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OTC scabies treatment

Medical Scabies Treatment:

The scabies rash results from a reaction of the skin to the mite’s body, eggs, and excretions. It’s a common skin disease worldwide, for the most part in the Third World, very itchy and easily contagious. Scabies is spread by the female scabies mite, which burrows into the upper layer of the epidermis to lay eggs, if the diagnosis’s show that a person has scabies, the doctor will prescribe most often anti scabies medications as a scabies treatment. Most are lotions and creams, applied after a tepid bath or shower and drying, put on the skin over the entire body with particular care being paid to skin folds, fingernails, toenails, behind the ears, from the scalp to the soles of the feet and are washed off after several hours.

Scabies treatment of close contacts:

No immunity develops to scabies (also known as sarcoptic mange). So, the entire family should be examined; Even if a family member doesn’t have a rash, all of them must be treated.

The following treatments are recommended by The Centers for Disease Control and Prevention (CDC):

A) Prescription scabies treatments:

As known the World Health Organization (WHO), recommends that Scabies treatment includes usually getting rid of the infestation with prescription ointments, topical creams, and lotions containing an insecticide “scabicide agent – permethrin, lindane” as a pharmaceutical topical pesticide cream.

If the patient suffers severe itching, the specialist may prescribe an anti-itch medication or antihistamine. And to prevent bacterial infection in the scratched scabies, the doctor possibly will prescribe an antibiotic or antimicrobial or a different form of treatment.

1- permethrin 5% cream

The first-line treatment for scabies is 5% permethrin cream. Permethrin 5% (Elimite) is an insecticide that kills the scabies mites. Permethrin actions by disrupting the sodium channel current, causing on delayed repolarization, paralysis and death of the pest.  5% permethrin is now the best recommended topical treatment It has low toxicity and superb results, applied right on the skin, starting from the neck down (not just those with rash) It should be left on overnight and then should be washed off after 8 to 12 h. Usually, a second treatment may be needed a week later

Permethrin 5% cream is effective during all phases of the life cycle of the scabies mite.  Otherwise, Permethrin 1% solution is furthermore used to treat head lice, which is not effective in treating scabies.

Topical 5% permethrin cream, applied for children over 2 months of age overnight to the whole body except for areas around the eyes.

a) Permethrin cream side effects

As we motioned permethrin cream, is a commonly used as insecticide prescribed to treat scabies rash, and it has a reputation to be “commonly safe” for adults, pregnant ladies, and kids ages 8 weeks and older (but is not recommended to nursing mothers) yet it’s actually a cancer-causing synthetic pyrethroid that has been related to lung cancers, liver cancers, immune system complications, and chromosomal irregularities

Moreover, Permethrin is an insecticide used in a lot of commercial bug sprays.

2- Lindane lotion cream 1%

Lindane cream or lotion (gamma benzene hexachloride) (this is not the best medicine for scabies treatment; simply, because it turns out that potentially Lindane lotion has a high risk of seizures. Also, due to his toxicity that has been proven. So, if you’re asking: Why is lindane banned?  Those are the principal reasons. But it still a substitute when 5% permethrin isn’t available

a) How to use lindane cream:

Apply a thin layer to the whole body from the neck down and carefully washed off after 12 h and reapplied 24 h later. However, Notice that it should not be used directly after a bath or shower.

Why to use Lindane with precaution, it because of The above-mentioned problems also for some other side effects; we should mention that lindane is not approved for children under age 10. Furthermore, It has been shown that there is a treatment resistance to this type of medication. Finally, People with skin problems should avoid using Lindane; you will find more articles on our web site about lindane side effects for more detail.

And from what we mentioned earlier, a lot of countries such as Australia and much of Europe now have removed lindane from the market. After the time it was the number one prescribed as the topical agent most commonly recommended for treatment of scabies rash.

3- Sulphur 7/10% sulfur ointment

Precipitated sulfur (7%) in petroleum jelly is a safe alternative therapy for very young infants, Sulfur ointment: applicable for all ages. And additionally, for pregnant and lactating ladies. It’s an ingredient employed in many prescriptions for scabies treatment it’s applied on 3 consecutive days, left on for twenty-four h after application and washed off before future application otherwise you may purchase sulfur over the counter and use it as a soap, ointment, shampoo, or liquid to treat scabies.

Precipitated sulfur 6% in petrolatum for infants beneath the age of two months: should be left on for twenty-four hours each day for three days.

4- 25% benzyl (benzoate) lotion

Benzyl benzoate (10%) solution is considered one among the off-label choices that your doctor would possibly consider if the therapies that are approved as an efficient treatment for scabies rash doesn’t improve.

Benzyl benzoate (or allethrin pyrethrin a topical spray) is a common alternative in Europe and Australia; but, not available in the United States. BENZYL is applied for twenty-four hours in most situations.  Moreover, it may be an alternative treatment for kids under < two years of age and pregnant women; however, in these two cases mentioned previously, it should be applied only for 12Hours.

5- 10% crotamiton cream

Crotamiton lotion (Eurax) It should not be used for children, it is a cream for topical use, for adults only.


B) Oral Medication for scabies

1- Ivermectin (Stromectol)

a) What is Ivermectin?

An oral medication used to treat many sorts of parasite infestations, including scabies rash. Ivermectin is currently registered as a scabies treatment, Especially when scabies covers a large part of the body and is crusted.

b) Is it safe to use Ivermectin in children:

No, you shouldn’t give ivomec to kids less than five years.

c) Ivermectin dosage:

The recommended dosage of Ivermectin is 200 mcg/kg orally as a single dose; repeated in two weeks.

d) Advantages:

Easy to use and doesn’t cause-related skin issues.

e) Ivermectin side effect:

Skin rash, nausea, headaches …

C) Additional medical treatment for scabies rash:

Usually, after the first week, you’ll notice less itchiness. You’ve got to contact your doctor quickly if you find that symptoms continue after four weeks of treatment, and your Skin hasn’t fully cured.

The doctor may also prescribe additional medications to help relieve some of the disagreeable symptoms related to scabies. It is possible to use an oral antihistamine to control the itchiness, and the skin infections will be treated with oral antibiotics.

These medications include:

  • Antihistamines:

Like Benadryl (diphenhydramine) or pramoxine lotion could help control the itch and allow sleep.

  • Antibiotics:

To kill any infections that develop as a result of constantly scratching your skin.

  • Steroid creams:

To relieve swelling and skin sensation.

  • Creams and lotions:

Will help soothe your skin as scabies clears up. Some creams—such as over-the-counter hydrocortisone cream, Benadryl cream, and Caladryl lotion—also have anti-itch ingredients which will diminish itching for hours.

  • Pain Medications and Anti-Inflammatories:

If you’ve got pain from your scabies, you will expertise some relief with Non-steroidal anti-inflammatory medications, like Advil (ibuprofen), will reduce pain furthermore as the inflammation caused by scabies infection, however alternative choices may offer comfort.

D) over the counter scabies treatment

Can scabies be treated with over the counter medicine?

Scabicidal medicines (drugs that kill the itch mites and eggs) are the first treatment choice as a result of their proven results to eradicate the mites. It’s necessary to notice, that no over-the-counter (non-prescription) scabies treatments or product have been tested and approved by the Food and Drug Administration FDA. OTC Therapies cannot treat the actual infection. But, can help to get relief from the symptom of itchiness, like Nix, Sulfur soap, Calamine lotion, diphenhydramine (Benadryl) which will help control the itch and allow sleep…

Always contact a doctor or health professional if unsure of the way to use a particular medicine.


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