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[URGENT]: Scabies is RAPIDLY on the rise – in the UK and possibly worldwide – and this appears to be an unusually virulent outbreak. It is anticipated that this is an unfolding major public health hazard. Diligence is vital in limiting the spread of this disease – and knowledge is power. This is a topic that I (unfortunately) have learned a very considerable amount about, having had scabies three times including one seriously resistant case that took the most extraordinary efforts to cure.
Here are 12 VITAL scabies prevention & outbreak control tips PLUS very detailed information on conventional and alternative treatments, together with much other useful information for prevention and management of scabies. This is probably the most comprehensive report you will find anywhere so please bookmark and share this page!
★ 12 Vital SCABIES PREVENTION & Outbreak Control Tips:
1) CLOTHING & BEDDING: Do not share any clothing or bedding with other persons. Do not let a friend wear your coat, hoodie, socks, gloves, shoes… anything… or put on anything that others have worn! Do not snuggle in blankets / bedding that others may have used! Don’t even share oven gloves! Symptoms may take weeks to appear and people could pass it to you before they even know they have it!
2) TOWELS: Do not share towels with another person at all. That includes hand towels, kitchen towels – any towel. Designate your own towel and make sure nobody else uses it! Launder towels more frequently; ideally after every bath or shower.
3) SEATING: Ideally, make “chair assignments” and give everyone their own designated chair. Try to avoid sitting on chairs that other people have sat on – including car seats. Toilet seats should be thoroughly cleaned / disinfected before each use. Use isopropyl alcohol / ethanol wipes or a disinfectant spray; just using a piece of toilet paper is not enough.
4) MITE-PROOF CASING: Wrap mattress, car seats, cushions and pillows in mite proof protective cases (Amazon Link). Get these NOW because if this outbreak becomes severe, supplies WILL run short VERY fast. Note, choose a brand that is marked as mite proof and waterproof, such as the one I linked to. There are some brands that are listed as ‘bed bug proof’ that are breathable fabric with bigger-than-mite-size holes!
These will also need to be laundered very regularly on the hottest setting, along with all bedding including duvets. Plastic bag up non-washable soft furnishings and put them away right now. If you have been thinking about throwing out old blankets etc, now is the time!
5) PUBLIC PLACES: Scabies is most common in crowded or highly communal areas. Care homes and university campuses are common areas of concern. Minimize physical contact with seating and other objects likely to have had prolonged physical contact with other persons. Wear gloves when out in public and drop the gloves straight in the laundry basket when getting home, ideally before touching anything at all!
6) LAUNDRY: Use the hottest possible setting for washing AND tumble drying laundry. 60ºC is good, 90ºC is better but will of course damage some fabrics. Tumble dry rather than line dry if possible, but only on the highest possible heat. Put away your delicate clothes this year, so as to not destroy them, and pull out your cheap clothes that don’t matter so much if they get destroyed. Use a SEPARATE crate for clean laundry and never put any dirty laundry in it! Assume that the dirty laundry crate is infected. Ideally, when undressing, drop clothing straight into the dirty laundry crate rather than letting it hit the floor or other furnishings. Consider adding select essential oils (list below) to the laundry soap for increased anti-mite action (10-20 drops per load). For further precaution, close up dried laundry in plastic bags and leave for 3+ days before wearing again.
7) SURFACES: Spray ‘n’ wipe all surfaces with 70% isoproyl alcohol (ventilate the area thoroughly), 70% ethanol (difficult to obtain but less toxic), strong disinfectants (ventilate), or water + essential oil blends (approx 30 drops per litre of water. Numerous essential oils have anti-mite action and some are very capable indeed. Use oil mixes not individual oils. See below for a full list of the best essential oils to use). Wear disposable gloves for cleaning tasks.
8) COMMUNAL SEATING: Clean communal seating extra carefully and treat it as though it is already infected, because it may well be! Vacuum soft furnishings VERY thoroughly and consider covering everything in mite proof casing. If hiring a rental car, consider putting a mite proof cover / plastic bagging over the seats before you sit in it – and when you are done, remove it straight into a plastic bag to be laundered.
9) VACUUMING: Vacuum the house, car and any other communal areas VERY, VERY thoroughly and regularly, using a HEPA vacuum cleaner. It MUST be genuine HEPA filter equipped – otherwise you will be blowing mites in all directions! Ideally, vacuum all surfaces, especially seating. When emptying the dust collector, do so outdoors, wearing disposable gloves and take great care to avoid getting the dust on yourself or your clothing. Steam cleaning (of carpets etc) is regarded as even more effective.
10) DEHUMIDIFY: Scabies is more prevalent in winter due to a) higher humidity b) lower temperatures c) more huddling together. Science has established that high humidity and cooler temps increase the survival time of mites “off the body” – so there is solid rationale for lowering humidity, especially in communal facilities, during times of outbreak.  Run a dehumidifier (Amazon UK link) in continuous mode where possible, especially in communal environments. In larger facilities more than one unit may be beneficial.
11) COUPLES: Act “as though you are one person”. Do treatments together, clean spaces together and assume that if one of you has it, you both do. “Long cuddles” and sexual activity are a high risk for transmission. Politely avoid hugs / physical contact where possible (sorry. I love hugs too – but you do not want this infuriating disease!)
