Scabies is treated with medicines to eliminate infestation with mites. Medicines used for the treatment of scabies can be in the form of creams and lotions or oral medication (to be taken by mouth). When scabies is treated, all the family members and sexual contacts will also need to be treated if they have symptoms or if transmission is likely.
Medications: Commonly used medications for treatment of scabies include:
Permethrin 5 percent: It is one of the most commonly used creams for scabies. It contains a chemical that kills the mites that cause scabies. The cream has to be applied on the whole body below the head including the hands, palms and soles of the feet. In some cases like children with scabies, the doctor may recommend applying the cream on scalp as well. Before applying the medicine, ensure that the skin is clean and dry. In has to be applied and left for 8-12 hours. After being left for a few hours, the cream is washed off (most creams have to be applied at night and washed off in the morning). You may be advised to apply the cream twice with a gap of a week or so between each application. It is a safe medication and can be used in children and adults of all ages including women, who are pregnant or nursing.
Lindane: It is available as cream, lotion and shampoo. It is usually applied twice with a gap of a week or so between each application. This medication is not used for children younger than 2 years, women who are pregnant or nursing or people with weakened immune systems owing to safety concerns.
Crotamiton: It is a nonchemical medication, which is meant to be applied once a day for two to five days. It may be recommended if your baby has scabies.
Ivermectin: This medicine is given orally (i.e. by mouth). It, however, is not approved by the FDA for the treatment of scabies. It is usually prescribed for people with weak immune system, people who have crusted scabies (Norwegian scabies) or if prescription of topical medications has failed. It is given at a dose of 200 micrograms per kilogram of body weight as a single dose followed by another dose 2 weeks later.
All the above mentioned medications kill the mites promptly, but the itching may not stop completely for several weeks. Your doctor may prescribe an antihistamine such as Benadryl to provide relief from intense itching. Some people may be given a short course of either topical or oral steroids to control itching. Relief from the itching can be obtained by soaking in cool water and using calamine lotion.
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