Scabies

Originally Published: November 15, 2002 - Last Updated / Reviewed On: May 8, 2012
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Alice,

I was wondering if there are any over-the-counter medications for scabies or crabs? If there are, where could I get it and what is it called?

Thank you Alice, and I will be waiting for your response.

Sincerely,

Leandra Student/Aspiring Troubled Teen Counselor

Dear Student/Aspiring Troubled Teen Counselor,

Scabies and crabs are two different organisms (both can easily spread from person to person) and are treated in two separate ways. For information on treating crabs (also known as pubic lice), including which over-the-counter products to use, see Pubic lice/crabs... Oh my! and Crabs and nit-picking in the Go Ask Alice! archives. If you suspect that you have scabies or crabs, it is highly recommended to see your health care provider as soon as possible. Columbia students can make an appointment at Medical Services by calling x4-2448 or logging into Open Communicator.

Scabies is caused by a microscopic mite called Sarcoptes scabei. This menacing little mite burrows into the upper layer of the skin where it lives and lays its eggs. A person may contract scabies through direct, prolonged, skin-to-skin contact with another person who already has scabies. While it’s normally spread via sexual contact, it can also be spread among members of the same household. Transmission is also possible (though less likely) through bedding, clothing, and towels.

The most common symptoms of scabies are intense itching, especially at night, and a pimple-like rash. The itching and rash can affect large parts of the body or be confined to common sites such as the wrist, elbow, armpit, fingers (especially between the fingers), nipples, penis, waist, belt-line, and buttocks. In young children, the head, face, neck, palms, and soles may be involved as well. These visible signs are accompanied by intense itching, especially at night. Moreover, constant itching runs the risk of causing infected sores.

No over-the-counter medicines have been approved for the treatment of scabies. Fortunately, scabies is easily treatable with scabicides — medicine especially developed to kill scabies mites (and sometimes their eggs as well). These medicines can only be obtained by getting a prescription from your health care provider. S/he will prescribe the most appropriate scabicide for your needs. Scabicide lotion or cream must be applied all over the body, with the exception of the head and face. Applying scabicide cream may require the assistance of a second set of hands, since it is extremely important that every part of the body is covered. The lotion is left on the skin for 8 to 12 hours and then washed off with soap and water. A health care provider may recommend that a second treatment with lotion is necessary about seven days later.

Although treatment may kill all the mites, the itching may continue for up to two or three weeks after. Antihistamines (such as Benadryl) and/or cortisone creams are common remedies to relieve itching and reduce inflammation. If the itching is severe, your health care provider may prescribe a stronger cream.

In addition to treating the body, it is important to treat any bedding, towels, and clothing that the infected person used in the three days before treatment. They all need to be washed in hot water (at least 140 degrees Fahrenheit or 60 degrees Celsius) for 20 minutes, and dried in a hot dryer. Mites can live on many surfaces for two to three days, so it's also important to clean and vacuum well. Items that cannot be washed easily, such as stuffed animals, can be sealed in bags for at least a week to ensure that all mites on them die.

If you suspect that you have scabies, consulting your health care provider can help you say hello to happier skin… and bye-bye to those burrowers!

Alice