12) PERSISTENT CASES OF SCABIES: If cases are persistent, vary the medications if possible rather than continuing to hit them with the same medication over and over again, so as to reduce the risk of making the mites resistant. If using essential oils, use oil mixes rather than single oils. Note, this is not medical advice or intended to cause you to go against the instruction of medical professionals. Just note that mites have a tendency to become resistant to medications / acaricides over time and this is a growing global problem.
★ If You Already Have Scabies:
1) Try to avoid physical contact with anyone, at all. Do not even shake hands with people. I know, it sounds extreme but trust me – act now – and don’t wait until the authorities have designated this as an action step: By then it will be too late.
2) Avoid sitting in chairs that will be used by others. Stand if possible, or designate your own chair to be avoided by all others.
3) Everyone in your household will need to be treated simultaneously, even if they do not have symptoms.
4) “Blitz” the place with deep cleaning as thoroughly as possible. Consider taking non-washable furnishings i.e. blankets, cushions etc that you have been in prolonged contact with, to the dump. I know it sounds drastic but after getting scabies you will wish you had done it! At the very least, bag them up in bin bags and go without them for several weeks.
5) Treat scabies somewhat like an STD: Avoid sexual contact and prolonged skin-on-skin contact.
6) Try not to scratch. At all. Quite important as scratching can increase the risk of potentially dangerous secondary staph infection. Dab or spray with diluted essential oils, 70% ethanol wipes, clean damp cloths or frontline treatments; but be aware that ‘spot treatment’ should be regarded as non-curative – and may simply cause other roaming mites to avoid that bitter-tasting local area! Assume that there will always be some roaming mites, possibly in areas that are not itching.
7) Topical treatments should be used as directed, typically providing complete cover, not just areas of skin that appear to be affected.
8) Rotate laundry. Bag up / crate up clothing and bedding and try to avoid re-use of recently used items for at least 3 days, even after laundry.
9) Keep a cool head. Scabies can be incredibly frustrating because the mites are too small to be seen with the naked eye – meaning that it’s difficult to know if you have it, difficult to know if you are rid of it and if you have “done enough”. Scabies is infamous for “making people crazy” and even doing desperate things in their attempts to be rid of it. Stay positive, be diligent, don’t take extreme or dangerous measures in your attempts to be well – and good luck!
★ Classic Symptoms Of Scabies:
1) Itching that gets significantly worse at night. You might feel almost no itching during the day and then have it be so bad at night that it wakes you up.
2) “Ridge line rash”. If you see rash in a line, as highlighted in the red circle in the image above – this is a classic scabies symptom.
3) Rash could appear almost anywhere but is more likely to appear in “classic areas”: Anywhere there is a fold of skin, such as wrists, elbows, armpits, back of the knees, horizontal buttock creases; around the belly button, under the ribs, around the neck, and on the inner thigh. It is unusual for the rash to appear on the face or scalp. Note that patches of rash may be your body’s allergic reaction to the scabies and not the actual spot where the mites are lurking.
4) If you have had scabies before, you will get the itching within a day of infection. If it is the first time you have had it, the rash can take several weeks to appear – due to the delayed immune response from the body.
5) You will not be able to see the mites with the naked eye – they are too small. If you see black specks after applying a topical treatment, it is not “the mites coming out of your skin”, it is fine dirt particles being lifted out! A dermatologist may take skin scrapings to view under a microscope to provide a definitive diagnosis but this is somewhat challenging. The particular appearance of the rash is usually considered enough by a doctor to prescribe treatment.
★ HOW LONG CAN SCABIES SURVIVE AWAY FROM HUMANS? – vital to understand!
Scabies mites fundamentally require a host in order to survive for long. We are somewhat like a “ship in an ocean” to them, and if they “fall overboard”, they are often doomed. So they will try to stay put and, unlike ticks or bedbugs, will not be ‘roaming the world’ looking for someone to pounce on. They can detect humans via scent, heat and/or CO2 exhalation but may not be able to travel very great distances. In one study, only 20% of mites migrated to a host placed 4.41 inches from the mites.  Note that scabies cannot jump or fly through the air, though they may fall from a person onto bedding, furniture, carpets etc.
It is typically regarded in scientific literature  that scabies can only survive on average 2-3 days away from a human host. The study typically quoted has them reported as surviving 24-36 hours at “normal” conditions of 21ºC and 40-80% relative humidity. For the above reason, it is typically advised to “rotate” clothing and bedding – so that the same items are not re-used within a few days of prior use, even after laundry. Putting clothing into a sealed plastic bag or crate for 3+ days before re-use is a commonly advised protocol.
Dry environments shorten the mites’ survival time away from a host – very useful to know! However, this “three days” figure may be somewhat questionable: Mites have been demonstrated able to survive up to 19 days under their “ideal” temperature and humidity conditions (10ºC and 97% humidity).  Cool and moist; which may explain the increased prevalence in winter. This may be a key insight that is beneficial for limiting the spread of the disease – and given the surprising virulence of the recent outbreak, it does seem possible that recent strains may be able to survive longer than anticipated. Dehumidify!
