How to Treat Scabies

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What is scabies?

Scabies is the name given to a condition caused when the itch mite infests the skin. It is signalled by a rash of tiny pimple-like spots, especially in the space between the fingers, on the wrists and around the genitals. Itchiness is particularly noticeable at night.

Scabies is contagious, and spreads by direct skin contact as well as indirect contact, via an infected person’s clothes or bedding. Shared accommodation and crowded living conditions contribute to its spread. Symptoms may not appear until several days or even weeks after infection, making scabies difficult to diagnose. A dermatologist can conduct a dermatoscopy to provide a diagnosis.

Who needs to be treated?

It is vital to treat the infected persons and decontaminate their personal effects, so as to eliminate the itch mites completely. Other persons who are in close contact (e.g. who share a bed or a living space with an infected person) should be treated at the same time, even if they are not showing symptoms

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It is possible for a person to be infected with scabies without showing symptoms, and unwittingly infect others. This is why it is important to treat all persons concerned, so as to eliminate the risk of scabies returning

Treatment

What is the treatment for scabies?

Oral Ivermectin pills are the treatment of choice. Pregnant women and babies may require a modified treatment (topical cream).

IMPORTANT
All of the affected persons must be treated at the same time.

Day 1

  • Take the Ivermectin as prescribed. Normally this will be in a single dose, preferably taken with your evening meal with a glass of water. For children, the pill may be crushed.
  • The next morning, or after at least eight hours, take a shower, washing your entire body with soap.
  • Use only clean, uncontaminated towels and clothes.

Day 14

  • Take a second dose of Ivermectine and repeat the decontamination of your personal effects (see instructions).

What to watch for

If any of the other persons who come into contact with an infected person start to experience itchiness within three weeks of the time you start the treatment, they should consult a dermatologist. Note that even if you are performing the treatment correctly, rashes and itching may persist for several days, or even up to three weeks (irritation induced by the medication). If the itching persists beyond four weeks, consult your doctor.

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Keep your nails trimmed short. This will prevent skin damage due to scratching, and keep mites from nesting under the nails.

Decontamination

How to decontaminate

Decontamination should be done eight hours after taking Ivermectine (after each dose). Wear gloves while doing it.

Laundry

Laundry that can be washed at 60 deg. C (140 deg. F) :

  • Wash all clothing, underwear, towels and bedding that you have used during the previous week. Use a 60 deg. C (140 deg. F) wash cycle

Laundry or clothes that cannot be washed at 60 deg. C (140 deg. F) :

  • Put this laundry in a sealed plastic bag (do not use anti-mite spray) and leave it shut for one week.
  • After one week, wash these items at the recommended temperature (30-40 deg. C, or 70-80 deg. F).
    or
  • Spray the items with a special anti-mite spray.
  • Now place them in a sealed plastic bag.
  • Leave shut for 48 hours.

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Here are some of the special antimite sprays, which contain permethrin: Sanytol, Baygon Vert and A-Par (approximate price 25-30 Swiss francs).

Other textiles

Mattresses, pillows, blankets, duvets, sofas, carpets, car seats, baby strollers, shoes and other textiles that cannot be washed should be treated with a special anti-mite spray.

  • Follow the instructions for use of the anti-mite spray carefully, as it can cause irritation.
  • Spray from a distance of 20 cm (8 inches).
  • After spraying, do not enter the room for 30 minutes.
  • Now air the room. Do not use any of the textiles for at least 12 hours after spraying.

If you have a clothes dryer, you can also use a hot drying cycle, or have the textiles cleaned with high-temperature steam (at least 60 deg. C or 140 deg. F).

Last update : 12/02/2019