Ivermectin (Oral): For severe cases, crusted scabies, or when topical treatments are difficult to apply, oral ivermectin may be prescribed. It’s an antiparasitic drug that kills mites systemically.

Crotamiton Cream or Lotion (10%): Less effective than permethrin but may be used in certain situations, especially for infants or pregnant women under medical supervision.

Sulfur Ointment (5-10%): An older but still effective remedy, often compounded by a pharmacist. It works by being toxic to the mites.

Oral Ivermectin: Dosage is weight-dependent and typically taken as a single dose, often repeated after 7-14 days.

Topical Steroids: Mild to moderate topical corticosteroid creams (e.g., hydrocortisone) can be prescribed by your doctor to reduce inflammation and itching.

Cool Compresses and Baths: Applying cool, wet compresses or taking cool baths can offer temporary relief. Adding colloidal oatmeal to bathwater can also be soothing.

Preventing Secondary Infections: Vigorous scratching can break the skin, leading to bacterial infections (e.g., impetigo, cellulitis). Keep fingernails short and clean. If signs of infection appear (redness, pus, increased pain), consult your doctor for antibiotics.

Bedding: Sheets, pillowcases, blankets, duvets (or duvet covers).

Towels: All bath, hand, and kitchen towels.

Stuffed Animals: If they have been regularly handled or slept with.

Fabric Furniture Covers: If removable.

High Heat Drying: After washing, dry all items on the highest heat setting in a dryer for at least 20 minutes. The combination of high heat and tumbling effectively kills any remaining mites or eggs.

Items That Cannot Be Washed: For delicate items, dry-cleanable items, or those that cannot withstand high heat, use the “suffocation” method.

• Sealed Bag Method: Place items in a sealed plastic bag (e.g., a garbage bag, Ziploc bag) and leave it undisturbed for at least 72 hours (3 days), but preferably 5-7 days to be absolutely sure. Mites will die from lack of a human host and starvation. Examples: delicate sweaters, certain shoes, non-washable decorative pillows.

• Post-Vacuuming: Immediately empty the vacuum cleaner bag or canister into a sealed plastic bag and dispose of it in an outdoor trash bin. For bagless vacuums, wash the canister and filter with hot, soapy water.

Floors: Mop hard floors with hot, soapy water.

Mattresses and Pillows:

• Mattress Encasing: Consider using mite-proof mattress and pillow covers. These create a barrier, trapping any remaining mites and preventing new ones from burrowing into the mattress.

• Vacuuming: If encasing isn’t an option, thoroughly vacuum mattresses and pillows.

• Airing Out: If possible, air mattresses and pillows outdoors in direct sunlight for several hours. UV light and heat can be detrimental to mites.

Furniture (Upholstered):

• Vacuuming: As mentioned, thorough vacuuming is key.

• Steaming: If you have a steam cleaner, using it on upholstered furniture can kill mites with high heat. Ensure the furniture can withstand steam.

• Isolation/Avoidance: If an item cannot be effectively cleaned (e.g., a very large, non-washable couch), consider isolating it from use for at least 72 hours, or ideally a week, to allow any mites to die off.

Wiping Down: Wipe down hard surfaces like the steering wheel, dashboard, and door handles.

Sun Exposure: If possible, park the car in direct sunlight with windows closed for several hours. The internal temperature can reach levels high enough to kill mites.

The Message: Explain the situation calmly and encourage them to monitor themselves for symptoms (itching, rash). Advise them to seek medical attention if symptoms develop.

Prophylactic Treatment: In some cases, especially in communal living situations or with very close contacts, a doctor may recommend prophylactic treatment (treating even if no symptoms are present) to prevent further spread. This decision should always be made by a healthcare professional.

Moisturize: Scabies treatment can dry out the skin. Use a good moisturizer to soothe and protect your skin.

Avoid Sharing Personal Items: Do not share towels, clothing, bedding, or personal care items with others. This is a good general hygiene practice that also helps prevent the spread of various infections.

Monitor for Symptoms: Continue to monitor your skin and the skin of household members for several weeks after treatment. While itching can persist for weeks, new burrows or rashes should prompt another visit to the doctor. Itching that is worse than before or accompanied by new lesions might indicate re-infestation.

• Post-scabies itch: Gradually improves over time, may be intermittent, and typically doesn’t present with new burrows or fresh lesions.

• Re-infestation: Itching gets worse, new characteristic burrows appear, or new widespread rashes develop after an initial period of improvement.

When to Re-Treat: Only re-treat if advised by a healthcare professional. Repeated use of scabicides unnecessarily can lead to skin irritation and potential side effects. Your doctor will assess whether new mites are present or if it’s simply a lingering allergic reaction.

Monitoring for Reactions: Infants and young children are more susceptible to skin irritation from scabicides. Monitor them closely for any adverse reactions.

Toys: All washable toys should go through the hot wash/dry cycle. Non-washable toys should be sealed in plastic bags for at least 72 hours.

Crusted Scabies (Norwegian Scabies): This severe form of scabies is more common in the elderly, immunocompromised, or those with neurological conditions. It involves thousands or even millions of mites and presents with thick, crusted lesions.