Can scabies survive longer with a supply of dust, in a manner similar to dust mites? Unknown: There are many anecdotal reports of people “re-catching scabies” from bedding that was not used for months – though it is of course totally unprovable! Also there are anecdotal reports of reinfection from exposure to dust collected in a vacuum cleaner bag (which might provide them with food from dead skin cells?) These cannot be considered as proof but should not be entirely disregarded, either. There is insufficient research to form a conclusion here: The tests on scabies longevity were merely observing different survival rates at various temperatures and humidities. Survival rate in a dust bag full of tasty snacks (dead skin cells) was not measured.
For optimal safety from re-infection, consider “crating up” or plastic-bagging all bedding and clothing and putting it on as long a “rotation cycle” as is reasonable before re-use, whilst also keeping it in the warmest, driest room available. Including 500g or 1kg silica gel bags (link below) in the crated / bagged laundry is also a good idea to lower humidity as much as possible. “Really Useful crates” [link below] are a good option; choose the clear type – and if possible these could be left in a conservatory or other sunny / warm room, with a dehumidifier running on full blast around the clock! Links below. Sanitize / sterilize crates before use. Label crates / plastic bags with the date the contents were added, and draw from the oldest crate first.
★ Scabies Risk Factors:
• Prolonged (more than a few minutes) physical contact with infected person (either clothed or unclothed)
• Recently used bedding, clothing, towels, shoes of infected person.
• Chairs, car seat, toilet seat, cushions and other objects that infected person has had prolonged physical contact with.
• Un-rug-doctored carpets of rooms inhabited by infected person.
Low (but not entirely negligible) Risk:
• Door Handles, light switches etc.
• Everyday objects touched by infected person (unless they have the more serious “crusted scabies” form, in which case all objects in living environment of said person should be regarded as potentially highly contagious).
★ SCABIES AND PETS:
Different animals typically suffer from their own variant of scabies, commonly known as mange in the animal kingdom. Sarcoptes (scabies) mites can in (uncommon) instances migrate from animals to humans or vice-versa, but typically will not. If you have pets and suspect that either you or your pets has scabies or mange, consult a veterinarian for advice. NOTE – many essential oils are toxic to pets, especially cats (cats can be HYPER sensitive to some oils such as clove) – but also some oils are toxic to dogs. Do not apply essential oil treatments to your pets “just because they are ok for you”.
★ SCABIES VITAL SUPPLY CHECKLIST:
HENRY Vacuum Cleaner with HEPA bags use genuine Henry bags for assured HEPA filtration.
HEPA Vacuum Cleaner (Amazon’s own brand, cheaper)
Rug Doctor Carpet Cleaning Machine – a bit pricey, but useful to own and has a deeper, more powerful carpet cleaning action than a vacuum cleaner. You can also add essential oils to the hot water + detergent mix (see below for oils list)!
Disposable Plastic Gloves
Mite-Proof Mattress Cover (measure your mattress for the correct size).
Plain E45 Skin Lotion
“Really Useful” Crates (84 Liter) (easy to disinfect; great for laundry, soft furnishings and for safe storage of ‘decontaminated objects’. Get these while you can, they are a high demand item and often out of stock!)
Spray Bottles (3-pack)
1kg Silica Gel Bags – very useful for placing in crated / bagged clean laundry so as to lower the humidity inside the bag and further reduce the survival time of any surviving scabies mites. These were the best priced ones I found on Amazon UK.
Oregano Oil (Do NOT put undiluted on skin!!) Oregano is one of the strongest anti-mite oils in lab tests. This is a very reputable brand.
Orange Essential Oil. Orange EO is very high in limonene, which has been found to have strong anti-mite action. This is an amazing brand, wonderful scent. Add to essential oil mix in spray bottle for surfaces, toilet seat etc etc.
Isopropyl Alcohol 99.9% Wipes – these are the max strength wipes. Suitable for commonly touched objects such as phone, door handles, countertops, etc. Note that these are TOO STRONG to use on skin (use 70% wipes for skin); furthermore it is advisable to wear plastic gloves and work in a highly ventilated area during use.
Grain Neutral Spirit (70% Ethanol). I personally hate isopropyl alcohol and it’s somewhat toxic. Ethanol is less toxic but quite hard to find. This 70% ethanol is a good, if somewhat expensive, way to go for making up your own cleaning wipes. Ethanol wipes are common but they all seem to have some denaturing chemical added or some other nasty chemical that does not smell like ethanol! This was one of the only actual ethanol products available in the UK that is food grade and not denatured. Note that of course being food-grade alcohol it is for 18+ only and will require age verification to purchase on Amazon. Fantastic also in herbalism for making tinctures!
Ethanol Wipes 75%. This is the only brand of wipes I have found that actually smells like ethanol only, and not some other nasty crap – however it seems to be out of stock almost everywhere at the moment! I highly rate these wipes and much prefer them to isopropyl alcohol types.
Liposomal Vitamin C. Keep your immune health up. It’s interesting to note that the immune system plays a very important role in keeping scabies from “going crazy” and turning into the more serious form of the disease, “crusted scabies”. Good immune health should also reduce the risk of secondary infections from the lesions.
[USA: coming very soon]
★ FRONTLINE ANTI-SCABIES MEDICATIONS IN DEPTH (note, this is not medical advice!)
There are currently no vaccinations against scabies – and increasing resistance has been reported in the most common frontline medications (ivermectin and permethrin). Many of the available medications also do not kill the eggs – which means that repeated treatments are typically required (typically around a week apart) in order to “break their life cycle”. 
