How are scabies mites treated in humans? - briefly
Scabies infestations are managed with prescription acaricides, most commonly a single application of 5 % permethrin cream or a dose of oral ivermectin, often repeated after 7–10 days to eradicate surviving mites. Adjunctive measures include washing clothing and bedding in hot water and applying soothing lotions to alleviate itching.
How are scabies mites treated in humans? - in detail
Scabies infestations are managed primarily with medications that kill the mite and its eggs, supplemented by measures to prevent reinfestation. The first‑line topical agent is a 5 % permethrin cream applied to the entire body from the neck down (or to the whole body in infants) and left for 8–14 hours before washing off. A second application after 24 hours eliminates newly hatched organisms.
Oral ivermectin, 200 µg/kg given as a single dose, is an effective alternative, especially for crusted disease or when topical treatment is impractical. A repeat dose 7 days later targets surviving stages. In pregnant or lactating women, 5 % permethrin remains the preferred option; sulfur ointment (5–10 %) is a safe, though slower‑acting, alternative for neonates and infants.
Second‑line topicals include benzyl benzoate 25 % applied for three consecutive nights, crotamiton 10 % lotion left on the skin for 24 hours, and precipitated sulfur 5–10 % ointment applied nightly for several days. These agents require strict adherence to contact time and thorough coverage.
Adjunctive actions are essential. All household members and close contacts should receive simultaneous treatment, regardless of symptom presence, to halt transmission. Bedding, clothing, and towels used within the prior 72 hours must be laundered in hot water (≥50 °C) and dried on high heat; items that cannot be washed should be sealed in plastic for at least one week.
For individuals with extensive disease, immunosuppression, or treatment failure, combination therapy (e.g., oral ivermectin plus permethrin) and extended courses may be necessary. Monitoring for adverse reactions—skin irritation from topicals, transient neurologic symptoms from ivermectin—should be part of follow‑up.
Effective eradication relies on correct drug selection, proper dosing intervals, comprehensive treatment of contacts, and rigorous environmental decontamination.