Getting rid of scabies

What is the best way to treat scabies at home?

Anyone trying a home remedy for scabies should consult a doctor if the infestation does not clear up or show signs of improving.

1. Tea tree oil

Share on PinterestTea tree oil may help to relieve some of the symptoms of scabies.

Tea tree oil is a well-known essential oil. In some studies, it has shown some promise as being effective in the treatment of scabies. Additional studies are still needed, however.

Tea tree oil can help alleviate some of the itchiness associated with scabies, in addition to other treatments.

The oil has not been found to be effective against the eggs that are buried deep within the skin.

Tea tree oil can be purchased online. Some people are allergic to tea tree oil. People who are allergic should not use tea tree oil for scabies and should find an alternative method.

2. Aloe vera

Aloe vera is well-known for its soothing effect on sunburn and other skin ailments. Aloe vera is usually considered safe to use with minimal side effects reported. Aloe vera gel can be purchased online.

One small study has shown that aloe vera is effective in treating scabies. It was, in fact, found to be as effective as a prescription drug called benzyl benzoate.

More research is required to fully test the effects of aloe vera in the treatment of scabies.

3. Neem

Neem is an oil. It can be found in creams and ointments available online. Neem has analgesic, antibacterial, and anti-inflammatory properties.

There have been some studies that suggest that neem is effective in treating scabies because it kills the mites.

One study tested the effects of neem on dogs. Most of the dogs were cured of scabies within 2 weeks of consistently using shampoo that contained neem. The dogs that did not fully recover saw big improvements in the total number of mites left in their skin.

Additional studies on humans are needed to test neem’s effectiveness as a treatment for scabies in humans.

4. Clove oil

A single study showed that clove oil was effective in treating scabies in a group of rabbits and pigs. Other oils tested did not perform as well as clove oil.

Again, this is a case where additional studies need to be done to fully test whether or not clove oil is effective on scabies when the mites occur in humans.

5. Cayenne pepper

Share on PinterestCapsaicin, found in cayenne peppers, is thought to help alleviate pain and itchiness.

Cayenne pepper has not been proven effective in treating scabies. Nevertheless, some people believe that it is an effective treatment against the mites.

Cayenne pepper does have some usefulness when it comes to scabies, despite some controversy.

According to one study, capsaicin, a compound found in cayenne pepper, desensitizes the skin when it is applied directly. This can help alleviate some of the pain and itchiness associated with scabies.

Creams with capsaicin are available to purchase online. Speak to a doctor before using these products.

6. Turmeric

Little evidence supports the effectiveness of turmeric in treating scabies. However, some people claim that it is effective in alleviating the symptoms.

Treating the symptoms will not stop or cure the infestation, so other methods of treatment will still be required.

7. Zinc

Zinc is not a direct treatment for scabies. Instead, people recommend using zinc to help fight off secondary infections that may result from the open skin wounds that can result from a person scratching.

8. Wash clothes in hot water

Though not a direct treatment for the infection, an individual should wash any clothing, bedding, or other fabric that has come in contact with them or their skin if they have scabies. This will remove mites hiding in the fabric and help prevent them spreading to other areas of their body or other individuals.

9. Borax

Borax or sodium borate is controversial at best. It is mostly used in household cleaning products, such as laundry washes.

Though some people claim it can help with scabies, others question it is safe to use for humans.

It should not be used directly on the skin, but it may be effective in a person’s laundry when trying to eliminate the scabies mites.

10. Bleach

Though it may kill the mites, bleach is a harsh chemical and should always be diluted and treated with great care.

It can also damage a person’s skin, eyes, and lungs. Again, it should only be used as a cleaning product and should not come into contact with the skin itself.

11. Vacuuming

Similarly to washing clothes, vacuuming the house will not cure the infestation that is affecting an individual. However, vacuuming up any mites that could be in floor coverings will help prevent scabies from spreading to other people.

12. Apple cider vinegar

Much has been written about apple cider vinegar, and some believe it may be effective in treating scabies. There is little evidence to back up the claims, however.