One of the most common causes of treatment failure is that people “think they’ve won” and stop treatment, only to find that surviving eggs hatch and the disease starts up all over again. The second treatment is highly advisable even if the symptoms faded after the first one! Here are some details on the commonly used medications:
Overview: My personal not-medical-advice opinion is that this is the most effective of the available treatments. In my own case, it was the only thing that worked!
Important: Never use Benzyl Benzoate at greater than 25% strength! I need to mention this because 99.99% pure Benzyl Benzoate can be obtained online quite easily, but do not, I repeat DO NOT put this undiluted on the skin!
Benzyl benzoate 25% used to be a very commonly prescribed medication, back in the good old days – and was also available over the counter. It is still listed by the WHO as an alternative scabies treatment.  When I had terrible resistant scabies in 2017, it was the only medication that seemed to do anything – and for this reason, I am surprised that it has fallen out of favour. The reason for its decline in use seems to be because it is somewhat irritant – causing discomfort to use and leading some patients to abandon treatment. It can give a burning sensation – and also makes the skin appear significantly wrinkled for several days after use. It used to be marketed as Ascabiol lotion (25% benzyl benzoate emulsion) but this product is very difficult / impossible(?) to obtain online nowadays. Ascabiol also contained inactive ingredients Stearic acid (emulsifier), Trolamine, Simethicone, Terpineol, Cassia Cinnamon Oil (interesting).
Application: If you are going to try benzyl benzoate, you will need to cover your entire body from the neck down in the 25% solution – aside from your scalp, face and “delicate tissues”. In general it’s better to put too much on than too little, but not so much that it is dripping off you. Take a shower or bath first, dry off, wait maybe 10 minutes for the skin to cool down and then apply. Don’t miss the area behind the ears, or the armpits. Trimming body hair might be beneficial to assist lotion coverage. Do NOT get benzyl benzoate on the urethral opening of the penis, vagina or anal sphincter – or you will fall down into a burning ring of fire, literally! 😉 Ask me how I know!
And it burns, burns, burns…
When applying benzyl benzoate (or any topical scabies treatment), be diligent and do not miss any areas. Mites move around and are not always located where the itching is, so do not be tempted to just “spot treat” – spot treatment may nuke a few mites but it should be assumed that it will absolutely NOT eradicate the disease.
You can apply a thin coat using a paint brush, or just use your hands. If you have reduced mobility and cannot reach some areas of the body, you must get assistance – contact your care provider if required. If you have a partner, you will likely be both applying it together – so you can help each other.
Pay special attention to the “classic areas” that scabies inhabits – anywhere there is a fold of skin, such as wrists, elbows, armpits, back of the knees. They also seem to love the abdominal area and the spot right underneath the rib cage. Note that patches of rash may be your body’s allergic reaction to the scabies and not the actual spot where the mites are lurking. In broad general terms, female mites burrow and male mites wander. The classic sign of the female mite is the “ridged line” as depicted in the image above, I drew a red circle around it. But you will need to hit the wanderers, too…
The product labeling says that you can put your clothes back on 10 minutes after application but you will probably find that clothing (and disposable gloves) will rub much of it off. It’s better in my view to wait longer before getting dressed. Washing your hands will of course also wash it off, and so it will need to be reapplied – paying attention to the folds in between the base of the fingers.
Leave the benzyl benzoate on for 24 hours and then shower off. The standard advice is to wait 5 to 7 days then re-do the treatment – although I’m of the view that while this gives your skin time to recover from the harsh chemical, it might give too much time to the scabies to get a foothold again. You will itch during those 5-7 days, but if the treatment has been effective, the itching should start to fade noticeably after 2-3 days and the rash will appear to ‘dry out’, feeling noticeably different to the touch from ‘fresh rash’.
If new eggs hatched out during that time, you will get new patches of itch. Sometimes you can actually see (and feel) new bites – they look like a tiny flea bite. In such cases, I think it’s a good idea to ‘nuke them’ right away with a dab of the treatment; but your second full treatment will still need to be done, even if you are no longer itching – and it will need to be full-coverage in order to work. I’ll bet you my bottom dollar that if you don’t do a second treatment, within a week it will all start up again and you will be wondering whether the treatment worked, whether your friends gave the scabies right back to you, whether the scabies survived the laundry… and the lack of concrete knowledge will start to drive you nuts…
Despite being the only medication that (in my own case) was actually effective, Benzyl Benzoate will probably not be prescribed by your doctor – and this is where I have to be careful what I say because I cannot and will not advise you to go against their directives, or self-diagnose, or self-treat – I could get into legal trouble. However, the pure chemical can be obtained readily from chemical suppliers via eBay, Amazon or other sources. A good supplier is Konrad (via eBay) in the UK.
Note that pure (99.9%) benzyl benzoate will freeze ‘hard as ice’ at below 16ºC and this can be used as a somewhat reliable (but not definitive) indicator of purity. If you put pure BB in the fridge and it does not freeze, it is not pure! At room temp, BB may take several hours to thaw out. The container can be placed in a bowl of warm water to speed the process if required.
