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Scabies: Management

Authors
Beth G Goldstein, MD
Adam O Goldstein, MD, MPH
Section Editors
Robert P Dellavalle, MD, PhD, MSPH
Moise L Levy, MD
Ted Rosen, MD
Deputy Editor
Abena O Ofori, MD

INTRODUCTION

Scabies is a cutaneous infestation caused by the mite Sarcoptes scabei. Classic scabies is typically characterized by an intensely pruritic eruption with small, often excoriated, erythematous papules in sites such as the fingers, wrists, axillae, areolae, waist, genitalia, and buttocks. Crusted scabies, a less common clinical variant, typically presents with scaly, crusted, fissured plaques and primarily occurs in immunocompromised individuals. (See "Scabies: Epidemiology, clinical features, and diagnosis".)

The successful management of scabies involves the eradication of mites from the affected person, management of associated symptoms and complications, assessment for additional individuals who may require treatment, and implementation of measures to minimize transmission and recurrence of infestation. Factors such as the clinical variant, patient characteristics, and the setting of infestation influence the selection of interventions.

The management of scabies will be reviewed here. The clinical manifestations and diagnosis of scabies are discussed separately. (See "Scabies: Epidemiology, clinical features, and diagnosis".)

ERADICATION OF INFESTATION

The approach to the eradication of scabies mites is dependent upon the clinical presentation (classic, crusted, or endemic scabies) and patient population (see 'Special populations' below). Treatment of both the patient and close personal contacts is suggested to prevent recurrent infestation. (See 'Contacts and environment' below.)

Classic scabies — The availability of antiscabietic agents for classic scabies varies worldwide [1,2]. Topical permethrin and oral ivermectin are the most common first-line treatments in the United States, United Kingdom, and Australia [3]. Benzyl benzoate, topical sulfur, crotamiton, lindane, and topical ivermectin are examples of other treatments. (See 'Other agents' below.)

                     
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Literature review current through: Oct 2017. | This topic last updated: Sep 29, 2017.
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