Treatment

Suggested General Guidelines

It is important to remember that the first time a person gets scabies they usually have no symptoms. Symptoms can typically take 4-8 weeks to develop after they are infested; however they can still spread scabies during this time.

In addition to the infested person, treatment also is recommended for household members and sexual contacts, particularly those who have had prolonged direct skin-to-skin contact with the infested person. Both sexual and close personal contacts who have had direct prolonged skin-to-skin contact with an infested person within the preceding month should be examined and treated. All persons should be treated at the same time to prevent reinfestation. Scabies may sometimes be sexually-acquired in adults, but is rarely sexually-acquired in children.

Bedding, clothing, and towels used by infested persons or their household, sexual, and close contacts (as defined above) anytime during the three days before treatment should be decontaminated by washing in hot water and drying in a hot dryer, by dry-cleaning, or by sealing in a plastic bag for at least 72 hours. Scabies mites generally do not survive more than 2 to 3 days away from human skin.

Use of insecticide sprays and fumigants is not recommended.

Medications Used to Treat Scabies

Products used to treat scabies are called scabicides because they kill scabies mites; some also kill mite eggs. Scabicides used to treat human scabies are available only with a doctor’s prescription. No “over-the-counter” (non-prescription) products have been tested and approved to treat scabies. The instructions contained in the box or printed on the label always should be followed carefully. Always contact a doctor or pharmacist if unsure how to use a particular medicine.

Scabicide lotion or cream should be applied to all areas of the body from the neck down to the feet and toes. In addition, when treating infants and young children, scabicide lotion or cream also should be applied to their entire head and neck because scabies can affect their face, scalp, and neck, as well as the rest of their body. Only permethrin or sulfur ointment may be used in infants. The lotion or cream should be applied to a clean body and left on for the recommended time before washing it off. Clean clothing should be worn after treatment. Both sexual and close personal contacts who have had direct prolonged skin-to-skin contact with an infested person within the preceding month should be examined and treated. All persons should be treated at the same time to prevent reinfestation.

The instructions contained in the box or printed on the label always should be followed carefully. Always contact a doctor or pharmacist if unsure how to use a particular medicine.

Because the symptoms of scabies are due to a hypersensitivity reaction (allergy) to mites and their feces (scybala), itching still may continue for several weeks after treatment even if all the mites and eggs are killed. If itching still is present more than 2 to 4 weeks after treatment or if new burrows or pimple-like rash lesions continue to appear, retreatment may be necessary.

Skin sores that become infected should be treated with an appropriate antibiotic prescribed by a doctor.

Permethrin Topical

Permethrin comes as a cream to apply to the skin. Over-the-counter permethrin comes as a lotion to apply to the scalp and hair. Permethrin cream is usually applied to the skin in one treatment, but occasionally a second treatment is necessary. Permethrin lotion is usually applied to the skin in one or two treatments, but occasionally three treatments are necessary. If live mites are seen two weeks (14 days) after the first treatment with permethrin cream, then a second treatment should be applied. If live lice are seen one week after the first treatment with over-the-counter permethrin lotion, then a second treatment should be applied. Follow the directions on your prescription label or the package label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use permethrin exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Permethrin should only be used on the skin or hair and scalp. Avoid getting permethrin in your eyes, nose, ears, mouth, or vagina. Do not use permethrin on your eyebrows or eyelashes.

If permethrin gets in your eyes, flush them with water right away. If your eyes are still irritated after flushing with water, call your doctor or get medical help right away.

To use permethrin cream, follow these steps:

  1. Apply a thin layer of cream all over your skin from your neck down to your toes (including the soles of your feet). Be careful to apply cream in all skins folds, such as between your toes and fingers or around your waist or buttocks.
  2. For treatment of babies or adults over 65 years of age, the cream should also be applied to the scalp or hairline, temples, and forehead.
  3. You may need to use all of the cream in the tube to cover your body.
  4. Leave the cream on your skin for 8-14 hours.
  5. After 8-14 hours have passed, wash off the cream by bathing or showering.
  6. Your skin may be itchy after treatment with permethrin cream. This does not mean your treatment did not work. If you see live mites 14 days or more after treatment, then you will need to repeat the treatment process.

