      • Diana

        My son has contracted scabies and is very uncomfortable, intense rash, has eczema (like I do) at baseline. Permethrin cream for him has not yet been effective after one treatment and second treatment is this evening. I have ordered Dr. Scabies cream to try as well, due to his intense issue. Working on the environmental issue: washing everything in his room, using Borax on carpeting, bedding as a dessicant. Added some oral sulphur / homeopathic, but he is skeptical (he is 14), inconsistent, and does not believe he has scabies…sigh.

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  20. Dan

    First of all, please do not panic. Scabies is
    a very common skin infection and is often seen in young children. You need to
    handle this calmly in order to not panic you child and make the situation
    worse. Inform your child’s teacher, so that the school authorities know that
    scabies might be present in their premises. Secondly, get ready with a plan to handle
    the itching when it will happen most aggressively in the night. Keep aloe versa
    gel, tea tree oil or any other such soothing product handy. Call your doctor
    and tell him your fear Scabies.

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