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Prescription permethrin, such as Elimite cream, is the most commonly used medicine 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 may be used in some cases if other treatments don't work. But it must be used exactly as your doctor says, because in rare cases this medicine can cause seizures and death when it isn't used according to directions.
  • In some cases, the doctor may prescribeivermectin pills to treat scabies.
  • Crusted (Norwegian) scabies (rare) often requires multiple treatments, sometimes with more than one medicine.
  • 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. Don't giveantihistamines to your child unless you've checked with the doctor first.
  • 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 medicine is also applied to the scalp, face, and neck, taking care to avoid the area around the mouth and eyes. The medicine usually is left on for 8 to 14 hours and then washed off.

Nonprescription medicines are not strong enough to kill the scabies mites

Medication Choices

Prescription medicines used to treat scabies include:

  • Permethrin cream 5% (Elimite), a standard first treatment for scabies. It usually cures scabies infestation after the first application.
  • Ivermectin, which comes as pills. In the United States, treating scabies with ivermectin is an unlabeled use of the medicine. Ivermectin does not work as well as permethrin but is effective against scabies mites.3
  • 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 medicines or you are unable to use other treatments.4
  • Sulfur ointment (precipitated sulfur) 5% to 10%, a milder and less effective medicine than permethrin or lindane, is sometimes used to treat infants andpregnant or breast-feeding women.
  • Crotamiton 10% (Eurax), which is not often used to treat scabies because it does not dependably kill all the mites and their eggs.

You may also need to take an antibiotic if you get 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, though, 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 medicine is not applied properly. Carefully follow instructions for using scabies medicines.
  • If the medicine 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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