Diagnosis

To diagnose scabies, your doctor examines your skin, looking for signs of mites, including the characteristic burrows. When your doctor locates a mite burrow, he or she may take a scraping from that area of your skin to examine under a microscope. The microscopic examination can determine the presence of mites or their eggs.

Treatment

Scabies treatment involves eliminating the infestation with medications. Several creams and lotions are available with a doctor's prescription. You usually apply the medication over all your body, from your neck down, and leave the medication on for at least eight hours. A second treatment is needed if new burrows and rash appear.

Because scabies spreads so easily, your doctor will likely recommend treatment for all household members and other close contacts, even if they show no signs of scabies infestation.

Medications commonly prescribed for scabies include:

  • Permethrin cream, 5 percent (Elimite). Permethrin is a topical cream that contains chemicals that kill scabies mites and their eggs. It is generally considered safe for adults, pregnant women, and children ages 2 months and older. This medicine is not recommended for nursing mothers.
  • Lindane lotion. This medication — also a chemical treatment — is recommended only for people who can't tolerate other approved treatments, or for whom other treatments didn't work. This medication isn't safe for children younger than age 2 years, women who are pregnant or nursing, the elderly, or anyone who weighs less than 110 pounds (50 kilograms).
  • Crotamiton (Eurax). This medication is available as a cream or a lotion. It's applied once a day for two days. This medication isn't recommended for children or for women who are pregnant or nursing. Frequent treatment failure has been reported with crotamiton.
  • Ivermectin (Stromectol). Doctors may prescribe this oral medication for people with altered immune systems, for people who have crusted scabies, or for people who don't respond to the prescription lotions and creams. Ivermectin isn't recommended for women who are pregnant or nursing, or for children who weigh less than 33 pounds (15 kg).

Although these medications kill the mites promptly, you may find that the itching doesn't stop entirely for several weeks.

Doctors may prescribe other topical medications, such as sulfur compounded in petrolatum, for people who don't respond to or can't use these medications.

Lifestyle and home remedies

Itching may persist for some time after you apply medication to kill the mites. These steps may help you find relief from itching:

  • Cool and soak your skin. Soaking in cool water or applying a cool, wet washcloth to irritated areas of your skin may minimize itching.
  • Apply soothing lotion. Calamine lotion, available without a prescription, can effectively relieve the pain and itching of minor skin irritations.
  • Take antihistamines. At your doctor's suggestion, you may find that over-the-counter antihistamines relieve the allergic symptoms caused by scabies.

Preparing for your appointment

Make an appointment with your family doctor or pediatrician if you or your child has signs and symptoms common to scabies.

Here's some information to help you get ready for your appointment and know what to expect from your doctor.

Information to gather in advance

  • List any signs or symptoms you or your child has had, and for how long.
  • List any possible sources of infection, such as other family members who have had a rash.
  • Write down key medical information, including any other health problems and the names of any medications you or your child is taking.
  • Write down questions you want to be sure to ask your doctor.

Below are some basic questions to ask your doctor about scabies.

  • What is the most likely cause of these signs and symptoms?
  • Are there any other possible causes?
  • What treatment approach do you recommend?
  • How soon do you expect symptoms to improve with treatment?
  • When will you see me or my child to determine whether the treatment you've recommended is working?
  • Are there any home remedies or self-care steps that could help relieve symptoms?
  • Am I or is my child contagious? For how long?
  • What steps should be taken to reduce the risk of infecting others?

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your doctor may ask:

  • What signs and symptoms have you noticed?
  • When did you first notice these signs and symptoms?
  • Have these signs and symptoms gotten worse over time?
  • If you or your child has rash, what parts of the body are affected?
  • Has anyone else with whom you have frequent, close contact had a rash, an itch or both within the past several weeks?
  • Are you currently pregnant or nursing?
  • Are you or is your child currently being treated or have you or your child recently been treated for any other medical conditions?
  • What medications are you or your child currently taking, including prescription and over-the-counter drugs, vitamins and supplements?
  • Is your child in child care?

What you can do in the meantime

In the time leading up to your appointment, try at-home and over-the-counter (OTC) remedies to help reduce itching. Cool water, antihistamines and calamine lotion may provide some relief. Ask your doctor what OTC medications and lotions are safe for your child.

July 07, 2015
References
  1. Scabies. Centers for Disease Control and Prevention. http://www.cdc.gov/parasites/scabies/. Accessed May 27, 2015.
  2. Scabies. American Academy of Dermatology. https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/q---t/scabies. Accessed May 27, 2015
  3. Medications. Centers for Disease Control and Prevention. http://www.cdc.gov/parasites/scabies/health_professionals/meds.html. Accessed May 27, 2015.
  4. Stromectol (prescribing information). Whitehouse Station, N.J.: Merck & Co. Inc.; 2010. http://www.merck.com/product/prescription-products/home.html. Accessed May 27, 2015.
  5. Permethrin cream (prescribing information). Bronx, N.Y.: Perrigo; 2010. http://www.perrigo.com/search.aspx?term=permehtrin%20cream. Accessed May 27, 2015.
  6. Lindane lotion (prescribing information). Morton Grove, Ill.: Morton Grove Pharmaceuticals Inc.; 2007. http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=770415b2-4555-4abc-b5d6-c67dfb07ab30. Accessed May 27, 2015.
  7. Eurax (prescribing information). Jacksonville, Fla.: Ranbaxy; 2009. http://euraxrx.com/. Accessed May 27, 2015.
  8. Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. June 4, 2015.
  9. Parasites — scabies. http://www.cdc.gov/parasites/scabies/health_professionals/meds.html. Accessed June 9, 2015.