Preparation: It’s certainly best to use a professionally made preparation – if you can locate one. In general, messing around with chemicals, especially if you are inexperienced, can be dangerous. I cannot condone experimentation, for legal / safety reasons, but here are some notes on what you might expect if you were to do so: Benzyl Benzoate should be diluted to 25% (one part BB, three parts lotion or oil). NEVER use it undiluted on skin (or lesser-diluted) and never take internally. It can be diluted with an oil such as olive oil – this works but you will be an oily mess and it’s not as easy to wash off as emulsion. To make into an emulsion, typically a plain, unfragranced, natural liquid hand soap such as Dr. Bronners could be used, together with lotion (plain, i.e. E45 Lotion). Mix ingredients, shake very vigorously. Try one part Benzyl Benzoate, one part plain liquid soap, two parts lotion. If it separates, try a little more soap and a little less lotion (but keep the benzyl benzoate at no more than 25%!) You might also add just a few drops of essential oils such as orange and tea tree. Important: shake very well before EACH use. Making stable emulsions, it turns out, is an advanced science – and the short version is that a home made BB25% emulsion will very likely separate quite quickly. What this can mean is potentially rather problematic; the benzyl benzoate floats to the top, meaning that you might be applying pure BB – which would give you a nasty and potentially dangerous chemical burn. On that note, don’t be tempted to make anything stronger than 25% in a misguided attempt to ‘increase the fire power’. And just as with essential oils, do a small patch test when applying any topical product – and wait a significant amount of time (hours, not minutes) before applying a larger amount.
Children: Benzyl benzoate is generally advised in the literature at 10% strength for children  though specific guidelines may vary according to the age of the child. In general, topical anti scabies meds are prescribed significantly more diluted on children. I do not make medical recommendations: Consult a medical practitioner for official advice and accurate directions for children / infants!
Note – your skin may appear noticeably wrinkled / aged after using benzyl benzoate. This effect is not permanent – and after some weeks your skin should return to normal appearance.
This is typically not prescribed as a standard treatment, but may be prescribed in cases of resistant or very serious (crusted) scabies, or in situations of outbreak such as a care facility, where it may be prescribed to all occupants.
Very Important: Ivermectin is very commonly regarded as a very harmless medication – however I beg to differ and can only advise extreme caution: When I had scabies in 2017 I (mis)used ivermectin many times and I had dreadful side effects that put me in hospital twice and took years to fully recover from.
The most important notes are these:
1) do not exceed the stated dose. Ivermectin is prescribed according to body weight.
2) Do NOT consume either grapefruit (either whole fruit or juice) or turmeric within 48 hours either side of taking ivermectin. Very, very important. I found this out the hard way and this information was not at all easy to find in the medical literature available online. These dangerous interactions are not even listed on drugs.com  – which is CRAZY, sorry gotta say it!
Grapefruit inhibits the metabolism of many prescription meds, and its effect on ivermectin is that it blocks the body’s ability to break it down – leading to potentially dangerously elevated levels of ivermectin in the body. Turmeric on the other hand interferes with the blood brain barrier and its ability to keep ivermectin out of the brain. Either of these interactions is potentially dangerous, but combine them and you could be in big, big trouble: In 2017, I did not know about these contraindications (barely anyone does!) and I was consuming both turmeric and grapefruit while taking ivermectin (numerous doses). I ended up in hospital twice, with awful seizure-like episodes, brain zaps, multiple recurring “awakening while awake” (waking up while awake, and then again, and then again – strangest symptom ever!), random moments of catalepsis (sudden inability to move for a few seconds) and agonizingly painful sensitivity to sound and vibration. This was actual brain damage and these symptoms took five years to fully subside. It’s not an exaggeration to say that I could have been killed. Be careful with ivermectin…
3) Ivermectin is regarded as non-ovicidal (doesn’t kill the scabies’ eggs) so more than one treatment is anticipated to be required in order to break the life cycle (typically 5 to 7 days apart).
4) Aside note, ivermectin action is reportedly decreased by orange juice. 
Ivermectin is in fact an extremely toxic substance – and the only reason it doesn’t kill humans is that our blood brain barrier keeps it out of the brain. Lice, mites and other arthropods do not have a blood brain barrier and so it wipes them out (in theory). Collies (dog) have a genetic deficiency in the blood brain barrier, which means that ivermectin can get into their brain. ONE DOSE of ivermectin will kill a collie!
Side effects. You may experience drowsiness, dizziness and even partial blindness. Driving or operating machinery is disadvised. If you take ivermectin in the evening and wake up at night to pee, you may find you can only see out of a small area in the centre of the field of vision, which can be quite scary. This effect should fade by morning.
Probably the most commonly prescribed medication for scabies nowadays. Typically prescribed as a 5% cream, such as “Lyclear” brand; which you cover yourself completely in from the neck down – and then leave on for numerous hours, as directed on the label. Lyclear Permethrin normally comes in a tube with one tube typically being regarded as the correct amount for one treatment for one adult. Permethrin is regarded as able to kill the eggs. 
Permethrin may or may not work: I used it 8 times in 2017 and it was completely ineffective. In my case, it was as if the scabies “lapped it up like cream”, it did not even seem to come close to eradicating them. Several scientific papers have indicated that some strains of scabies are resistant to it  and many users self-report online that it is completely ineffective. Some doctors are completely in denial of this, including the clueless doctor I had in 2017, who treated me as though I was incompetent. Their attitude was “the treatment works and the only reason it does not work is because you are not applying it completely, do it again.” I certainly did cover myself completely, in addition to the most extreme possible levels of social distancing and disinfection of bedding, clothing etc.