To use the lotion, follow these steps:

  1. Wash your hair with shampoo and rinse with water. Do not use a conditioner or a shampoo that contains a conditioner because your treatment will not work as well.
  2. Dry your hair with a towel until just damp.
  3. Shake permethrin lotion well right before use to mix the medication evenly.
  4. Use a towel to cover your face and eyes. Be sure to keep your eyes closed during this treatment. You may need to have an adult help you apply the lotion.
  5. Apply permethrin lotion to your hair and scalp area. Begin to apply the lotion behind your ears and at the back of your neck and then cover all of the hair on your head and scalp.
  6. Keep the lotion on your hair and scalp for 10 minutes after you finish applying permethrin lotion. You should use a timer or clock to track the time.
  7. Rinse your hair and scalp with warm water in a sink. You should not use a shower or bathtub to rinse the lotion away because you do not want to get the lotion over the rest of your body.
  8. Dry your hair with a towel and comb out tangles.
  9. You and anyone who helped you apply the lotion should wash your hands carefully after the application and rinsing steps.
  10. A lice comb may also be used to remove the dead lice and nits (empty egg shells) after this treatment. You may also need to have an adult help you to do this.
  11. If you see live lice on your head 7 days or more after treatment, repeat this entire process.

After using permethrin, sanitize all the clothing, underwear, pajamas, hats, sheets, pillowcases, and towels you have used recently. These items should be washed in very hot water or dry-cleaned. You should also wash combs, brushes, hairs clips and other personal care items in hot water.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

Can Scabies Be Treated with Over-the-Counter Products?

Nix

Nix is an OTC version of 1 percent permethrin. It’s most often used for head lice. Most doctors recommend using permethrin of at least 5 percent for the treatment of scabies in order to kill both the mites and their eggs. Since scabies spreads quickly, treating with Nix may not kill the infestation.

Sulfur soaps and creams

Sulfur can be used in the form of soap, ointment, shampoo, or liquid. It’s possible to get OTC soaps and creams containing 6 to 10 percent sulfur. This treatment can be used alongside treatments from your doctor. However, discuss using sulfur with your doctor before use for best results.

Calamine lotion

This is a treatment for symptoms only. It won’t kill scabies or their eggs.

Calamine lotion causes a cooling sensation on your skin that helps relieve itching. Clean your skin with soap and water and let dry. Then apply the lotion to your skin with cotton or a soft cloth. You can use calamine lotion up to four times per day.

Antihistamines

This is a treatment for symptoms only. Antihistamines won’t kill scabies or their eggs.

OTC histamines can also help relieve itching. Popular antihistamines include Zyrtec, Allegra, and Claritin. Benadryl and Chlor-Trimeton are considered first-generation antihistamines. This means they may make you drowsier than others. A pharmacist can help you choose which is right for you.

Over-the-counter products for the home | Products for the home

Since scabies spreads fast, you’ll need to treat your home as well. This will help ensure the scabies are fully removed from your environment.

  • Use disinfectant sprays, including those that contain permethrin, on surfaces and clothing.
  • Apply rubbing alcohol or Lysol to kill bugs on hard surfaces.
  • Wash clothes and bed linens in hot water and dry on a hot cycle.
  • If you don’t have access to hot water, place the items in plastic bags and store them away from home for five to seven days.
  • Wash your pets with a pet-specific solution, such as sulfur concentrate pet dip.
  • Sprinkle borax on carpets and vacuum after about an hour.
  • Steam clean your carpets. Many grocery stores and department stores rent out steam cleaners at a reasonable price.
  • Replace your mattress or use a zippered cover without removing it for a few weeks.
  • Put all stuffed toys or unwashable fabrics in a sealed bag for a few weeks and the scabies will die off.

