Scabies treatment: how to get rid of the mites and the itch
Got a relentless itch that’s worse at night? That’s the classic sign of scabies—tiny mites burrowing into the skin. The good news: scabies is treatable. The better news: with the right steps you can stop the spread and start feeling better in days. Here’s a simple, practical plan you can use now.
Diagnosis and first steps
Before treating, aim for confirmation. A doctor will usually spot the thin tracks or bumps and may take a skin scraping. If a clinic visit isn’t possible right away, treat quickly when symptoms and close contact history point to scabies—delaying only spreads it to others.
Don’t wait: treat household members and close contacts at the same time, even if they have no symptoms. Scabies spreads easily through skin contact and shared bedding.
At-home and prescription treatments
Permethrin 5% cream is the most common first-line treatment. Apply it to clean, dry skin from the neck down (and to the scalp and face for infants or the elderly) and leave on overnight—8 to 14 hours—then wash off. Repeat once after 7 days to catch newly hatched mites.
Oral ivermectin is another effective option, usually given as a single dose and repeated after 7–14 days. Your doctor will tell you the right dose. Ivermectin is handy for large outbreaks, nursing homes, or when creams are impractical. It’s not typically used in young children or during pregnancy.
Other options include topical benzyl benzoate, sulfur ointment (safe for infants), and crotamiton in some countries. Use only what your clinician recommends—don’t mix multiple treatments without advice.
Practical tips: trim fingernails, wash bedding and clothes in hot water (60°C/140°F) and dry on high heat, or seal items in plastic for 72 hours. Vacuum floors and furniture. Pets rarely transmit human scabies, so treating them is usually unnecessary.
Expect itching to continue for a while after treatment. The immune reaction to dead mites can keep the rash and itch going for 2–4 weeks—sometimes longer. Antihistamines, mild topical steroids, or soothing lotions can help control symptoms while your skin heals. If you see signs of infection (increasing redness, pain, pus), see a doctor—antibiotics might be needed.
When to get urgent help: if you’re immunocompromised, have widespread crusted scabies (thick crusts and heavy scaling), are pregnant, or your child is very young. Crusted scabies needs aggressive treatment and public-health measures because it’s highly contagious.
One final tip: avoid repeated self-treating without guidance. Overusing permethrin or other products can irritate skin and mask problems. Follow your prescriber's instructions, treat contacts, clean your home, and give your skin time to recover. If symptoms don’t improve after a proper treatment course, revisit your clinician for re-evaluation and next steps.
