Scabies - Treatment 

Treating scabies 

See your GP immediately if you contract scabies and have not had a previous infection. If you delay treatment, you risk passing scabies on to someone else.

As other, more serious skin conditions can sometimes cause similar symptoms to scabies, your GP will need to rule these out.

If your partner has been diagnosed with scabies, you should visit your nearest sexual health clinic to be checked and, if necessary, treated.

To reduce the chances reinfection, avoid having sex and other forms of prolonged close bodily contact, such as holding hands, until both you and your partner have completed the full course of treatment.

Lotions and creams

The two most widely used treatments for scabies are special lotions or creams. Your doctor, pharmacist or nurse can advice you on which treatment to use.

Applying the cream or lotion

To prevent re-infection, all members of your household and any close contacts, including recent sexual partners (see diagnosing scabies for further details) should be treated at the same time as you, even if they do not have any symptoms.

You should apply the lotion to cool, dry skin and not after a hot bath. If you apply it when the body is hot, it will quickly be absorbed into the skin and will not remain on the area where the scabies burrows are present. You should also:

  • read the patient leaflet that comes with the product for details about where to apply the cream or lotion; some products need to be applied to the whole body, including the scalp and face, whereas others must only be applied from the neck down
  • pay particular attention to the areas that are difficult to reach, such as the back, the soles of the feet, between fingers and toes, under fingernails and the genitals
  • ensure that you apply it to areas where the scabies mites often burrow, such as the wrists, elbows, armpits, under the breasts and around the nipples in women
  • use a cotton bud or old toothbrush to apply the treatment under fingernails and toenails (afterwards, put the cotton bud or toothbrush in a bag and throw it away)
  • leave the treatment on the skin from 8-24 hours (depending on the preparation used) before washing it off thoroughly; follow the manufacturer's guidance regarding how long to leave on the cream or lotion
  • immediately re-apply the cream or lotion to any areas of skin that are washed during the period of application
  • wash bed linen, nightwear and towels after the first application (see below)
  • repeat the treatment procedure seven days after the first application to ensure it is successful; the second application will ensure any mites hatched from existing eggs are killed

You should contact your GP if the itching does not improve after two weeks of treatment and you notice new burrows on your skin. They may recommend the treatment is repeated or prescribe a different lotion for you to use.

Also speak to your GP or pharmacist if you experience any persistent side effects.

Infection control

On the day you first apply the cream or lotion you should wash all bed linen, nightwear and towels at a temperature above 50C (122F).

If you are unable to wash certain items, place them in a plastic bag for at least 72 hours. After this time, the scabies mites will have died.

In cases of crusted scabies, you should clean the floors in your house and thoroughly vacuum your carpets and furniture (armchairs and sofa).

If you have been diagnosed with scabies, avoid close and prolonged physical contact with others until you have applied the cream or lotion. You should also avoid close contact with other household members until their treatment has been completed.

Children and adults can return to school or work after the first treatment has been completed.

Itchiness

Your GP should also be able to prescribe creams, such as a mild steroid cream, to help reduce itchiness. Calamine lotion, available without a prescription at pharmacies, may also help relieve itchy skin.

Oral antihistamines can also be used to help control itching and enable you to get a better night’s sleep. They can also be bought at your local pharmacy. However, oral antihistamines can cause drowsiness, so avoid driving or operating heavy machinery if you are affected in this way. Check with your GP or pharmacist if you are unsure.

You may continue to experience itchiness for a couple of weeks after your treatment has been completed. This is because your immune system will still be reacting to the presence of dead mites and their droppings. Visit your GP if you are still experiencing itchiness for longer than six weeks after your treatment has been completed.


Page last reviewed: 28/05/2012

Next review due: 28/05/2014

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The 1 comments posted are personal views. Any information they give has not been checked and may not be accurate.

cbarker said on 12 November 2009

According to another site there are national guidlines that state the whole body and scalp should be treated. I would expect the NHS site to reflect this, surprisingly, it does not. Conflicting advice (or out of date advice) causes confusion.

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