What Is the Treatment for Lice?

Head Lice

Getting rid of head lice involves the use of over-the-counter treatments or prescription medications, typically in conjuction with combing the hair with a special comb. In some geographical locations, lice are resistant to certain treatments. Ask your doctor if your area has resistant lice so that you can be sure to get the most effective treatment.

Some prescription and over-the-counter treatments kill both the live lice and their eggs, also called nits. Other products require two applications, approximately 7 to 9 days apart. Check the label to see if the product kills both lice and eggs, and how to use it correctly.

Over-the-counter products with pesticides include:

  • Pyrethrins are a common treatment that is available over the counter. Some studies suggest pyrethrins can affect cognitive development in children. More research is needed. Brand names include Rid, Triple X, Pronto, A-200. For best results, follow the directions exactly.
  • Permethrin lotion 1% (also known as Nix) is another over-the-counter product that only kills lice, but not eggs, and will require repeat treatment in nine to 10 days.

Pesticide-free, over-the-counter treatments can contain dimethicone. This is a nonpesticide, silicone-based material that works by coating lice and disrupting their ability to manage water. Some studies have shown it to be more effective than products that contain pesticides.

Prescription treatments include:

  • Malathion lotion 0.5% (also known as Ovide) is a prescription medication that is approved for head lice and can kill some eggs. Directions and precautions for use must be strictly followed.
  • Lindane shampoo 1% is not approved for lice treatment anymore, since in young children, it can attack and damage the brain and other parts of the nervous system.
  • Spinosad (Natroba) is topical and applied to the scalp. It is not approved for use on children under age 4.
  • Another treatment is a topical lotion called Sklice. A comb is not required with Sklice and one treatment may be all that’s needed. The active ingredient is ivermectin, a powerful parasite killer. Sklice can be used in children as young as 6 months.

Search for a condition

To prevent getting scabies in the first place, try to avoid direct contact with somebody who’s infested. Be wary of using public areas such as tanning booths unless you’re sure that they’ve been disinfected.

A one-time application of permethrin cream or lotion to the skin is usually effective in curing scabies, but a second application is recommended after a week to ensure all mites are killed. The whole body has to be cleaned (with warm water, not hot) and covered with the cream. Clean clothes should be worn during treatment, which lasts 8 to 14 hours, and then again after the cream has been washed off.

Clothes worn during the 3 days before treatment and any used bed sheets or towels should be washed in hot soapy water and then placed in the dryer on the hot cycle to kill both the mites and their eggs.

Get special instructions from your doctor or pharmacist about how much cream infants or young children need. A small amount of permethrin can be absorbed through the skin, and might come out in breast milk. If you’re pregnant or breast-feeding, talk to your doctor about an alternative treatment.

In the past, another medication called lindane was used to treat scabies. It is not used very frequently now because it can cause neurotoxic side effects such as seizures.

After treatment, the itching won’t go away immediately and might last for several weeks. This can be relieved with antihistamines, mild soaps, or prescribed corticosteroid lotions. But if you still feel intense itching after a month, you should see your doctor again as you may need to be retreated.

It’s a good idea for everyone living under the same roof to be treated at the same time. This will lessen the chances of reinfection with the scabies mite. Disinfect your home, and wash all clothing and linen in hot water and then dry on a hot cycle. You could also put clothes, linens, toys, or household articles in a sealed plastic bag for a week. The pest will die off and the clothes can be worn again.

*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.

