Treatment of Scabies

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Washing yourself and using over-the-counter medicines will not remove scabies, so it is important to visit your GP if you have an unidentified itchy skin condition.

There are two main types of lotions in use for scabies in the UK. These are applied to the whole body including the scalp, face, neck and ears. Special attention should be paid to skin between the toes and between the fingers, and under the nails. To prevent re-infestation, all people in close contact should be treated at the same time. This includes sexual partners and all members of the household, even if they are not yet showing any symptoms.

It is recommended that scabies should be treated with one of two medicines:

Permethrin cream. It tends not to irritate the skin and should be left on for 8 to 12 hours, or overnight, before being washed off.
Malathion lotion. This should be washed off after twenty-four hours. A small brush may help with application.

It is not advisable to apply your treatment straight after a hot bath or shower, because the lotion will be absorbed deeper into the body â€“ to work effectively it needs to stay on the surface of the skin. If hands are washed during the period of treatment, then the cream or lotion should be reapplied.

To prevent you becoming re-infested and to prevent you transmitting the mite to others, all clothing, towels, and bed linen should be machine-washed (at 50 degrees Celsius or above) after the first treatment is applied. Items that cannot be washed e.g. upholstery can be kept in plastic bags or covered in plastic for at least 72 hours to contain the mites until they die.

If applied correctly, the prescribed lotion or cream will kill the mites, but their bodies are still in the skin, which means that itching may continue for up to three weeks after successful treatment. Your GP may prescribe a topical corticosteroid or an anti-histamine lotion to help relieve itching. Calamine lotion and cool showers or baths may also be helpful.

If the itching does not begin to lessen or gets worse, or new burrows appear, treatment may need to be repeated.

Crusted scabies, in which thousands of mites may have infested the skin, can be more resistant to treatment. It may require more than one set of treatment to remove all the mites, and your GP may refer you to a specialist to ensure that the most appropriate treatment is given.