Scabies is a highly contagious skin condition caused by microscopic mites called Sarcoptes scabiei. The female mites burrow into the top layer of the skin and lay eggs, causing an intensely itchy rash. Scabies spreads quickly through direct skin-to-skin contact and by sharing things like clothing, towels, and bedding. The key to getting rid of scabies is using medications and cleaners that kill the mites. Some of the most effective scabies killers include permethrin, ivermectin, benzyl benzoate, sulfur, and tea tree oil.
How is scabies treated?
There are two main ways to treat scabies infestation:
- Medications: Prescription and over-the-counter medications that kill scabies mites, including permethrin, ivermectin, crotamiton, lindane, benzyl benzoate, sulfur, and tea tree oil.
- Cleaning: Thoroughly cleaning or disinfecting items that may be infested with scabies, using hot water, bleach, and acaricides (chemicals that kill mites).
For best results, medications and cleaning should be used together. Medications kill live mites on the skin, while cleaning gets rid of any eggs or mites living on surfaces, clothing, and bedding.
Permethrin
Permethrin is often the first-line treatment for scabies. It is the most effective topical medication available for killing scabies mites.
Permethrin belongs to a class of medications called pyrethroids. It works by quickly paralyzing and killing mites through disrupting their nervous system. Permethrin creams, lotions, or sprays are applied to the entire body from the neck down and left on for 8-14 hours before showering off.
One or two applications of permethrin, a week apart, will eliminate a scabies infestation in most cases. It is safe for children over 2 months old and adults, including pregnant or nursing women.
Brand names for OTC permethrin products include Elimite Cream and Nix Dermal Cream. Stronger prescription 5% permethrin is also available.
Benefits of Permethrin
- Highly effective – kills >90% of mites with first use
- Low risk of side effects
- Easy to apply topical treatment
- Relatively inexpensive and widely available
Ivermectin
Ivermectin is an oral medication sometimes prescribed for stubborn or severe scabies infections. It works systemically, binding to mite proteins and paralyzing them.
Ivermectin is taken as a single oral dose on an empty stomach with water. For scabies treatment, a second dose is usually administered 7-14 days after the first. Ivermectin has higher efficacy when combined with a topical scabicide like permethrin.
Ivermectin can have neurological side effects in some individuals, so consult a doctor before use. It has not been extensively studied in pregnant or nursing women.
Benefits of Ivermectin
- Extremely effective for killing scabies, especially in combination therapy
- Requires only 1-2 oral doses
- Used for difficult cases or crusted scabies
Benzyl Benzoate
Benzyl benzoate is a topical scabicide and disinfectant. It is used in some countries as a prescription treatment for scabies.
Benzyl benzoate works by suffocating mites, disrupting their nervous system, and dissolving their waxy outer coating. It is applied topically and left on the skin for 24 hours before rinsing off.
Using benzyl benzoate for 2-3 applications, a week apart, can eliminate a scabies infestation. It can cause minor skin irritation in some people.
Benefits of Benzyl Benzoate
- Kills scabies mites through asphyxiation and dissolving their wax coating
- Requires only 1-3 topical applications
- Low cost and usually well tolerated
Sulfur
Sulfur is an ancient topical treatment for scabies. It disrupts mites’ metabolism and kills scabies eggs. Sulfur ointments or lotions are applied over the entire body and left on for 24 hours before washing off.
Using sulfur for 2-7 consecutive days can successfully treat a scabies infestation. Sulfur has antibacterial properties that may also help reduce secondary infections. It is safe for infants over 2 months and pregnant women.
Over-the-counter sulfur products like Wright’s Sulfur Soap can be used. Sulfur does have an unpleasant smell and can be messy to apply.
Benefits of Sulfur
- Kills scabies mites and eggs
- Antibacterial properties help prevent secondary infections
- Safe for infants and pregnancy
- Low cost topical treatment
Tea Tree Oil
Tea tree oil is a natural essential oil extract that can help treat scabies. It contains terpinen-4-ol, which has potent antibacterial, antifungal, and insecticidal properties.
For scabies treatment, a 5-10% tea tree oil solution is applied to affected areas of skin and left to soak in for up to an hour before rinsing off. This is repeated 1-2 times per day for a week.
