Scabies Treatment

How is Scabies Diagnosed?

A dermatologist or general physician usually diagnoses scabies by examining the affected skin, reviewing symptoms and medical history. The doctor looks for typical signs such as burrows, red bumps, blisters or nodules, especially on the wrists, between the fingers, elbows, waistline, buttocks and genitals. In infants, young children and older adults, the scalp, face, palms and soles may also be affected.

While doctors frequently diagnose scabies based on the appearance of the rash and the classic pattern of itching, a skin scraping or dermoscopy is often recommended to confirm the diagnosis by identifying live mites, eggs, or fecal matter. It helps rule out other similar skin conditions like eczema, allergic dermatitis or fungal infections.

Types of Scabies and Their Treatment

The treatment of scabies may vary depending on the type, the person's age, immune status, and the severity of the infestation. Some of the scabies treatments include:

General Treatments for Scabies

Scabies treatment usually involves a combination of approaches to eliminate the mites, relieve symptoms and prevent the infection from spreading or returning. The treatments include: 

Topical Medicines for Scabies

Topical medicines are the most common treatment for scabies. It is applied directly to the skin and kills scabies mites. The most widely used topical medicines for scabies include: 

• Permethrin 5% Cream: Kills scabies mites on the skin.

• Benzyl Benzoate Lotion: Kills scabies mites and may be used as an alternative topical treatment.

• Precipitated Sulfur Ointment (5–10%): Kills scabies mites and can be used in selected patients, including young infants.

• Crotamiton Cream or Lotion (10%): Helps treat scabies and can also relieve itching.

• Lindane 1% Lotion: Helps kill scabies mites but is generally reserved for cases where other treatments are unsuitable due to the risk of serious neurological side effects.

Note: These medicines should only be used under the guidance of a doctor.

Oral Medicines for Scabies

Oral medicines may be used to eliminate scabies mites, relieve itching, or control bacterial complications. Common oral medicine options to treat scabies include:

• Ivermectin: Helps kill scabies mites and is used particularly for widespread or crusted scabies or when topical treatment is unsuitable.

• Antihistamines: Help relieve itching and may make it easier to sleep, but do not kill scabies mites.

• Antibiotics: Treat secondary bacterial infections (like impetigo) caused by scratching. 

Note: It is always recommended to consume medicines under the guidance of a doctor.

Ayurvedic and Alternative Treatments for Scabies

Some Ayurvedic treatments for scabies may help support skin health and relieve itching, but they should only be used as supportive therapy alongside doctor-prescribed treatment. Some of these Ayurvedic treatments for scabies include:

• Gandhaka Rasayana: Helps maintain and heal the skin.

• Arogyavardhini Vati: Treats various skin conditions.

• Mahamanjishthadi Kashaya: Supports the proper function of the skin.

• Khadirarishta: Supports skin cleansing and health.

• Mahatiktaka Kashaya: Aids in controlling and easing inflammation.

• Rasamanikya: Used for chronic skin disorders.

• Aragwadhadi Kashaya: Supports skin purification.

Note: Ayurvedic medicines should only be taken under the guidance of a qualified Ayurvedic practitioner. They may help support symptom relief, but should be used only as a complementary therapy alongside doctor-prescribed scabies treatment, not as a replacement.

Home Care During Scabies Treatment

Proper home care for scabies plays an important role in preventing reinfestation and ensuring treatment is successful. These home care tips include:

• Follow the prescribed treatment exactly as directed.

• Apply topical medicines to clean, dry skin as instructed.

• Keep the skin clean and avoid excessive scratching.

• Use clean clothes, towels and bedding after treatment.

• Wash recently used clothes, towels and bedding in hot water and dry them thoroughly.

• Vacuum or clean carpets, rugs and upholstered furniture after treatment.

• Keep unwashed items sealed in a plastic bag for 3-4 days.

