What is scabies?

Scabies is a skin disease caused by the parasitic mite, sarcoptes scabiei. In recent years, there has been an increasing incidence of scabies. It also seems that the mite has gained an increased tolerance to the drugs. This, in addition to the fact that the treatment is expensive, means that it is very important to follow treatment advice and remediation advice carefully.

If you are unsure whether you have scabies, it may be an advantage to have scabies diagnosed by a doctor before starting treatment. Detecting scabies can be difficult, even for experienced doctors. When you are going to treat yourself, all your close contacts should/must be treated at the same time. This is important to avoid the risk of scabies infection. By close contacts we mean everyone in the same household and possibly people with whom you have had sexual contact. They should be treated at the same time even if they do not itch. The treatment is divided into two; medical treatment and sanitation.

Scabies does not go away by itself – it always needs to be treated!

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Medical treatment of scabies

Two remedies are recommended. Nix cream (permethrin) or Benzybenzoate linement (33%).

Both creams can be used in children under 6 years for up to 2 months, and can be bought without a prescription at a pharmacy. For children under 2 years of age, diluted liniment (Benzyl benzoate 15%) should be used, and the scalp and face should also be treated.  

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Instructions

• Shower and dry yourself well
• Wait fifteen minutes after showering until the skin temperature has returned to normal
• Cut and clean nails
• Smear all over your body including face (leave out eyes and mouth) to the hairline and down to the feet
• Remember to also lubricate the hard-to-reach places on the body such as: the back, the ears and behind the ears, between the fingers and toes, the soles of the feet, the cuticles, under the nails, the navel, the external genitalia and around the rectum.
• The cream should be applied well both on the hands, wrists, feet and ankles.

Treatment recommendations

• Note that when using benzyl benzoate, the agent must be applied twice, 5-10 minutes apart
• If you wash your hands before 12 hours have passed (24 hours for benzyl benzoate), you must lubricate your hands again.
• Put on new underwear and nightwear.
• After at least 12-24 hours, the bedding is changed and the permethrin cream is showered or washed off (when using benzyl benzoate, this must be done after at least 24 hours)
• Put on clean underwear and clean clothes
• After a week, do the same procedure with lubrication with the same agent (permethrin or benzyl benzoate)

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Sanitation

• All clothes and bedding, towels and similar textiles that have been used before the treatment starts, must be washed at at least 60 degrees.
• Clothes and shoes that cannot be washed at at least 60 degrees should be stored without skin contact for a week at room temperature, preferably wrapped in plastic.
• PCs and mobile phones can be possible routes of infection and are therefore recommended to be cleaned with a suitable cleaning agent

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Other advice for scabies

The itching may continue for several weeks after successful treatment. This is because the skin still reacts to dead eggs and mites in the skin. This itching is described by many patients as less intense than the one they had before treatment. You can apply a medium-strength cortisone cream against the itch, in addition to plenty of perfume-free moisturiser. Strong cortisone cream is available on prescription from a doctor.

The treatment is considered very effective if it is carried out in the right way. The recommendation is that you can return to nursery school, school and work the day after the first treatment has been completed

If the itching continues, there may be other reasons for your itching than scabies. You can read more about other causes of itching here .

It may also be that you haven't gotten rid of the scabies, and you need to treat yourself again. In case of treatment failure, an alternative remedy to the one used first is recommended. Tablet treatment as a single dose may in some cases be relevant, and this treatment must be repeated after two weeks.