Scabies is an utterly transmissible parasitic dermatitis which occurs among humans and home pets because of direct skin-to skin contact when one is infested with the mite called Sarcoptes scabiei. Although scabies mites are very tiny, they are visible to the human eye. There are over 300 million cases of scabies reported worldwide every year. Scabies may affect people regardless of age, race, gender, and social rank, however, risk factors often involve poor hygiene, malnutrition, dementia and poverty.

Treatment options

Scabies is commonly treated with numerous medications called acaricides. The treatment regimen often includes topical application of scabicidal agents, like permethrin 5% cream, lindane 1% lotion or cream, crotamiton 10% cream, and others, applied to the whole body surface. More recently, the use of ivermectin 0,8 % cream has also obtained popularity for the fast cure and achieving clinical results in 2 to 4 weeks.

Note: All family members and intimate contacts, should be treated simultaneously to avoid reinfestation.

Permethrin 5% Cream

Permethrin is a topical cream most commonly used as the first-line treatment for scabies in the United States, which contains chemicals that kill scabies mites and their eggs. It is considered more effective than crotamiton in stopping a scabies infestation and safe for infants from 2 months old due to its minimal toxicity and high cure rate. It is applied from the neck down and left on the skin for 8–12 hours before washing off.

Price checker | Topical creams
Permethrin (Acticin) 5% 30mg.	topical	10 tubes	per tube	from $10.80	BEST BUY

Note: Clothes and bedding should be washed well in hot water throughout the treatment period.

Crotamiton 1% (Eurax, Crotan)

Crotamiton is FDA-approved medication for the treatment of scabies which should be considered as a second-line therapy and comes as a 10% cream or lotion. Crotamiton is known for its antipruritic effects and other therapeutic options. Crotamiton lotion is usually applied from the chin down to the tips of the toes after taking a bath or shower. After the first application, it may be recommended to apply again after 24 hours. Note: It is highly important to use crotamiton as prescribed. This drug may potentially cause problems if applied too much or too often. Caution should be advised when used in breastfeeding women.

Price checker | Topical Antibiotics
Crotamiton (Eurax) 20gr.	topical	6 tubes	per tube	from $24.49	BEST BUY

Ivermectin (Stromectol)

How to treat scabies in home pets?

Ivermectin was initially discovered back in the 70s as a veterinary treatment for home pet’s parasites and now is widely used as an effective therapy for the treatment of human scabies. Ivermectin lotion has been approved also for use in dogs and cats for the prevention of dirofilariasis and treatment of ear mites and scabies due to its ease of administration and good safety profile.

Price checker | Oral Antibiotics
Ivermectin (Stromectol) 12mg.	oral	120 pills	per pill	from $4.95	BEST BUY

Note: Oral ivermectin is an effective treatment for crusted scabies, but not for nail scabies.

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Key symptoms of scabies

There are few methods to diagnose the scabies to be sufficiently sensitive, cost effective and convenient. The human scabies with 100% specificity is the identification of mites, eggs, or feces from scrapings of the infested skin or by visual identification of mite burrows. Alternate diagnosis method includes polymerase chain reaction (PCR), microscopic examination of KOH prepared skin scrapings and dermoscopy, but they are still not easily applied to clinical or public health settings.

Summary

The selection of meds is often depends on personal preferences of dermatologists, local availability and cost for the patient, rather than on medical evidence. The research found the topical application of 5% permethrin cream, crotamiton lotion and 10% sulfur ointment were equally effective at one-month follow up. Nevertheless, complete clearance of scebies occured earlier in pertmehrin treated group than in crotamiton and sulfur groups. No side effects and no re-infections were observed both after administration of permethrin and crotamiton. Although permethrin seems to be the most effective drug in the treatment of scabies, its administration is much more expensive for patients that other common creams. Thus, we conclude that crotamiton may be a cost-effective alternative to permethrin with acceptable cure rate in the treatment of Sarcoptes scabiei infection.