How is a scabies mite treated? - briefly
Scabies is treated with topical scabicidal agents, most commonly permethrin 5 % cream applied to the entire body from the neck down and left on for 8–14 hours before washing off. Oral ivermectin is reserved for severe, crusted, or treatment‑resistant cases, and simultaneous therapy for close contacts plus laundering of bedding in hot water is essential to prevent recurrence.
How is a scabies mite treated? - in detail
Scabies infestation is eradicated primarily with topical acaricides and, when indicated, systemic agents.
The first‑line topical preparation is a 5 % permethrin cream. Apply a thin layer over the entire body from the neck down, including interdigital spaces, wrists, elbows, and genitalia. Leave the medication on for 8–14 hours, typically overnight, then wash off. A second application 24 hours later eliminates any newly hatched mites.
Oral ivermectin serves as an alternative or adjunct, especially for crusted scabies, treatment failures, or patients unable to use topical agents. The standard regimen is 200 µg/kg body weight taken on day 1 and repeated on day 2; a third dose on day 8 may be added for severe cases. Dosage adjustments are required for children weighing less than 15 kg and for pregnant or lactating women, for whom ivermectin is contraindicated.
Second‑line topical options include benzyl benzoate 25 % lotion, sulfur ointment 5–10 % (applied nightly for 3–7 days), and crotamiton 10 % cream. These agents are less effective than permethrin and may cause irritation.
Adjunctive measures reduce reinfestation risk:
- Wash bedding, clothing, and towels in hot water (≥ 50 °C) and dry on high heat; items unable to withstand heat should be sealed in plastic for at least 72 hours.
- Treat household contacts simultaneously, regardless of symptom presence.
- Apply soothing emollients to alleviate itching; antihistamines may be used for symptomatic relief but do not affect mite survival.
Monitoring involves re‑evaluation 2–4 weeks after therapy. Persistent lesions or new burrows suggest treatment failure, possible resistance, or secondary infection, warranting repeat dosing or alternative medication.
In immunocompromised patients or those with extensive crusted disease, combination therapy (topical permethrin plus oral ivermectin) and extended treatment courses are recommended to achieve complete clearance.