Lyclear cream is somewhat difficult to obtain online at the moment. I am not seeing it on either Amazon USA or Amazon UK; however it is available on Ebay UK – with a “questionnaire” required before purchase. Note – DO NOT be tempted to experiment with stronger permethrin, such as the 37% which is typically purchased as a concentrate for livestock use.
Often prescribed in the UK. A chemical insecticide. May be prescribed at 0.5%. Regarded as low toxicity but a breakdown product is more toxic (malaoxon) and is highly toxic to arthropods (hence its use as a pesticide). Malathion is listed by the IARC as a probable carcinogen (IARC Group 2A), and as “suggestive evidence of carcinogenicity” by the EPA. Resistance to malathion has been noted in head lice cases.  I would anticipate, reasonably, that resistance in scabies will be on the increase through the years.
Marketed as Eurax cream (10% strength), Crotamiton is another all-over topical medication that is sometimes used for scabies. It is also sold as an anti-itching drug for other insect bites. For scabies use it is advised to take a bath or shower, dry off, then apply 2 treatments, 24 hours apart, with no bathing or showering until 48 hours after the second application. This is all followed up by a second round of treatment 7-10 days after the first.  One authoritative source advises 3 to 5 treatments of 5% or 10% Crotamiton 24h apart.  Eurax is widely available and inexpensive. Here’s the Amazon UK link (6k sold in the last month on Amazon UK alone – but reviews mention its use as a general anti-itch cream and very little in the way of reports on its effectiveness for scabies; of the 1,337 reviews only 6 mention scabies at all and no claims of total eradication!)
A nasty chemical insecticide that used to be prescribed at 1% strength (“Quellada” was one brand) but has been withdrawn in many countries due to causing seizures and other neurotoxic effects.  It was banned in 52 countries by 2006.  Lindane was also used as a household and agricultural pesticide, but was banned from such use in 2009 under the Stockholm Convention owing to its being designated as a persistent organic pollutant (but not before 600,000+ tons of the stuff was dumped on the fields of the earth between 1950-2000, of course). However – an exception to this ban was made for its use as a scabies and head lice treatment!! Lindane is an evil chemical that is, shockingly, still used for scabies / lice in some third world countries. (Typical chemical company practice is to only withdraw a chemical when it is legislated against!) As you can tell, I am NOT a fan. There is a thing called Conscience; have they not heard of it? A crime against nature and an awful legacy of pollution, the effects of which we are still dealing with.
★ ACARICIDE (Anti-Scabies / Anti-Mite) Essential Oils (Tutorial + List):
Very many essential oils have anti-mite action. Essential oils are the plant kingdom’s own “immune response” against insects – and they have been waging this battle since time immemorial. They are rather good at it! There are over 17,500 plant species that could be considered for anti-mite approaches – however most of these have simply not been tested. 
Theory: One of the first things to note is that due to the high number of molecular components of any given oil (some oils contain over 300 different molecules! ), the spectrum of action of essential oils is fundamentally more diverse than that of “single molecule” medications. This typically means that it is more difficult for mites to develop resistance to oils than industry-created insecticides. Science is now starting to catch up to this, with multiple studies in recent years echoing these sentiments.
Mite resistance to insecticides has already gone “full circle” in agriculture, with some strains of red spider mite immune to all the legally available insecticides. Growers have been turning again to essential oil blends – which have been found to be significantly effective.
IMPORTANT – use mixes: Note that disease resistance to single essential oils is now becoming a “known thing” – for example toenail fungus developing resistance to tea tree essential oil. For this reason, it is regarded as important to blend multiple essential oils, rather than just using one oil – and keep varying the mix. Don’t give the bugs a chance to get immune to anything! If you find you have an aversion to any particular oil, skip it.
Essential Oil Mist Sprays: These can be very valuable and there are some anecdotal reports of clearing scabies 100% with essential oil (diluted) sprays! I would say start using 20 drops of mixed essential oils per 16oz spray bottle. You can mist spray this on your skin; again, test with a small, gentle amount before major application – and adjust strength as required. Mist sprays can also be used for spray ‘n’ wipe of hard surfaces, flooring, counter tops, toilet seats and other commonly touched objects.
Topical ointments: Do not use essential oils undiluted on skin. Dilute significantly with a carrier / base. Even 10% essential oil / 90% base is “too hot” and will probably make your skin peel like sunburn. It’s far too easy to get carried away with essential oils, especially when you have scabies and you are there thinking “die, you bastards”. Ask me how I know. Essential oils are powerful. Try 5 drops to a teaspoon of base oil (almond, coconut etc) and do a “patch test” on an unaffected patch of skin – typically the inside of the forearm. Wait at least 30 mins and note any reaction – burning sensation, redness, irritation, rash or any other symptom. Discontinue if there is a reaction. Keep an eye on your skin also and if it starts to feel super dried out, like sunburn, stop. Shower off the oils if necessary.
Bath: You can also try adding 10-20 drops of oil to a hot bath. Again, start gentle. It’s better to use too little than too much.
