How Long Does Treatment for Scabies Take?
Treatment for scabies typically takes 2–4 weeks to completely eliminate the infestation, assuming proper adherence to prescribed medication and hygiene practices; however, itching may persist for several weeks even after the mites are dead.
Understanding Scabies: A Microscopic Invader
Scabies, caused by the human itch mite Sarcoptes scabiei, is a highly contagious skin infestation. These microscopic mites burrow into the upper layer of skin where they live and lay eggs. This burrowing and the body’s reaction to the mites trigger intense itching, particularly at night. Scabies spreads through prolonged, skin-to-skin contact with an infected person. While anyone can get scabies, it is more common in crowded conditions where close contact is frequent, such as nursing homes, childcare facilities, and prisons.
The Goal of Scabies Treatment
The primary goal of scabies treatment is to eradicate the mites and relieve the associated symptoms, primarily the intense itching. This is achieved through the use of prescription scabicides, which are medications designed to kill the mites. It’s crucial to understand that treating scabies involves not only addressing the infected individual but also treating close contacts, even if they aren’t showing symptoms, to prevent re-infestation.
Treatment Options for Scabies
The most common and effective treatments for scabies involve topical scabicides. These medications are applied directly to the skin and left on for a specified period, usually overnight. Oral medication is used in severe cases or when topical treatments fail.
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Permethrin Cream (5%): This is the most commonly prescribed topical treatment. It is applied from the neck down, left on for 8-14 hours, and then washed off. A second application is usually required one week later.
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Ivermectin Lotion (0.5%): Another topical option.
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Lindane Lotion/Cream (1%): This is less commonly used due to potential neurotoxicity and is generally reserved for cases where other treatments have failed.
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Oral Ivermectin: This medication is taken orally and is typically prescribed for people with severe scabies or those who are unable to use topical treatments. It is often given in two doses, one week apart. This is especially helpful when dealing with crusted scabies.
How Long Does Treatment for Scabies Take? The Timeline
How long does treatment for scabies take? As mentioned earlier, the active treatment phase generally lasts 2-4 weeks. However, understanding the nuances of this timeline is crucial:
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Initial Application: The first application of topical scabicide is a crucial step. It targets the adult mites and some of the larvae.
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Second Application (1 week later): This application targets any newly hatched mites, ensuring complete eradication. Skipping this second application significantly increases the risk of treatment failure.
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Post-Treatment Itching: It’s important to note that itching can persist for several weeks even after the mites are dead. This is due to an allergic reaction to the dead mites and their waste products under the skin. Antihistamines and topical corticosteroids can help alleviate this itching.
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Follow-up: A follow-up visit with a healthcare provider is recommended to confirm that the treatment has been successful and to address any persistent symptoms.
The Importance of Environmental Control
Treating scabies isn’t just about medication. Thorough environmental control is vital to prevent re-infestation.
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Wash Clothing and Bedding: All clothing, bedding, and towels used in the 3 days prior to treatment should be washed in hot water and dried on high heat or dry-cleaned.
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Seal Items: Items that cannot be washed or dry-cleaned should be sealed in a plastic bag for at least 72 hours to kill the mites. Some recommend 10 days.
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Vacuuming: Vacuum carpets, rugs, and upholstered furniture thoroughly.
Common Mistakes in Scabies Treatment
Several common mistakes can hinder the effectiveness of scabies treatment:
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Incomplete Application: Failing to apply the medication to all affected areas of the body, including between fingers and toes, under nails, and around the genitals.
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Skipping the Second Application: As mentioned, the second application is crucial for killing newly hatched mites.
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Not Treating Close Contacts: Treating only the infected individual allows the mites to continue circulating.
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Not Following Environmental Control Measures: Neglecting to wash clothing and bedding can lead to re-infestation.
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Stopping Treatment Too Early: Continuing treatment until all mites are eradicated is important.
Potential Side Effects of Scabies Treatment
While generally safe, scabicides can cause some side effects:
- Skin Irritation: Redness, itching, and burning at the application site.
- Dryness: The skin may become dry and flaky.
- Sensitivity: Increased sensitivity to sunlight.
Table: Scabies Treatment Options and Duration
| Treatment | Application | Duration | Notes |
|---|---|---|---|
| Permethrin 5% Cream | Neck down, including skin folds & under nails | 8-14 hours per application | Two applications, one week apart. Most common treatment. |
| Oral Ivermectin | Oral dose | Single dose, repeated | Two doses, one week apart. For severe cases or when topical treatments fail. |
| Environmental Control | Washing/Sealing affected items | 72 hours minimum | Essential to prevent re-infestation. Some recommend 10 days. |
How soon after treatment will the itching stop?
Itching may not stop immediately after treatment. While the mites are killed with the scabicide, the itching can persist for several weeks due to an allergic reaction to the dead mites and their waste products. Antihistamines and topical corticosteroids can help manage this post-treatment itching.
Is it possible to still have scabies even after treatment?
Yes, it is possible. Treatment failure can occur due to improper application of the medication, failure to treat close contacts, or re-infestation from contaminated items. If itching persists despite treatment, a follow-up visit with a healthcare provider is essential to reassess the situation.
Do I need to wash my bedding and clothes every day while treating scabies?
It is generally recommended to wash all clothing and bedding used in the 3 days prior to beginning treatment in hot water and dry them on high heat. Daily washing after the initial treatment isn’t typically necessary unless you have reason to believe you’ve been re-exposed.
Can scabies live on furniture?
Scabies mites can survive for a few days (2-3 days) away from human skin. Therefore, it’s important to vacuum carpets, rugs, and upholstered furniture thoroughly and seal items that can’t be washed in plastic bags for a week to ten days.
Can I go back to work or school after starting scabies treatment?
It’s generally recommended to stay home from work or school for 24 hours after applying the scabicide to avoid further spread. Check with your healthcare provider or local health department for specific recommendations.
Are there any over-the-counter treatments for scabies?
There are no effective over-the-counter treatments for scabies. Prescription scabicides are required to kill the mites. Over-the-counter remedies may provide temporary relief from itching but will not eliminate the infestation.
How do I know if the treatment is working?
If the treatment is working, you should notice a gradual decrease in itching over several weeks. The skin lesions should also begin to heal. A follow-up visit with your healthcare provider is recommended to confirm that the treatment has been successful.
Can I get scabies from my pet?
Human scabies mites do not typically live on pets. The scabies mites that affect animals are different species and usually do not survive on humans.
Is crusted scabies more difficult to treat?
Yes, crusted scabies, also known as Norwegian scabies, is more difficult to treat because it involves a much higher number of mites. Treatment typically requires a combination of topical and oral scabicides, and multiple applications may be necessary.
What happens if scabies is left untreated?
If left untreated, scabies can lead to secondary skin infections due to scratching. In rare cases, untreated scabies can also lead to more serious complications, such as kidney disease.
How long does it take for scabies symptoms to appear after exposure?
It typically takes 2-6 weeks for symptoms to appear after the initial exposure to scabies in people who have never had it before. In individuals who have had scabies previously, symptoms may appear much more quickly, within 1-4 days.
Can I build immunity to scabies?
While you don’t develop complete immunity to scabies, subsequent infestations tend to cause symptoms more quickly due to the body’s immune response. This accelerated reaction can make it easier to detect and treat subsequent infestations promptly.