How can a scabies mite infection be treated? - briefly
First‑line therapy is a topical scabicide, usually 5 % permethrin cream applied from the neck down, left on for 8–14 hours, and repeated after 7 days. Oral ivermectin (200 µg/kg) provides an effective alternative, particularly for extensive or resistant cases.
How can a scabies mite infection be treated? - in detail
Scabies, caused by the mite Sarcoptes scabiei, requires eradication of the parasite and relief of skin irritation. Effective management combines topical acaricides, oral agents, and supportive care.
Topical therapy remains first‑line. Permethrin 5 % cream is applied to the entire body from neck to toes, left on for 8–14 hours, then washed off. A second application after 7–10 days eliminates newly hatched mites. Alternative lotions include benzyl benzoate (25 % in oil) and sulfur ointment (5–10 %); both are applied nightly for 3–5 days, then repeated after a week. Proper application demands covering all skin surfaces, including interdigital spaces, genitalia, and under nails.
Oral options are reserved for resistant cases, infants, pregnant women, or when topical use is impractical. Ivermectin, 200 µg/kg, is given as a single dose and repeated after 7–10 days. A second dose may be required for severe infestations. Albendazole (400 mg daily for 3 days) is an alternative, though less commonly employed.
Adjunctive measures reduce secondary infection and itching. Antihistamines (e.g., cetirizine 10 mg) control pruritus, especially at night. Low‑potency topical corticosteroids (hydrocortisone 1 %) applied to inflamed areas alleviate inflammation. Antibacterial creams treat superimposed bacterial infection. All household members and close contacts should receive prophylactic treatment, regardless of symptoms, to prevent reinfestation.
Environmental control limits re‑exposure. Wash clothing, bedding, and towels in hot water (≥ 60 °C) and tumble‑dry for at least 20 minutes. Items unable to be laundered should be sealed in plastic bags for a minimum of 72 hours, as mites cannot survive beyond three days off the host. Vacuuming carpets and upholstered furniture removes detached mites.
Follow‑up evaluation occurs 2–4 weeks after therapy completion. Persistence of burrows or new lesions warrants repeat treatment, typically with the same regimen. Absence of new lesions confirms successful eradication.
In summary, effective eradication relies on correctly applied topical acaricide, supplemented by oral ivermectin when indicated, combined with symptomatic relief, contact prophylaxis, and strict environmental hygiene.