Here’s a list of some of the most potent anti-mite oils, with reference links to scientific research:
Oregano (Origanum vulgare) (look for high carvacrol content- (85%+). By far the most effective oil in one study; Carvacrol killed all mites at a concentration of 0.5% within a median lethal time of 6.7 minutes.  To give a realistic perspective, 0.5% would be is around 100 drops of carvacrol / 120 drops of oregano oil in a litre of water. This is a very strong mix and in my view quite wasteful, not to mention far too intense for skin use.
Clove (Eugenia caryophyllata) – regarded as highly effective  – but can cause seizures in some individuals – use with caution, if it makes you feel unwell, avoid. Extremely toxic to cats.
Tulsi (Holy Basil) (Ocimum sanctum) – one of the most powerful oils in one important study of 31 essential oils vs. scabies mites. 
Eucalyptus (Eucalyptus spp.) – reported to give complete cure in one old study. 
Lemongrass / Citronella (Cymbopogon citratus / spp.) – High in geraniol, which has been found to have powerful anti-mite action. 
Palmarosa (Cymbopogon martinii) – second most effective oil in an in vitro study of 10 essential oils vs. scabies 
Cajeput (Melaleuca cajuputi / spp.)
Camphor (Cinnamomum camphora) – promising reports as an anti-scabies oil. 
Lavender (Lavandula angustifolia Mill.) – lavender EO showed the strongest acaricidal effect against poultry mite in a test of 10 essential oils.  Different mite, but somewhat similar effects can be anticipated for S. Scabei. And it smells nice, so why not add a few drops to your blends?
Tea Tree (Melaleuca alternifolia) – commonly regarded as effective. Good reports from studies.  Note; possible resistance. Use in combination!
Cedarwood (Cedrus spp.) – has been used as a ‘natural insecticide’ since ancient times.
Cinnamon (Cinnamomum zeylanicum) – cinnamon bark EO showed the strongest acaricidal activity against poultry red mite (different mite) in a test of 30 oils.  interestingly, cinnamon EO actually contains benzyl benzoate, as well as eugenol which is a principal active component in clove.  Interesting aside; Ascabiol lotion also contained Cassia EO (Cinnamomum cassia) (cheaper but similar), which while listed on the label as an inactive ingredient, may have had some action.
Orange Citrus x sinensis – limonene, found at typically 91-97% in orange oil  has been found effective against scabies mites at 1% concentration.  Interestingly limonene is present only only in citrus peels but also numerous coniferous and broadleaf trees – such as pines, fir, spruce.  Although orange oil smells lovely, do not be tempted to use undiluted on skin as it can cause contact dermatitis. Interestingly also, orange oil / limonene is used as a dermal penetration enhancer for other topical medications and skin care products.  A few drops of orange oil in your blend may assist in this regard. Use cautiously and test on a small area first.
★ OTHER NATURAL ANTI-SCABIES REMEDIES
There are a mountain of these – and the internet is full of bad information! When I had prolonged scabies in 2017 I tried very many natural treatments and most of them were ineffective. Here’s a list:
Sulfur: This is an ancient scabies remedy. Sulfur 10% Cream is available on Amazon USA (and also ships to the UK). The cream is probably the way to go: In 2017 I tried adding sulfur powder to baths, pushing the amount as high as I could stand. It seemed to have very little effect, other than creating the most ridiculously unenjoyable (and messy) bathtime experience ever. I also tried sulfur soaps, didn’t seem to do much.
Neem oil: I found it ineffective. A 2000 study noted similar ineffectiveness. 
Turmeric and neem paste: An old ayurvedic remedy for scabies used a paste made from blended neem and turmeric. This was reported in 1992 to give a 97% cure in a trial of 814 cases.  If you try this, expect everything to turn orange… it won’t permanently stain skin but clothing stains may be difficult to remove.
Borax / Hydrogen Peroxide Bath Soak: I’ve seen this mentioned on a forum here, with “rave reviews” of success (and many reports of permethrin failure!) I have no idea how effective or safe it is – and there seem to be many random theories flying around that forum, so be cautious. The formula seems to be one cup of borax (i.e. mule team borax) and one cup of peroxide added to a hot bath. (What strength peroxide??? Not sure – but possibly 3% or 6%; it would be rather valuable – vital even – to know, as guesswork is not recommended here!)
Salt Water Baths / ocean bathing: Might be worth a try – at the worst it won’t do much, and at best it might harm the bugs! Add Himalayan or sea salt to hot water and dissolve as much of it as you can in it. You could also do this with a bowl of hot water and then use a washcloth to clean up.
Ultra Violet Light: Now this one is interesting: UV-C lamps / bulbs such as this one (Amazon) are commonly used to control dust mites [similar enough to scabies mites? quite probably!], in addition to performing various other tasks of sterilization. In typical use, these are switched on in a room unoccupied by either humans or pets and left on for 30-60 mins. The short wavelength light generates ozone and the room’s air must be evacuated before use. Great care must be taken to avoid looking at the bulb, even briefly and the light can also be damaging to skin. These might be very valuable for disinfection of rooms and other objects, though caution / correct use is advised so as to avoid risk of serious damage to eyes or skin – and it should be noted that while they may be beneficial for decontaminating an environment, these should not be used to attempt to zap bugs that are on a person. Further research required here.
