Fending Off a Scabies Attack in the Home

By MaryAnn DePietro, CRT. Medically reviewed by Tom Iarocci, MD. May 7th 2016

Scabies is a contagious skin condition caused by tiny mites that burrow under the skin causing a rash and itching.

A scabies infestation is almost always passed through direct skin-to-skin contact with an infected individual. Symptoms may resemble other skin conditions, so always consult your healthcare provider for a diagnosis.

Treatment is necessary to destroy the mites, and without treatment, a scabies infestation will not resolve on its own. The whole family, close personal contacts and/or significant others, if applicable, should also be treated, even if they do not show any symptoms.  

In the United States, prescription medication is needed to kill the mites, but this is only one aspect of treatment. Proper home care is also necessary, and consists of symptom relief and a good cleaning to decontaminate and decrease the risk of reinfection.

Symptom Relief

A prescription medication such as permethrin cream, 5%, is required to kill the mites that cause the itching, but itching often continues for 2 weeks or more after treatment. Control of itching is important because scratching can sometimes lead to a secondary bacterial infection. Ask your doctor which over-the-counter (OTC) medications you can buy without a prescription to temporarily ease the itching. OTC medications for itching may include the following:

  • Calamine lotion
  • Corticosteroid creams:It is usually best to wait to use corticosteroid creams until after you have been seen and diagnosed by a healthcare professional, since these creams can alter the appearance of the rash, which can interfere with a correct diagnosis.
  • Oral antihistamines: These are sometimes used to help with very bad itching, but talk to your doctor first.

Next Steps

On the same day treatment begins, wash underwear, towels, and sleepwear in the hottest water possible, and dry them using the ‘hot’ setting. If a mite survives, you can get scabies again.

Mites can live on items such as clothing, sheets and towels for about 72 hours. It is possible to become infected through contact with these items if the mites are still alive. According to the US Centers for Disease Control and Prevention (CDC), items used by an infected person should be decontaminated. Keep in mind, the CDC recommends other members of the household should also have their items decontaminated in case they have been infected and do not realize it.

Prompt cleaning is an essential part of home treatment for scabies. Consider some of the tips below for cleaning specific items.

  • Clothing: As soon as treatment has started, items, such as clothes worn in the last three days, should be washed in hot, soapy water.
  • Bedding: Blankets, comforters, sheets and pillowcases should also be washed in hot water. This also includes pillows and washable stuffed animals. Items should be dried in a hot dryer.  
  • Rugs: Carpets and rugs should be vacuumed and the vacuumed bag should be emptied.

Special Considerations

Not all items that may have come in contact with an infected person’s skin can be washed in hot water. Dry-cleaning is also an acceptable way to destroy mites on infected items. Items that cannot be washed or dry-cleaned should be quarantined for a few days. Items that cannot be cleaned can be sealed in a plastic bag for at least three days in order to allow the mites to die.

Although scabies is usually not a life-threatening condition, it can cause itching and discomfort. A prompt diagnosis and start of treatment is critical to get rid of the condition. Homecare also plays a crucial role in not only easing the symptoms and treating the condition, but also preventing reinfection.

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