Scabies
Medications
Prescription permethrin cream or lotion are also used to treat scabies. Unlike the more toxic lindane, permethrin is considered safe for infants as young as 2 months old.
- Only permethrin, crotamiton, and sulfur ointment are considered safe for treating children younger than age 2.
- Lindane is sometimes used as a secondary treatment for a defined group of people. It must only be used as a single application exactly as directed. Lindane is not recommended for babies, older adults, anyone who weighs less than 50 kg (110 lb), or people who have a weakened immune system.3 Lindane should also not be used for people who have widespread dermatitis or women who are pregnant or breast-feeding.4 Lindane shampoo and lotion are not available in California for treating lice or scabies.5
- Crusted (Norwegian) scabies (rare) often requires multiple treatments, sometimes with more than one medication.
- Steroid creams, antihistamines (such as Benadryl), and, in severe cases, steroid pills can be used to relieve itching, but they do not kill scabies mites.
- Persistent nodular scabies may be treated with injections of steroids into the nodules or (rarely) with coal tar products applied to the skin.
Most creams or lotions are applied to the entire body from the neck down. On infants, the medication is also applied to the scalp, face, and neck, taking care to avoid the area around the mouth and eyes. The medication usually is left on for 8 to 14 hours and then washed off.
Medication Choices
Medications used to treat scabies include:
- Permethrin cream 5% (Nix, Kwellada), a standard first treatment for scabies. It usually cures scabies infestation after the first application.
- Lindane 1%, which must be used exactly as directed to avoid dangerous side effects. Lindane is only used if your scabies persists after trying other medications or you are unable to use other treatments.6
- Crotamiton 10% (Eurax), which can kill the scabies mite and also may relieve itching.
- Sulfur ointment (precipitated sulfur) 5% to 10%, a milder and less effective medication than permethrin or lindane, is sometimes used to treat infants and pregnant or breast-feeding women.
You may also need to take an antibiotic if you develop a secondary skin infection.
What To Think About
When used correctly, lindane is considered a safe and effective treatment for scabies. With incorrect use or overuse, however, lindane can be dangerous and can permanently damage the central nervous system. If your doctor prescribes lindane to treat scabies, make sure you receive, understand, and follow detailed instructions for using it correctly.
Scabies treatment can fail:
- When the medication is not applied properly. Carefully follow instructions for using scabies medications.
- If the medication does not kill the scabies eggs. When the eggs hatch, a new infestation begins.
- When other members of the affected person's household are not treated.
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| Author: | Shannon Erstad, MBA/MPH | Last Updated: May 24, 2007 |
| Medical Review: | Adam Husney, MD - Family Medicine Kathleen Romito, MD - Family Medicine Donald Sproule, MD, CM, CCFP, FCFP - Family Medicine | |
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