Moldy Lemons In Oil: This is a curious old gypsy / folk remedy for sarcoptic mange (animal form of scabies that affects dogs and foxes) that a friend of mine swears by – and may actually have some scientific merit – although I couldn’t bring myself to try it. 1) Put lemons in a ziplock bag, close up and allow them to go moldy. 2) Once they are fully wearing their “grey fur coats”, open the bag (outdoors, don’t breathe the spores) and pour in olive oil to cover them. 3) Close up the bag and smush it all together thoroughly, taking care not to burst the bag. 4) Cover yourself in the oily muck. It sounds grotesque, but there are actual reasons why this may have some merit: a) lemons contain a goodly amount of limonene, which has been found to have anti-scabies action . b) the oil will extract the volatile components from the lemon, including limonene and act as a carrier. c) Mold toxins are quite potent and they may be very powerful against scabies – though I would advise great caution. I cannot truly recommend this because it is such a “wild card” remedy and may or may not have negative consequences, but I listed it for interest’s sake – and perhaps someone with sufficient scientific knowledge may be able to investigate it further. We should certainly consider ancient remedies before discarding them, as many others have proven extremely valuable and even become the basis for frontline medications (for example willow bark, yew tree, many others!)
★ PRINTABLE / PINNABLE / SHAREABLE CHECKLIST (please share!):
12 Vital SCABIES PREVENTION Tips (printable)
FURTHER READING: Scabies: Epidemiology, Diagnosis, and Treatment (Dtsch Arztebl Int., 2021). This is a very good quality paper with excellent medical information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8743988/
 In Vitro Efficacy of Terpenes from Essential Oils against Sarcoptes scabiei (Molecules, 2023) https://www.mdpi.com/1420-3049/28/8/3361/htm
 Comparing acaricidal and ovicidal activity of five terpenes from essential oils against Psoroptes cuniculi (Treatment and Prophylaxis, 2020) https://link.springer.com/article/10.1007/s00436-020-06823-z
 Lemongrass (Cymbopogon citratus) oil: A promising miticidal and ovicidal agent against Sarcoptes scabiei (PLoS Negl Trop Dis. 2020) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162540/
 Scabies in the age of increasing drug resistance (PLoS Negl Trop Dis, 2017) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5708620/
 The repellent and persistent toxic effects of essential oils against the poultry red mite, Dermanyssus gallinae (Vet Parasitol, 2015) https://pubmed.ncbi.nlm.nih.gov/26548812/
 Toxicity and effects of essential oils and their components on Dermanyssus gallinae (Acari: Dermanyssidae) (Exp Appl Acarol. 2019) https://pubmed.ncbi.nlm.nih.gov/31069572/
 In vitro activity of ten essential oils against Sarcoptes scabiei (Parasites & vectors, 2016) https://parasitesandvectors.biomedcentral.com/articles/10.1186/s13071-016-1889-3
 Studies in vitro on the relative efficacy of current acaricides for Sarcoptes scabiei var. hominis (Trans R Soc Trop Med Hyg., 2000) https://pubmed.ncbi.nlm.nih.gov/10748911/
 Essential Oils against Sarcoptes scabiei (Molecules, 2022) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9788335/
 In vitro efficacy of essential oils against Sarcoptes scabiei (Sci rep., 2022) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9065015/
 Orange Oil, Wikipedia https://en.wikipedia.org/wiki/Orange_oil
 Limonene, Wikipedia https://en.wikipedia.org/wiki/Limonene
 Recent advances in understanding and treating scabies (Fac Rev., 2021) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8009191/
 A review of Sarcoptes scabiei: past, present and future. (Parasit Vectors. 2017) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5477759/
 Malathion. Wikipedia https://en.wikipedia.org/wiki/Malathion
 Eucalyptus globulus against the zoonotic scabies, Sarcoptes scabiei. (J Egypt Soc Parasitol. 2003) https://pubmed.ncbi.nlm.nih.gov/12739800/
 The use and efficacy of Azadirachta indica ADR (‘Neem’) and Curcuma longa (‘Turmeric’) in scabies. A pilot study. (Trop Geogr Med., 1992) https://pubmed.ncbi.nlm.nih.gov/1496714/
 Therapeutic potential of medicinal plants for the management of scabies (Wiley Online Lib., 2019) https://onlinelibrary.wiley.com/doi/10.1111/dth.13186
 Essential Oils’ Chemical Characterization and Investigation of Some Biological Activities: A Critical Review. (Medicines, Basel. 2016) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5456241/
 Ivermectin interactions. Drugs.com https://www.drugs.com/drug-interactions/ivermectin-index.html
 Orange Juice Decreases The Oral Bioavailability Of Ivermectin In Healthy Volunteers. (Clinical Pharmacology & Therapeutics, 2003). https://www.researchgate.net/publication/232796255_Orange_juice_decreases_the_oral_bioavailability_of_ivermectin_in_healthy_volunteers
 Lindane, Wikipedia. https://en.wikipedia.org/wiki/Lindane
 Crotamiton, Medscape. https://reference.medscape.com/drug/eurax-crotamiton-topical-343500
 Crotamiton, Wikipedia. https://en.wikipedia.org/wiki/Crotamiton
 Natural Terpenes as Penetration Enhancers for Transdermal Drug Delivery. (Molecules, 2016). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6273457/
 Scabies: Epidemiology, Diagnosis, and Treatment. (Dtsch Arztebl Int., 2021) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8743988/
 The effects of climate factors on scabies. A 14-year population-based study in Taiwan. (Parasite, 2016) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5134670/
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