Latest Treatment for Scabies in India

Current scabies treatment focuses on eliminating mites quickly while reducing the risk of reinfestation. Permethrin 5% cream continues to be the first-line treatment for most people with classic scabies because of its high effectiveness and favourable safety profile.

For crusted scabies, severe infestations, or institutional outbreaks, doctors often recommend oral ivermectin along with repeated applications of topical scabicides. This combination has significantly improved treatment outcomes in difficult cases.

Researchers are experimenting with new treatments and new ivermectin doses. For now, treatment of scabies includes applying topical agents or taking oral medication, and cleaning contaminated clothing and bedding.

How Long Does Scabies Treatment Take?

Most people begin treatment of scabies immediately after diagnosis. While the mites are usually killed within a few days of effective treatment, complete recovery of the skin takes longer. The duration of scabies treatment is as follows:

Note: If new burrows or fresh rashes continue to appear more than four weeks after treatment, you should consult your doctor to rule out reinfestation, incorrect application of treatment or an alternative skin condition.

Scabies Treatment Side Effects

Most scabies treatments are generally safe and well tolerated, but mild side effects may occur, including:

• Burning, stinging or pain at the application site

• Skin irritation, redness or dryness

• Nausea

• Diarrhoea

• Headache

• Dizziness

• Mild stomach discomfort

Note: Itching may continue for 2 to 4 weeks after successful treatment because the skin is still reacting to dead mites. This does not necessarily mean the treatment has failed.

Lifestyle Changes to Prevent Scabies

Making a few changes to daily habits can help reduce exposure to scabies, limit its spread, and lower the chances of getting infected again. Some helpful measures include:

• Avoid prolonged skin-to-skin contact with people who have scabies.

• Avoid close physical contact with someone who has an itchy rash until they receive treatment.

• Do not share clothing or bedding with a person who has scabies.

• Ensure household members receive treatment at the same time someone is diagnosed.

• Keep frequently used bedding and clothing clean and properly dried.

Factors That Can Affect Scabies Treatment

Scabies may worsen, persist or return if treatment is not used correctly or preventive measures are not followed. Risk factors that can worsen the scabies condition include:

• Incorrect or incomplete application of topical medicines.

• Not applying the medicine to the entire body, including between the fingers, toes and skin folds.

• Not reapplying the medicine after washing your hands.

• Not successfully treating household members and other close contacts.

• Not following recommended personal and environmental hygiene measures.

• Not reading or following the treatment instructions provided by the doctor.

• Delaying treatment for more than one month after the onset of symptoms.

• Missing the second treatment within 7 to 14 days, when recommended.

• Inadequate cleaning of clothing, bedding and furniture.

Scabies Treatment Cost in India

The price for scabies treatment in India varies depending on the severity of the infestation, the type of medicines used, and whether it is taken on an OPD basis or as an in-patient treatment. An appointment with a general physician or dermatologist to treat scabies typically costs about ₹800 - ₹2,500. First-line medications used to treat scabies include 5% Permethrin cream, which can range from ₹50 - ₹120 per tube, and Benzyl Benzoate lotion, which can range from ₹100 - ₹200. Ivermectin pills given orally are cost-effective, but their cost may vary depending on size, brand, and the number of tablets given to the patient.

Does Health Insurance Cover Scabies Treatment in India?

Yes. Health insurance generally covers scabies treatment, including in-patient hospitalisation, diagnostic tests and medicines if hospital admission is medically necessary, such as in cases of crusted scabies or severe complications. However, most cases are treated on an outpatient (OPD) basis, and thus, consultations and prescription medicines may be covered if your policy has OPD cover.

A health insurance plan with a sum insured of at least ₹5 lakh to ₹10 lakh is generally sufficient to cover OPD and hospitalisation expenses for most cases of scabies and other related medical conditions. However, make sure to read all the policy terms, sub-limits, waiting periods and exclusions before choosing a health insurance plan.