All material copyright MediResource Inc. 1996 – 2020. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Scabies

7 Most Effective Home Remedies for Scabies

Scabies is a skin condition caused by the mite Sarcoptes scabiei. Sarcoptes scabiei is a parasitic mite that infests and attacks the skin to cause this skin disease. Symptoms of scabies include itching and a pimple-like rash. The itching usually becomes severe at night. Anyone can get scabies and the disease usually spreads by direct skin to skin contact with an infected person. The scabies’ mite can only survive without human contact for 48-72 hours. But once the mites are on a human being, they can survive for almost 2 months. The symptoms usually take two to six weeks to show when a person is infected for the first time. When somebody develops this infection for the second time, the symptoms may begin within a day. Rashes are normally seen around the wrists, elbows, finger webs, skin around the nails and buttocks.Scabies usually occurs in the people with a poor immune system. Crusted scabies is commonly seen in elderly people and people who already have an impaired immune system due to HIV or cancer.

According to dermatologist Dr. Deepali Bhardwaj, there are no home remedies for scabies and we should aim to get rid of the mites. There are, though, some remedies which can provide relief from itches and rashes.

Let’s go through some simple home remedies that can be useful to get rid of scabies symptoms:

1. Neem
Neem leaves have anti-bacterial properties which is why it works wonders on infections, burns and any kind of skin problems.Neem is one medicinal tree with a multitude of benefits. A paste of neem and turmeric proves to be very helpful for scabies. Even neem oil can help provide relief.

(Also Read:Neem for Dandruff: A Natural Remedy to Get Rid of It)
Neem leaves have anti-bacterial properties

2. Clove Oil
Studies have found that clove oil helps in getting rid of scabies because it has anti-inflammatory and anti-bacterial properties. But, experts advise against using clove oil in its undiluted form. Instead, mix it with coconut oil and apply it on your skin before bathing. Do this for 2-3 weeks.
(Also Read: 14 Amazing Benefits of Clove Oil)


Clove oil helps in getting rid of scabies because it has anti-inflammatory and anti-bacterial properties

3. Turmeric
We’ve already mentioned above how turmeric makes an excellent home remedy for scabies when mixed with neem oil. Here is another way to use turmeric for relief from severe itching. Add a few drops of lemon juice to one tablespoon of turmeric and form a smooth paste before applying it. Apply the paste and leave for a little while and wash it off.
(Also Read: 8 Health Benefits of Turmeric (Haldi): Getting Back to the Roots)


Turmeric is filled with anti-inflammatory properties

4. White Vinegar
Mix equal amounts of white vinegar and water thoroughly in a bowl. Use a cotton ball to apply the solution on the affected skin and leave it on for a few minutes. Rinse it off with lukewarm water. Repeat three times daily for 10 to 15 days to fight the infection completely. White vinegar has an acidic nature which helps to change the pH levels of skin and the changes in pH levels cause mites to die.

5. Aloe Vera
Aloe Vera has many medicinal properties which can accelerate the healing process of scabies. Apply fresh aloe vera gel on the affected skin. Leave it on for half an hour and then rinse it off with lukewarm water. Repeat two or three times daily for a few days and you will begin to notice an improvement in the skin condition.
(Also Read: 6 Amazing Benefits of Aloe Vera for Hair, Skin and Weight-Loss)


Aloe Vera has many medicinal properties

6. Bleach
Bleaching is an essential part of skin and beauty care regimen. Bleach helps in killing mites. Mix together one part of bleach and four parts of water and spray this solution on the affected area twice daily. Repeat the process for a few days.

7. Curd and Fish
Curd is loaded with several essential nutrients like calcium, vitamin B-2, vitamin B-12, potassium, and magnesium. Including curd and fish in your diet could prove to be a relief from all the itchiness and rashes.

These are a few simple and easily available home remedies that will help you reduce the itchiness and rashes associated with scabies. Dr. Deepali also suggests taking a bath twice daily with a transparent soap which contains glycerin and wearing linen clothes.
Disclaimer:

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Fastest Way To Get Rid Of Scabies

