Newer treatment for scabies

Newer treatment for scabies offers long-lasting relief


Scabies is a skin disease caused by infestation by the mite Sarcoptes scabiei. The female mite lays eggs under the skin, triggering an allergic response with intense itching. The World Health Organization recently added scabies to the list of Neglected Tropical Diseases, and estimates that at any time, 200,000 globally are infected.

Scabies is treated by one or two applications of a topical insecticide lotion or by one or two doses of a pill. The insecticide lotion is somewhat inconvenient and needs to be applied on every bit of skin from the neck down. It is recommended that anyone in close contact (such as family) be treated as well, since the mite is so contagious.

Oral treatment

Public health experts have been interested in the oral medication as a better treatment. Research just published in the New England Journal of Medicine (NEJM), presented a prospective, randomized study concluding that indeed, the oral medication appears to be more effective, and may protect the person for up to 2 years after treatment.

Scabies symptoms and diagnosis

Scabies most prominent symptom is intense itching, over several areas of the body, typically worse at night. The infected person develops small clusters of red bumps that may break open from the scratching and become secondarily infected (impetigo).

There may also be irregular raised or slightly red lines in the infected skin, corresponding to the mite burrows.  It often starts in the hands, between the fingers, but could start anywhere. Diagnosis is made by inspection of the rash by a trained professional, and if necessary, a microscopic exam of a skin scraping showing the mite or eggs.

How spread

It is not considered a sexually transmitted disease, but can be spread by intimate or close contact (as well as sexual contact). People living in close proximity are probably also infected, as it can be spread through sharing towels, clothing, bedding, or even contact with infested furniture.


There are several insecticide creams or lotions that have a high cure rate, the most common being permethrin. Carefully follow the instructions from your pharmacist or doctor. If the first overnight application of the lotion does not cure, it can be repeated. The topical treatment is considered safe for children above 2 months, adults, and pregnant women.

The oral treatment is called ivermectin, and the dose depends on the person’s weight. Often the initial dose has to be repeated in a week to ensure a cure. In some cases, both oral and topical treatment are recommended. But the oral treatment is NOT considered safe for pregnant or nursing mothers, or children below 15 kg.

The recent research

The NEJM article discussed a comparison of the oral vs. the topical treatment in three communities in Fiji where the disease is common. It found that the oral ivermectin treatment produced better cure rates, and that one course of treatment typically protected the person for the following two years.

If you have itching

Sometimes scabies is not diagnosed until later since many think it is only found in poor living conditions. This is not true, and if you have been suffering from itching on various areas of your body, associated with small bumps, see your doctor or a dermatologist. If you have scabies, treatment is relatively simple and effective.

To find a doctor, of any specialty, anywhere in Brazil, check out our website:

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Esta postagem também está disponível em: Portuguese (Brazil)

Recommended doctors

This post is related to specialty Dermatology. Below is a list of some physicians related to this specialty.