How to treat or cure scabies

Scabies can be cured. A single, correctly used course of medicine, repeated as advised, clears the mites in nearly all people. The most important points are using the medicine properly, treating everyone in the household at once and cleaning clothes and bedding.

Step 1: Confirm the diagnosis A doctor can recognise scabies from the itch pattern and burrows, and may confirm it with a skin scraping or dermoscopy. Eczema, allergic rash and other conditions can look similar.

Step 2: Use a mite-killing medicine

• Permethrin 5% cream applied from the neck down, left on overnight (8 to 14 hours), then washed off, and repeated after 7 to 14 days.
• Or oral ivermectin, repeated after 7 to 14 days, if prescribed.
• Other options exist for babies and pregnancy, and are chosen by a doctor.

Step 3: Treat contacts at the same time Everyone in close contact needs treatment on the same day, even without symptoms.

Step 4: Clean the environment Wash and hot-dry clothes, towels and bedding used in the last three days, bag unwashable items for 72 hours and vacuum furniture.

Step 5: Ease the itch Moisturisers, cool compresses, antihistamines and a doctor-prescribed mild steroid cream if needed. Itching can persist for two to four weeks.

Step 6: Follow up If new burrows or rash appear after two to four weeks, see the doctor, since a second course or a different medicine may be needed.

Crusted scabies Needs stronger, combined treatment, often with oral medicine and sometimes isolation, under medical supervision.