Fastest Way To Get Rid Of Scabies

  1. 1. Fastest Way To Get Rid Of ScabiesIf the itching continue for more than 7 days, do not more than use the medication and contactto your medical professional.So to get rid of scabies you need to quickly get started cure and ought to keep away fromspreading the mite.Scabies is a variety of contagious skin infection brought about by a type of mite. Scabies ischaracterised by intensive itching, unrelenting skin discomfort and tiny skin papules. The mitedependable for resulting in scabies is regarded as sarcoptes scabeii. Scabies is usuallymistaken for pimples, mosquito bites and, most lately, bed bug bites. If you have an irritatingskin infection, verify for these typical traits of a scabies outbreak: tiny, pimple-like bumpssores caused by incessant itching, rashes, especially on your wrists, amongst fingers, on theelbow, knee, shoulder blades, breasts or genitals intense itching and deficiency of restbecause of to skin pain.Some of the most generally recommended medications applied to handle scabies consist ofpermethrin, lindane and malathion. Permethrin is very harmful to pets and can haveneurotoxic results on human beings. The Entire world Health Business classifies lindane aspossibly, acutely harmful. Continual publicity to and absorption of malathion can impairmemory.Finding rid of scabies by natural means is non-toxic and wont cause harm to your animals.Balsam of Peru is an important oil derived from South and Central American trees employedas a topical antiseptic applied externally to your skin. Balsam of Peru, offered above-the-counter at health foods outlets, performs like an antimicrobial and eases skin discomfort anditching. Incorporate in between thirty and forty drops to a ten % sulfur ointment andimplement at bedtime. Cajeput, an oil derived a native Australian tree, is an organic scabiescure. Merge from two to 5 drops of cajeput oil with a topical, about-the-counter ointment torelieve skin discomfort related with scabies. Camphor, a scabies counterirritant, is a pale-coloured, waxy compound that is quite fragrant. It is derived from the wood of an Asianevergreen tree. Mix a handful of drops of camphor oil and coconut oil and apply to impactedlocations.Due to the fact scabies is contagious, in buy to avert acquiring re-infected, you require to becertain that all people in your residence scabies cost-free, even if they do not show signs. Itreally is not unconventional for some persons to show number of or no signs and symptomsfrom a scabies infection. Whilst the normal therapies used for managing scabies is safe, youmay possibly want to check with your pediatrician just before applying to the skin of ayouthful little one. There are no scabies vaccinations.If you are hunting for the swiftest way to get rid of scabies, the real truth is that a
  2. 2. multidimensional approach is ideal. While there are some very effective insecticides whichwill eliminate the scabies mites, reinfestation is amazingly common and will happen if you donot consider safety measures.Scabies is characterised by intensive itching in the areas populated by the mites. Scabiesburrow through the skin and lay their eggs underneath the area. They have a tendency toseek out shelter in the much less uncovered regions of the human body, these kinds of asinvolving the fingers and toes, in the armpits, and close to the genitals, despite the fact thatthey can surface anywhere.the scabies 24-hour natural remedy report ebook

What to Do About Scabies

The vast amount of internet discussion notwithstanding, Dr. Taylor suggests patients rid themselves of scabies with conventional scabicides, not unproven natural approaches. If you Google “scabies” and “natural remedies,” you will get hundreds of hits. There are many internet sites devoted to this pesky problem. Among the recommendations are applying tea tree oil, eating a diet of only fresh citrus fruit, and even ingesting raw egg yolks. Family physicians, pediatricians and dermatologists evaluate and treat a lot of patients for scabies, many of whom do not like the idea of using strong chemical insecticides on their own or their children’s skin. In addition to concerns about toxicity, resistance of the scabies mite to conventional topical and oral therapies is increasing.1 Let’s quickly review what scabies is, the natural remedies that your patients may be trying, and whether anything natural is likely to kill those mites.

