Scabies Guidelines

Updated: Nov 18, 2022
  • Author: Catharine Lisa Kauffman, MD, FACP; Chief Editor: Dirk M Elston, MD  more...
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Guidelines Summary

The US Centers for Disease Control and Prevention offer the following suggested guidelines for the treatment of scabies [65] :

  • Treatment should be given to both the infested person a nd to household members and sexual contacts, particularly those who have had prolonged direct skin-to-skin contact with the infested person.
  • All persons should be treated at the same time to prevent reinfestation.
  • Bedding, clothing, and towels used by infested persons or close contacts anytime during the 3 days before treatment should be decontaminated by washing in hot water and drying in a hot dryer, by dry-cleaning, or by sealing in a plastic bag for at least 72 hours. Scabies mites generally do not survive more than 2-3 days away from human skin.
  • Use of insecticide sprays and fumigants is not recommended.
  • Scabicides are available only with a prescription. No over-the-counter (nonprescription) products have been tested and approved to treat scabies.
  • For classic scabies, one or more of the following may be used: permethrin cream 5%, crotamiton lotion 10% and crotamiton cream 10%, sulfur (5-10%) ointment, lindane lotion 1%, or ivermectin.
  • For crusted scabies, both oral and topical agents should be used together.

Japanese guidelines cite phenothrin lotion and oral ivermectin as first-line therapy. [66]  German guidelines list permethrin as first-line therapy. [67]  Some German authors have published data suggesting that outcomes are similar with currently available agents. [68]