How to treat for scabies mites? - briefly
Apply a prescription scabicide—commonly 5 % permethrin cream—over the whole body, leave it on for 8–14 hours, then repeat after 7–10 days; for extensive or refractory infestations, a single dose of oral ivermectin (200 µg/kg) may be used. Wash all clothing, bedding, and towels in hot water and dry on high heat to prevent re‑infestation.
How to treat for scabies mites? - in detail
Scabies infestation requires a two‑pronged approach: medication that eradicates the mite and measures that prevent re‑contamination.
The first‑line topical agent is 5 % permethrin cream. Apply a thin layer over the entire body from the neck down, including the soles of the feet and interdigital spaces. Leave the preparation on for 8–14 hours (typically overnight) and wash it off. A second application after 7 days eliminates newly hatched parasites. For infants and elderly patients, extend coverage to the scalp and face, avoiding the eyes and mouth.
Oral ivermectin offers an alternative or adjunct, especially for crusted scabies or when topical treatment is impractical. The standard regimen is 200 µg/kg body weight taken on day 1 and repeated on day 8. Severe cases may require additional doses on days 15 and 22. Ivermectin is contraindicated in pregnancy, lactation, and children weighing less than 15 kg.
Adjunctive measures:
- Wash all clothing, bedding, and towels used within the previous 72 hours in hot water (≥ 50 °C) and dry on high heat for at least 30 minutes. Items that cannot be laundered should be sealed in plastic bags for a minimum of 72 hours.
- Vacuum carpets and upholstered furniture thoroughly; discard vacuum bags after use.
- Treat household members and close contacts simultaneously, regardless of symptom presence, to interrupt transmission.
- Avoid scratching to reduce secondary bacterial infection; consider short courses of topical corticosteroids or antihistamines for intense pruritus.
Monitoring and follow‑up:
- Re‑examine the patient 2–4 weeks after treatment completion. Persistent lesions may indicate treatment failure, resistance, or secondary infection.
- In cases of inadequate response, combine oral ivermectin with a second application of permethrin, or switch to benzyl benzoate 25 % or sulfur ointment 5–10 % for 3–5 days.
- Document any adverse reactions such as rash, gastrointestinal upset, or neurologic symptoms; discontinue the offending agent if severe.
Special populations:
- Pregnant or lactating women: prefer topical permethrin; avoid oral ivermectin.
- Immunocompromised patients: monitor closely for crusted scabies; may require prolonged therapy and repeated decontamination cycles.
- Children under 2 months: use sulfur ointment, applied nightly for 3 days, repeated after a week.
Effective eradication hinges on correct drug administration, comprehensive environmental sanitation, and simultaneous treatment of all at‑risk individuals.