Scabies and its Symptoms2

Scabies is a parasitic infestation in which tiny Sarcoptes scabiei mites burrow under the skin and cause intense allergic itching. The itching of scabies results primarily from the body’s allergic reaction to the mites, their eggs and their feces. Intense itching, which is classically worse at night, is the main and most bothersome symptom. Aside from the itching, symptoms may include red or urticarial papules on the skin. These lesions can be found on the fingers, wrists, elbows, waist, buttocks and genital area. The mites can also burrow under fingernails or around the skin near watchbands or rings. Breaks in the skin from vigorous scratching can lead to secondary Staphylococcal and Streptococcal bacterial infections. It is important to remember that people infected with scabies usually have no symptoms during the first 2 to 6 weeks they are infested; however, they can still spread scabies during this time.2

Scabies Transmission2

Sarcoptes scabiei var. hominis, the human itch mite, is in the arthropod class Arachnida, subclass Acari, family Sarcoptidae. Sarcoptes scabies is an eight-legged mite. Females burrow into the stratum corneum, creating a tunnel in which they deposit their eggs. Female mites live for 4 to 6 weeks and produce two to three eggs per day, which are deposited in the burrowed tunnel. Larvae hatch 3 to 4 days after the eggs have been laid, and adult mites develop 10 to 14 days later. Under the most favorable of conditions, about 10% of the eggs eventually give rise to adult mites. The new adult mites move closer to the skin’s surface, from which they can spread to other areas of the skin or to other people.2 Close physical contact and, less often, sharing clothing or bedding with an infected person can spread the mites. The mites can live for up to a month on the human body, but can’t survive for more than 48 to 72 hours elsewhere. Also, humans cannot get scabies from pets. Dogs and cats attract other types of mites that don’t survive on the human body. Scabies occurs worldwide and has no predilection for certain races or social classes. Scabies can be a significant public health problem, as it can be spread in environments with numerous people in an enclosed setting such as hospitals, rehabilitation centers, childcare facilities, nursing homes and correctional institutions.

Diagnosing Scabies2

Scabies is often diagnosed by a history of intense itching that is worse at night in addition to an erythematous papular eruption with excoriations. Characteristic burrows may or may not be present. Scrapings may be taken of a burrow to determine the presence of mites, mite eggs or mite feces on microscopic examination. However, a person can still be infested, even if mites, eggs or fecal matter cannot be found; fewer then 10 to 15 mites may be present on an infested person who is otherwise healthy.

Conventional Treatment Options2-6

Conventional medical treatment for scabies involves various types of scabicides. All of these are by prescription only, as there are no over-the-counter preparations approved to treat scabies. Primarily used are permethrin (Elimite, Acticin), lindane and malathion (Ovide), with permethrin being the drug of choice. By itself crotamiton (Eurax) is not as effective as the others, but some physicians prescribe it in addition to one of these preparations. Most are considered to be of low toxicity. However, lindane has fallen out of favor because of numerous reports of neurotoxic symptoms such as skin numbness, restlessness, anxiety, tremor and convulsions. These scabicidal creams or lotions are applied over the entire body, from the neck down, where they are left on the skin for at least 8 to 12 hours, then washed off. These medications effectively kill the mites, but itching may linger for several weeks as the immune system still responds to the eggs, waste and dead mites themselves. Sometimes oral medications are prescribed for people with compromised immune systems or resistant rashes not responding to prescription topicals; ivermectin is a common and effective choice. The safety of ivermectin in children weighing less than 15 kg and in pregnant women has not been established. Oral or topical antihistamines are often recommended to relieve intense itching. In addition to the infested person, treatment also is recommended for household members and sexual contacts, particularly those who have had prolonged direct skin-to-skin contact with the infested person. Both sexual partners and close personal contacts who have had direct prolonged skin-to-skin contact with an infested person within the preceding month should be examined and treated. All persons should be treated at the same time to prevent reinfestation.