• Treatment for Crusted Scabies: Requires aggressive treatment, often involving both oral ivermectin and topical permethrin, sometimes for extended periods. Environmental decontamination needs to be even more rigorous due to the massive mite load.

• Increased Contagiousness: Crusted scabies is highly contagious, and strict infection control measures are essential.

Caregivers: Caregivers for these individuals are at higher risk of contracting scabies and should be vigilant about monitoring for symptoms and considering prophylactic treatment if advised by a doctor.

Outbreak Management: Scabies outbreaks in communal settings require a coordinated and comprehensive approach.

Mass Treatment: Often involves simultaneous treatment of all residents and staff, regardless of symptoms, to break the chain of transmission.

Environmental Cleaning Protocols: Enhanced environmental cleaning protocols will be implemented, often with professional cleaning services.

Isolation: In some cases, temporary isolation of infested individuals may be considered to prevent further spread.

Increased Risk: Healthcare workers who have direct patient contact are at an elevated risk of contracting scabies, especially if dealing with crusted scabies.

PPE: Use of appropriate personal protective equipment (gloves, gowns) when caring for patients with scabies is crucial.

Vigilance: Self-monitoring for symptoms and prompt reporting to occupational health departments are essential.

Recognizing Symptoms: Early recognition of symptoms can lead to quicker diagnosis and treatment, limiting the extent of an infestation.

Dispelling Myths: Scabies is not a sign of poor hygiene. It can affect anyone, regardless of cleanliness. Dispelling this myth helps reduce stigma and encourages prompt treatment.

Hotels and Accommodations: While rare, scabies can be acquired from infested bedding in hotels or other accommodations. Inspect mattresses and bedding upon arrival. If you have concerns, report them to management.

Crowded Environments: Be mindful in crowded environments where skin-to-skin contact is common.

Persistent Itching: If intense itching persists for more than 4-6 weeks after treatment, or if new burrows or rashes appear.

Signs of Infection: If the skin becomes red, swollen, painful, or discharges pus, indicating a secondary bacterial infection.

Treatment Failure: If symptoms do not improve or worsen despite following treatment instructions carefully. This could indicate resistance to the medication, a misdiagnosis, or ongoing re-infestation.

Uncertainty: Always consult your doctor if you have any doubts or concerns about your condition or the treatment process.

Support System: Lean on your support system – family, friends, or a therapist – if the experience causes significant stress or anxiety.

Focus on Recovery: Remind yourself that scabies is treatable, and with diligent effort, you will overcome the infestation. Celebrate small victories, like a reduction in itching or completing a round of laundry.

Ivermectin (Oral): For severe cases, crusted scabies, or when topical treatments are difficult to apply, oral ivermectin may be prescribed. It’s an antiparasitic drug that kills mites systemically.

Crotamiton Cream or Lotion (10%): Less effective than permethrin but may be used in certain situations, especially for infants or pregnant women under medical supervision.

Sulfur Ointment (5-10%): An older but still effective remedy, often compounded by a pharmacist. It works by being toxic to the mites.

Oral Ivermectin: Dosage is weight-dependent and typically taken as a single dose, often repeated after 7-14 days.

Topical Steroids: Mild to moderate topical corticosteroid creams (e.g., hydrocortisone) can be prescribed by your doctor to reduce inflammation and itching.

Cool Compresses and Baths: Applying cool, wet compresses or taking cool baths can offer temporary relief. Adding colloidal oatmeal to bathwater can also be soothing.

Preventing Secondary Infections: Vigorous scratching can break the skin, leading to bacterial infections (e.g., impetigo, cellulitis). Keep fingernails short and clean. If signs of infection appear (redness, pus, increased pain), consult your doctor for antibiotics.

Bedding: Sheets, pillowcases, blankets, duvets (or duvet covers).

Towels: All bath, hand, and kitchen towels.

Stuffed Animals: If they have been regularly handled or slept with.

Fabric Furniture Covers: If removable.

High Heat Drying: After washing, dry all items on the highest heat setting in a dryer for at least 20 minutes. The combination of high heat and tumbling effectively kills any remaining mites or eggs.

Items That Cannot Be Washed: For delicate items, dry-cleanable items, or those that cannot withstand high heat, use the “suffocation” method.

• Sealed Bag Method: Place items in a sealed plastic bag (e.g., a garbage bag, Ziploc bag) and leave it undisturbed for at least 72 hours (3 days), but preferably 5-7 days to be absolutely sure. Mites will die from lack of a human host and starvation. Examples: delicate sweaters, certain shoes, non-washable decorative pillows.

• Post-Vacuuming: Immediately empty the vacuum cleaner bag or canister into a sealed plastic bag and dispose of it in an outdoor trash bin. For bagless vacuums, wash the canister and filter with hot, soapy water.

Floors: Mop hard floors with hot, soapy water.

Mattresses and Pillows:

• Mattress Encasing: Consider using mite-proof mattress and pillow covers. These create a barrier, trapping any remaining mites and preventing new ones from burrowing into the mattress.

• Vacuuming: If encasing isn’t an option, thoroughly vacuum mattresses and pillows.

