Treatment and Medication Options

Successful treatment of scabies means eradicating the mites. This involves using a medication known as a scabicide. While some over-the-counter creams and products can help reduce or alleviate symptoms like itching, they won’t kill mites. Scabicides are currently only available by prescription.

Medication Options

For common, noncrusted scabies, patients may be prescribed a topical medication.

Permethrin cream (Elimite) is the most commonly prescribed. Crotamiton lotion, crotamiton cream (Eurax, Crotan), sulfur ointment, or Lindane lotion may also be considered, depending on the needs of the patient.  These are applied to the entire body, from the neck down, on clean, dry skin and left on for about 8 to 14 hours before being washed off. You usually need to repeat this process a week after the first treatment to get rid of any newly hatched mites.

Treatment of crusted scabies calls for an oral antiparasitic medicine, Stromectol (ivermectin), along with topical medication. Depending on the severity of the infestation, these pills are taken in three, five, or up to seven doses.

In conjunction with a scabicide, your doctor may prescribe an antihistamine or steroid cream to help reduce itching and inflammation of the skin. 

Adults can usually go back to work, and children to school, the day after treatment.

Alternative and Complementary Therapies

Researchers have been looking into the effectiveness of essential oils as an alternative in treating scabies. A study published in April 2020 in the journal PLoS Neglected Tropical Diseases concluded that lemongrass oil — which is reported to have antiparasitic, antioxidant, antimicrobial and anti-inflammatory properties — should be considered a promising treatment.

Tea tree oil, which has antibacterial, anti-inflammatory, and anti-itching effects, has also been examined as a possible remedy for scabies. In a review of studies published in February 2016 in the American Journal of Tropical Medicine and Hygiene study authors called for more research into the topic, noting a growing resistance to current standard treatments like ivermectin and permethrin.