Natural Remedies for Scabies

There is less scientific information about the anti-scabietic activity of natural treatments and their clinical and pharmacologic characteristics compared with conventional treatments, which means more controversy and uncertainty about their use. Among the natural compounds discussed below, tea tree oil is perhaps the most studied preparation and shows the most promise as an effective agent against the scabies mite. Tea tree oil (Melaleuca alternifolia): 7,8 Tea tree oil topical preparations are readily available in health food stores. The principal antimicrobial in a wide range of pharmaceuticals sold in Australia, with the main active component being oxygenated terpenoids, tea tree oil is highly effective in vitro, demonstrating rapid killing times of the mites as compared to permethrin and ivermectin. Human studies, however, are lacking. Neem (Azadirachta indica) and Turmeric (Curcuma longa):9 The neem tree belongs to the mahogany family and is found in many of the Asian countries, especially India. Turmeric is a rhizomatous herbaceous perennial plant of the ginger family, Zingiberaceae. It is native to tropical South Asia. In the Ayurvedha and Sidha system of medicine (Indian system of medicine) Azadirachta indica ADR (‘Neem’) and Curcuma longa (‘Turmeric’) have been used for healing of scabies and chronic ulcers. There is one study using a paste of each of these natural products on 814 individuals with scabies, with 97% of people showing cure within 15 days of treatment. Bush tea (Lippia multiflora):10 This is a plant native to Africa, commonly known as ‘Tea of Gambia,’ and is widely used in Africa for many medical problems. In a clinical trial in Nigeria involving 268 male prison inmates, it was compared to OTC benzyl benzoate, a treatment rarely used by physicians due to its low efficacy for killing mites compared to permethrin. The trial showed a higher cure rate using essential oil from the leaves of the bush tree than the benzyl benzoate (100% versus 87%, respectively).

What to Tell your Patients

Among the natural treatments above, tea tree oil shows the most promise as an effective agent against the scabies mite; however, it has not been studied in humans and is thus not recommended as an effective treatment at this point in time. Therefore, I recommend patients first seek conventional treatment and to take these measures to prevent reinfestation and the spread of mites to other people. • Use hot (60oC/140oF) soapy water to wash all clothing, towels and bedding that were used at least 2 days before treatment. Machine-dry with the highest heat. Dry-clean items that can’t be washed at home. • Nonwashable articles should be isolated for 2 to 4 weeks in sealed plastic bags with the expectation that the mites will die within a few days. Mites cannot survive off human skin for more than 2 or 3 days. This bag should be put somewhere such as the garage or outside. • Vacuum the entire house thoroughly and throw away the vacuum cleaner bag to prevent any mites from escaping into the house.

Dr. Taylor, a resident in the Department of Dermatology at Wake Forest University Baptist Medical Center in Winston-Salem, NC, is board-certified in Family Medicine, which she practices in Winston-Salem, NC. Disclosure: Dr. Taylor has no conflict of interest with any materials presented in this article.

Medications

If you have scabies, your doctor will prescribe a medication called a “scabicide.” It contains permethrin, and it comes in a lotion or cream form.

Adults and children should apply the medication all over their body — from the neck down to the feet and toes. If your baby or young child has scabies, you’ll apply the product in the same manner. Leave the medication on for the recommended amount of time (usually 8 to 14 hours), then wash it off. Change into clean clothes. Infants ages 2 months and younger and pregnant women will use a topical sulphur ointment rather than permethrin.

Your doctor may recommend a second treatment with a scabicide 1 to 2 weeks later, to make sure the mites are gone.

If you have a more severe type of scabies called ”crusted” or “Norwegian scabies,” a rare form of the condition that may affect people with weaker immune systems, the treatment will be permethrin for 7 days. You’ll continue to apply it twice per week until the scabies are gone. You’ll do this in addition to taking an anti-mite pill.

Even if no one else in your household shows signs of scabies, your doctor will probably recommend they be treated. Ask your doctor about whether scabicides are a good option for the rest of your family.

Once the mites are gone, you may still have intense itching, even for weeks afterward. Antihistamines, like loratadine (Claritin) or cetirizine (Zyrtec) can help make you more comfortable. If your itching is severe, your doctor might prescribe a steroid cream or oral glucocorticoids. You might also need to be retreated with scabicide.

Your skin should heal once the mites are treated. But if you develop signs of infection (redness, pus, swelling), see your doctor. He’ll likely prescribe an antibiotic.

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