• Airing Out: If possible, air mattresses and pillows outdoors in direct sunlight for several hours. UV light and heat can be detrimental to mites.

Furniture (Upholstered):

• Vacuuming: As mentioned, thorough vacuuming is key.

• Steaming: If you have a steam cleaner, using it on upholstered furniture can kill mites with high heat. Ensure the furniture can withstand steam.

• Isolation/Avoidance: If an item cannot be effectively cleaned (e.g., a very large, non-washable couch), consider isolating it from use for at least 72 hours, or ideally a week, to allow any mites to die off.

Wiping Down: Wipe down hard surfaces like the steering wheel, dashboard, and door handles.

Sun Exposure: If possible, park the car in direct sunlight with windows closed for several hours. The internal temperature can reach levels high enough to kill mites.

The Message: Explain the situation calmly and encourage them to monitor themselves for symptoms (itching, rash). Advise them to seek medical attention if symptoms develop.

Prophylactic Treatment: In some cases, especially in communal living situations or with very close contacts, a doctor may recommend prophylactic treatment (treating even if no symptoms are present) to prevent further spread. This decision should always be made by a healthcare professional.

Moisturize: Scabies treatment can dry out the skin. Use a good moisturizer to soothe and protect your skin.

Avoid Sharing Personal Items: Do not share towels, clothing, bedding, or personal care items with others. This is a good general hygiene practice that also helps prevent the spread of various infections.

Monitor for Symptoms: Continue to monitor your skin and the skin of household members for several weeks after treatment. While itching can persist for weeks, new burrows or rashes should prompt another visit to the doctor. Itching that is worse than before or accompanied by new lesions might indicate re-infestation.

• Post-scabies itch: Gradually improves over time, may be intermittent, and typically doesn’t present with new burrows or fresh lesions.

• Re-infestation: Itching gets worse, new characteristic burrows appear, or new widespread rashes develop after an initial period of improvement.

When to Re-Treat: Only re-treat if advised by a healthcare professional. Repeated use of scabicides unnecessarily can lead to skin irritation and potential side effects. Your doctor will assess whether new mites are present or if it’s simply a lingering allergic reaction.

Monitoring for Reactions: Infants and young children are more susceptible to skin irritation from scabicides. Monitor them closely for any adverse reactions.

Toys: All washable toys should go through the hot wash/dry cycle. Non-washable toys should be sealed in plastic bags for at least 72 hours.

Crusted Scabies (Norwegian Scabies): This severe form of scabies is more common in the elderly, immunocompromised, or those with neurological conditions. It involves thousands or even millions of mites and presents with thick, crusted lesions.

• Treatment for Crusted Scabies: Requires aggressive treatment, often involving both oral ivermectin and topical permethrin, sometimes for extended periods. Environmental decontamination needs to be even more rigorous due to the massive mite load.

• Increased Contagiousness: Crusted scabies is highly contagious, and strict infection control measures are essential.

Caregivers: Caregivers for these individuals are at higher risk of contracting scabies and should be vigilant about monitoring for symptoms and considering prophylactic treatment if advised by a doctor.

Outbreak Management: Scabies outbreaks in communal settings require a coordinated and comprehensive approach.

Mass Treatment: Often involves simultaneous treatment of all residents and staff, regardless of symptoms, to break the chain of transmission.

Environmental Cleaning Protocols: Enhanced environmental cleaning protocols will be implemented, often with professional cleaning services.

Isolation: In some cases, temporary isolation of infested individuals may be considered to prevent further spread.

Increased Risk: Healthcare workers who have direct patient contact are at an elevated risk of contracting scabies, especially if dealing with crusted scabies.

PPE: Use of appropriate personal protective equipment (gloves, gowns) when caring for patients with scabies is crucial.

Vigilance: Self-monitoring for symptoms and prompt reporting to occupational health departments are essential.

Recognizing Symptoms: Early recognition of symptoms can lead to quicker diagnosis and treatment, limiting the extent of an infestation.

Dispelling Myths: Scabies is not a sign of poor hygiene. It can affect anyone, regardless of cleanliness. Dispelling this myth helps reduce stigma and encourages prompt treatment.

Hotels and Accommodations: While rare, scabies can be acquired from infested bedding in hotels or other accommodations. Inspect mattresses and bedding upon arrival. If you have concerns, report them to management.

Crowded Environments: Be mindful in crowded environments where skin-to-skin contact is common.

Persistent Itching: If intense itching persists for more than 4-6 weeks after treatment, or if new burrows or rashes appear.

Signs of Infection: If the skin becomes red, swollen, painful, or discharges pus, indicating a secondary bacterial infection.

Treatment Failure: If symptoms do not improve or worsen despite following treatment instructions carefully. This could indicate resistance to the medication, a misdiagnosis, or ongoing re-infestation.

Uncertainty: Always consult your doctor if you have any doubts or concerns about your condition or the treatment process.

Support System: Lean on your support system – family, friends, or a therapist – if the experience causes significant stress or anxiety.

Focus on Recovery: Remind yourself that scabies is treatable, and with diligent effort, you will overcome the infestation. Celebrate small victories, like a reduction in itching or completing a round of laundry.