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Conventional Treatment for Mites and Scabies
Treatment for Scabies
When scabies or mite infestations are diagnosed, the most common treatment is topical permethrin — and sometimes a dose or two of ivermectin. But for persistent, resistant, or misdiagnosed cases, these may not be enough. A broader understanding of anti-parasitic medications is crucial for comprehensive care.
Standard treatment includes:
- Topical medications:
- Permethrin cream 5% – most common and effective.
- Benzyl benzoate, sulfur ointment, crotamiton, or malathion.
When Internal Treatment Matters
For many patients, topical treatment alone isn’t enough. If there are signs of systemic involvement — gut dysfunction, chronic fatigue, recurring infections, or organ stress — internal anti-parasitic support may be essential.
- Oral medication:
- Ivermectin – often used for large outbreaks or crusted scabies.
Fenbendazole & Mebendazole
Originally used in veterinary medicine, fenbendazole and mebendazole are gaining traction as low-toxicity antiparasitic agents. They target a range of worms and helminths, but some practitioners and researchers are now exploring their off-label use in resistant skin cases where internal parasites or systemic support is needed.
Albendazole and Thiabendazole
These medications are more aggressive in clearing systemic and tissue-burdened parasites. Albendazole, in particular, is sometimes used in protocols involving strongyloides or hydatid infections — both of which can complicate mite infestations.
Rotating Treatments
A rotation strategy is often more effective than repeated use of a single medication. This includes alternating ivermectin, albendazole, and mebendazole in cycles to reduce resistance and target different parasite stages. Gaps between cycles allow the immune system to reset and reduce toxic load.
⚠️ Important Considerations
- Post-treatment itching (especially with scabies) can persist for weeks due to allergic reaction to dead mites.
- Hygiene and environmental cleaning (e.g., washing bedding, clothes in hot water) to prevent reinfestation.
- Demodex is part of the normal microbiome, so the goal is often population control rather than eradication.
Treatments for Demodex
Topical Metronidazole
- Reduces inflammation and mite population.
- Commonly used for Demodex-related rosacea.
Topical Ivermectin (Soolantra 1% cream)
- Anti-inflammatory and anti-parasitic.
- Applied once daily; effective in reducing Demodex counts.
Permethrin 5% cream
- Used to reduce Demodex mites.
- Often used in cycles or as part of rotation protocols.
Benzyl Benzoate
- Sometimes used for stubborn Demodex infestations.
Oral Ivermectin
- May be used in persistent or systemic Demodex overgrowth.
*It’s important to note that Demodex is a normal part of a healthy and diverse relationship with microorganisms. As we age, Demodex can overgrow creating histamine and Mast cell issues, biofilm production and skin irritation. The goal is not to eradicate Demodex but to reduce the population to a range a healthy immune system and consistent personal care can manage.
Early or Aggressive Treatment
Two Part Approach
Traditional treatment is hard to find due to numerous factors like misdiagnosis, treatment shortages, and a general dismissal of mites in the United States. In the last two years there has been a considerable increase in telemedicine services available online, some dedicated to nothing but scabies. That alone should tell us that there has been a significant rise in scabies cases and people are desperate for relief.
Some online telemed services include:
Most treatment plans for scabies call for a two part approach that includes 5% permethrin cream topically and ivermectin tablets orally.
Permethrin cream is applied from head to toe making sure to get it under the finger and toenails and in the skin folds of the wrists, knees, elbows, neck and knuckles. Some information suggests only applying the cream from the neck down, but research shows that scabies do live on the face, scalp and in the ears. Apoly the cream everywhere except around the eyes and genitals.
Ivermectin is given as two doses, two weeks apart, or as prescribed.
Treating the family, household, roommates or any other community group in close contact is necessary to prevent reinfestation.
Treating furniture, car interiors, school equipment, community areas can be done with permethrin spray as directed.
Launder all clothes and bedding daily on the highest temperature possible and dry on high heat as well.
Vacuum daily and empty the canister outside away from living quarters.
Traditional treatments are usually repeated in two weeks to target the life cycle in every stage.
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Treatments work temporarily until treatments fail.
Traditional treatments are an effective and immediate line of defense but are rarely successful.
Why?
Overuse or underuse, too frequently or not enough, covering one area but not another, not treating living quarters and cars, being exposed again or repeatedly in a common area, not repeating treatments as directed, not avoiding personal contact with infested people...there are countless reasons.
Medications are meant to kill the mites and do, but if the conditions are right for re-exposure and re-infestation they will return, they will build resistance to treatments, and they will trigger the production of biofilm to stay alive.
In order to kill scabies and reduce the population of Demodex we have to:
clean the terrain,
clear the waste,
and breakup the biofilm.
How I Started…
I used CalllonDoc.
I uploaded photos, answered some questions and within a few hours had a diagnosis and treatment plan for scabies.
Finally.
I used the service, the prescribed medications, and the consult, three times to ensure targeting every stage of the life cycle. I washed all of the linens, vacuumed every inch of the house, laundered clothes and showered twice a day for months.
I could get it to calm down, slow down, heal to the point where I thought I was winning, but it would always come back.
I cancelled plans. I lost friends. I sprayed my body with apple cider vinegar and hydrogen peroxide and took pictures of every spot and stage.
I lint rolled my skin and the bedding.
I felt like I had reached an all time low and I was all alone. I was afraid to talk about it and tell people what I was going through and I was afraid to talk about it with people I knew had it. I was afraid to talk about it with any healthcare provider. I was afraid I would give it to and get it back from everyone.
Scabies and Demodex had stolen my life, my self esteem and my sanity.
I felt like I had to surrender to it and accept it as part of my life in order to live. That was both defeating and defining, and showed me that not only am I not going to accept everyone having scabies as the new normal, but I don’t want to see people suffer if there is a way to beat it for good.
First I had to find it…