Tea tree oil likely needs to be used in combination with other scabies treatments to fully eliminate an infestation. It can help reduce itching and kill mites on the skin’s surface.
Benefits of Tea Tree Oil
- Natural essential oil remedy
- Helps relieve itchiness
- Kills mites on contact
- Antibacterial properties prevent infection
Household Cleaners That Kill Scabies
In addition to medications, it’s critical to clean household items like clothes, towels, and bedding to get rid of any lingering mites or eggs. Hot water, bleach, benzyl benzoate soap, and other disinfectants can kill scabies on surfaces and objects.
Hot Water
Washing clothes, towels, and bedding in hot 140°F (60°C) water or drying them on the hot cycle will kill scabies mites and eggs. Place items in plastic bags until they can be washed to prevent reinfestation.
Bleach
Bleach can kill scabies mites and should be used to disinfect surfaces. Wipe down furniture, floors, countertops, mattresses etc. with a 1:10 bleach solution. Soak towels, clothing, sheets in bleach water for 5-10 minutes before washing.
Benzyl Benzoate Soap
Benzyl benzoate soap contains 25% benzyl benzoate. Lathering with this special soap and leaving it on for 5-10 minutes can eliminate scabies from surfaces, clothes, and skin. Brands like Ascabiol Soap are available online.
Acaricides
Pesticide sprays like permethrin and benzyl benzoate work as acaricides to kill scabies mites on surfaces and belongings. Spray acaricides onto objects and leave for recommended time before rinsing.
How to Clean Your Home of Scabies
To fully rid your home of scabies, comprehensive cleaning and disinfection is needed:
- Wash clothes, towels, and linens used in last 3 days in hot water and dry on hot cycle. Place in plastic bags until washed.
- Vacuum and remove vacuum contents to prevent reinfestation.
- Wipe down furniture, countertops, doorknobs, electronics with bleach solution.
- Spray acaricides like permethrin in crevices and on upholstered furniture. Let sit before wiping away.
- Steam clean carpets, rugs, and upholstered furniture.
- Disinfect mattress using benzyl benzoate soap or spray permethrin and let dry before covering with protector.
Repeat cleaning of recently used items every 3-7 days during treatment. Isolate items that can’t be washed for at least 4 days to allow any living mites to die off.
Conclusion
Scabies is highly contagious, so treatment with miticides and thorough disinfection is needed to get rid of an infestation. Prescription topical permethrin and oral ivermectin are very effective at killing scabies mites. Benzyl benzoate, sulfur, and tea tree oil also have miticidal properties. Combining medications with hot water, bleach, acaricide sprays, and benzyl benzoate soap can eliminate scabies mites from surfaces, clothing, and skin. Consistent and proper use of scabicides and cleaning provide the best chance of getting rid of scabies from a home.
Frequently Asked Questions
What is the most effective scabies treatment?
Permethrin cream is the most effective topical treatment, killing over 90% of mites with one application. Oral ivermectin is also extremely effective, especially when combined with permethrin. Two applications of permethrin, a week apart, along with thorough disinfection, successfully treats most scabies infestations.
Does bleach kill scabies on surfaces?
Yes, bleach is an effective disinfectant that can kill scabies mites and eggs on surfaces and objects. A dilution of 1 part bleach to 10 parts water should be used. Surfaces should be sprayed thoroughly and left to sit for 5-10 minutes before rinsing/wiping off.
Does washing clothes in hot water kill scabies?
Yes, washing clothes and linens in water of at least 140°F (60°C) can reliably kill scabies mites and eggs. Machine drying on the hot cycle is also recommended if possible.
Can sulfur soap get rid of scabies?
Sulfur soap can help treat scabies but may not fully eliminate the infestation on its own. It is most effective when used along with other topical scabicides like permethrin cream. Sulfur kills scabies mites and eggs and has antibacterial properties that support healing.
Is tea tree oil effective for treating scabies?
Tea tree oil has natural insecticidal properties, so it can kill scabies mites on the surface of the skin and provide some relief from itching and inflammation. However, it likely needs to be used in conjunction with prescription scabicides like permethrin to fully eliminate a scabies infection.