How should a scabies mite on the head be treated? - briefly
Apply a topical scabicide, preferably permethrin 5 % cream, to the entire scalp, leave it on for 8–14 hours, then wash off and repeat the treatment after one week; for extensive or resistant infestations, add a single dose of oral ivermectin (200 µg/kg). Ensure close contact persons receive prophylactic treatment and wash all bedding and clothing in hot water.
How should a scabies mite on the head be treated? - in detail
Scabies affecting the scalp presents with intense itching, erythematous papules, and crusted lesions often concentrated around the hairline, ears, and nape of the neck. Infestation of the head is common in infants, young children, and immunocompromised individuals; early identification prevents spread to family members.
Diagnosis relies on visual inspection of characteristic burrows and papules, supplemented by skin scraping examined under microscopy for Sarcoptes scabiei mites, eggs, or fecal pellets. Dermoscopy may reveal the “jet‑liner” sign, confirming active infestation.
Pharmacologic therapy includes:
- Topical permethrin 5 % cream applied to the entire scalp, left on for 8–12 hours, then washed off; a second application after 7 days eliminates newly hatched mites.
- Sulfur ointment 5–10 % for infants or pregnant patients, applied nightly for 3 consecutive nights, then rinsed.
- Oral ivermectin 200 µg/kg as a single dose, repeated after 7 days when topical treatment is contraindicated or in cases of crusted scabies.
Adjunct measures:
- Launder bedding, towels, and clothing at ≥50 °C; items unable to withstand heat may be sealed in plastic bags for 72 hours.
- Treat all household contacts simultaneously with the same regimen to interrupt transmission.
- Avoid scratching to reduce secondary bacterial infection; antiseptic creams may be applied to compromised skin.
Follow‑up assessment after 2–4 weeks should verify the disappearance of lesions and cessation of pruritus. Persistent symptoms warrant repeat microscopy and consideration of resistance, prompting alternative agents such as benzyl benzoate or malathion. Comprehensive management combining medication, environmental decontamination, and contact treatment ensures resolution of scalp scabies and prevents recurrence.