Medicines and products for scabies

Scabies is treated with medicines that kill the mites. Doctors usually choose between permethrin cream, oral ivermectin and a few other options. Treat everyone in close contact at the same time, and follow instructions carefully.

Permethrin 5% cream The most common first-line treatment. Apply it over the whole body from the neck down (and the scalp, face and ears in babies and the elderly), including under the nails, between the fingers and toes, and in skin folds. Leave it on for 8 to 14 hours, usually overnight, then wash off. A second application after 7 to 14 days is often advised to kill newly hatched mites.

Oral ivermectin Tablets taken as a weight-based dose, usually repeated after 7 to 14 days. It is useful for crusted scabies, outbreaks and people who cannot use creams. It is not advised in pregnancy, in breastfeeding without advice, or in children below a certain weight, so a doctor must decide.

Other options

• Benzyl benzoate lotion, which can sting and is used in diluted form for children.
• Sulphur ointment (5 to 10 percent), a traditional option sometimes used for babies and pregnancy under medical advice.
• Crotamiton cream, less effective but sometimes used.

Relief of itching Antihistamine tablets, moisturisers and calamine lotion. A doctor may prescribe a mild steroid cream for the lasting itch after the mites are killed, but steroid cream should not be used alone.

Infection Skin infections from scratching may need antibiotics.

Special groups Babies, pregnant and breastfeeding women, the elderly and people with weak immunity need medicine chosen and dosed by a doctor.

Ayurvedic view (interpretive) Herbal and sulphur-based preparations are used traditionally, but they should not replace proven treatment without medical advice.

Remember Repeat the treatment as advised and treat the whole household. Itch may remain for weeks after the mites are gone.