What should be done if a scabies mite is found? - briefly
Apply a topical scabicidal agent such as 5 % permethrin cream to the entire body and wash all clothing, bedding, and towels in hot water, then repeat the treatment after 7–10 days. Seek medical evaluation to confirm clearance and receive guidance on household decontamination.
What should be done if a scabies mite is found? - in detail
When a scabies organism is identified, immediate medical intervention is required to halt transmission and relieve symptoms.
First, confirm the diagnosis through microscopic examination of skin scrapings or dermatoscopic visualization of the mite, eggs, or fecal matter. Accurate identification prevents unnecessary treatment and guides appropriate drug selection.
Second, initiate pharmacologic therapy. The standard topical agent is 5 % permethrin cream applied to the entire body from the neck down (including the soles of the feet) and left in place for 8–14 hours before washing off. For infants, apply to the scalp and face as well. Oral ivermectin, 200 µg/kg as a single dose, may be used in parallel with permethrin or as an alternative in resistant cases, severe infestations, or when topical treatment is impractical. A second dose is typically administered 7–10 days later to eliminate newly hatched mites.
Third, treat all close contacts—family members, sexual partners, and anyone sharing sleeping arrangements—simultaneously, even if asymptomatic, because the parasite spreads rapidly through skin‑to‑skin contact.
Fourth, decontaminate the environment. Wash all bedding, towels, and clothing used within the preceding 72 hours in hot water (≥ 50 °C) and dry on a high‑heat setting for at least 30 minutes. Items that cannot be laundered should be sealed in airtight bags for a minimum of 72 hours, during which the mites cannot survive. Vacuum carpets and upholstered furniture, then discard vacuum bags or clean the canister.
Fifth, monitor treatment efficacy. Persistent itching after the first week is common due to allergic reactions to dead mites; however, new lesions or worsening symptoms after 2 weeks suggest treatment failure and warrant re‑evaluation. Follow‑up examination should include repeat skin scraping if uncertainty remains.
Sixth, address special populations. In pregnant or lactating individuals, permethrin remains the preferred agent; ivermectin is contraindicated. In immunocompromised patients, more aggressive regimens and longer treatment courses may be necessary.
Finally, educate the patient on hygiene practices that reduce reinfestation: avoid prolonged skin contact with untreated individuals, maintain regular laundering of personal items, and seek prompt medical care if symptoms recur.