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 (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. Denise

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

  2. 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

  3. 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.

  4. 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

  5. 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.

  6. allie

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

  7. 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 !!

    • 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.

      • 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.

  8. 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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