How to treat scabies mite infestation? - briefly
Effective therapy uses a single application of a topical scabicide—most commonly permethrin 5 % cream left on for 8–14 hours, then washed off, with a repeat dose after seven days. Oral ivermectin (200 µg/kg) given once and repeated after one week serves as an alternative for widespread infestation or when topical treatment is impractical.
How to treat scabies mite infestation? - in detail
Scabies is caused by the microscopic mite Sarcoptes scabiei burrowing into the epidermis. Effective management requires a coordinated approach that includes pharmacologic therapy, environmental decontamination, and patient education.
The first step is to confirm the diagnosis through clinical examination and, when necessary, skin scraping examined under microscopy. Typical findings include intense nocturnal pruritus, erythematous papules, and characteristic burrows in interdigital spaces, wrists, and the genital region.
Pharmacologic agents are the cornerstone of eradication. Recommended topical options are:
- Permethrin 5 % cream: apply to the entire body from neck to toes, leave for 8–14 hours, then wash off. Repeat after 7 days to eliminate newly hatched mites.
- Ivermectin 200 µg/kg oral dose: single dose for adults and children over 15 kg; a second dose after 7 days improves efficacy, especially in crusted scabies or immunocompromised patients.
Alternative topicals include benzyl benzoate 25 % lotion (apply for 24 hours, repeat after 48 hours) and sulfur 5–10 % ointment (applied nightly for 3 days, then weekly for 2 weeks). Oral ivermectin is contraindicated in pregnancy and in children under 15 kg; permethrin remains the preferred choice in these groups.
Environmental control reduces reinfestation risk:
- 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 20 minutes.
- Items that cannot be laundered should be sealed in plastic bags for a minimum of 72 hours, as mites cannot survive beyond this period without a host.
- Vacuum carpets and upholstered furniture thoroughly; discard vacuum bags immediately.
Adjunctive measures address symptom relief:
- Oral antihistamines (e.g., cetirizine 10 mg) can mitigate itching.
- Low‑potency topical corticosteroids (e.g., hydrocortisone 1 %) applied to inflamed areas reduce secondary irritation.
- Cool compresses and oatmeal baths provide additional comfort.
Follow‑up evaluation should occur 2–4 weeks after treatment completion. Persistent lesions may indicate treatment failure, resistance, or secondary infection, necessitating repeat therapy with an alternative agent or combination regimen. In cases of crusted scabies, multiple weekly doses of oral ivermectin together with daily topical permethrin are recommended, alongside strict isolation measures.
Patient counseling emphasizes:
- Avoiding close skin‑to‑skin contact with untreated individuals until the treatment course is finished.
- Informing household members and close contacts to undergo simultaneous therapy, even if asymptomatic.
- Maintaining skin hygiene and avoiding excessive scratching to prevent bacterial superinfection.
By adhering to this protocol—accurate diagnosis, appropriate medication selection, rigorous environmental sanitation, and comprehensive patient instructions—complete eradication of the mite infestation can be achieved.