Scabies is a parasitic infection on your skin caused by microscopic mites called Sarcoptes scabiei. They take up residence just beneath your skin’s surface, laying eggs that cause an itchy skin rash.

The condition is extremely contagious and is passed through skin-to-skin contact. You can also catch scabies from clothing or bedding that’s been used by someone with scabies.

The scabies rash is incredibly itchy and itching becomes worse at nighttime. If you have scabies, you might see:

  • bumps beneath your skin
  • swollen, red bumps
  • very small bites on the surface of your skin
  • burrow tracks (discolored, tiny raised lines on your skin) from the mites

In adults and older children, scabies rashes may develop between fingers or between thighs. They may also appear on your:

  • wrists
  • waist
  • elbows
  • armpits
  • nipples
  • buttocks
  • penis

For an infant, older person, or someone with a compromised immune system, the rash might manifest on the neck, face, head, hands, and bottoms of the feet.

Standard treatments for scabies are usually prescribed by a doctor but some people claim over-the-counter (OTC) options can work.

Scabies treatments, called scabicides, target both mites and their eggs. They’re only available by prescription. If you receive a scabies diagnosis, your doctor will likely recommend that your entire family be treated. Your doctor may also prescribe antibiotics if you develop a skin infection from scratching a scabies rash.

There are currently no over-the-counter treatments for scabies that are approved by the U.S. Food and Drug Administration (FDA). Prescription options include the following:

  • Elimite is a 5 percent permethrin cream that’s generally effective and safe when it’s used as directed. This is the most often-prescribed scabies treatment on the market. Children as young as 2 months old may be treated with this prescription.
  • Eurax is a 10 percent crotamiton lotion or cream that’s safe for use in adults. It’s not approved for children and isn’t always effective.
  • Sulfur ointment (5 to 10 percent concentration) is a safe skin treatment for all ages — even infants younger than 2 months. However, it has an unpleasant odor and can leave stains on your clothes.
  • Lindane lotion (1 percent) is a last-resort treatment, even though it’s FDA-approved for use in some adults. It’s generally suggested for people who can’t use other treatments, or for whom other prescriptions have failed. Lindane can be dangerous for certain individuals, such as:
    • breastfeeding mothers
    • premature infants
    • people experiencing seizures
    • individuals weighing less than 110 pounds
    • Stromectol (ivermectin) is an oral anti-parasite medication that’s sometimes prescribed off-label for people who’ve had unsuccessful scabies treatment. It’s not FDA-approved to treat scabies, but it may be a safe treatment for some.
    • Benzyl benzoate (25 percent) is a topical treatment that may be used instead of permethrin and may contain tea tree oil. Irritated skin is a possible side effect of this option. Children may use reduced dosages of benzyl benzoate.
    • Keratolytic topical cream is sometimes recommended for crusting scabies and may be combined with benzyl benzoate treatment.

Nix

Nix is an OTC version of 1 percent permethrin. It’s most often used for head lice. Most doctors recommend using permethrin of at least 5 percent for the treatment of scabies in order to kill both the mites and their eggs. Since scabies spreads quickly, treating with Nix may not kill the infestation.

Sulfur soaps and creams

Sulfur can be used in the form of soap, ointment, shampoo, or liquid. It’s possible to get OTC soaps and creams containing 6 to 10 percent sulfur. This treatment can be used alongside treatments from your doctor. However, discuss using sulfur with your doctor before use for best results.

Calamine lotion

This is a treatment for symptoms only. It won’t kill scabies or their eggs.

Calamine lotion causes a cooling sensation on your skin that helps relieve itching. Clean your skin with soap and water and let dry. Then apply the lotion to your skin with cotton or a soft cloth. You can use calamine lotion up to four times per day.

Antihistamines

This is a treatment for symptoms only. Antihistamines won’t kill scabies or their eggs.

OTC histamines can also help relieve itching. Popular antihistamines include Zyrtec, Allegra, and Claritin. Benadryl and Chlor-Trimeton are considered first-generation antihistamines. This means they may make you drowsier than others. A pharmacist can help you choose which is right for you.

Over-the-counter products for the home | Products for the home

Since scabies spreads fast, you’ll need to treat your home as well. This will help ensure the scabies are fully removed from your environment.

  • Use disinfectant sprays, including those that contain permethrin, on surfaces and clothing.
  • Apply rubbing alcohol or Lysol to kill bugs on hard surfaces.
  • Wash clothes and bed linens in hot water and dry on a hot cycle.
  • If you don’t have access to hot water, place the items in plastic bags and store them away from home for five to seven days.
  • Wash your pets with a pet-specific solution, such as sulfur concentrate pet dip.
  • Sprinkle borax on carpets and vacuum after about an hour.
  • Steam clean your carpets. Many grocery stores and department stores rent out steam cleaners at a reasonable price.
  • Replace your mattress or use a zippered cover without removing it for a few weeks.
  • Put all stuffed toys or unwashable fabrics in a sealed bag for a few weeks and the scabies will die off.

There are a number of treatments available for scabies. You can talk with your doctor and decide which course of treatment is right for you. OTC products can help with symptoms and scabies on surfaces when you’re undergoing a prescribed treatment. However, these products may not fully remove the infestation, which needs to be dealt with quickly.

To prevent further spread of scabies:

  • Avoid skin-to-skin contact with a person who has scabies.
  • Avoid touching items such as the clothing or bedding of a person who may have scabies.
  • Undergo treatment if anyone in your household has scabies, even if you don’t.
  • Get tested regularly for sexually transmitted infections.
  • Clean and vacuum each room, wash linens in hot, soapy water and keep anything unwashable in a sealed plastic bag for at least 72 hours.