Scabies is a contagious skin condition caused by the human itch mite Sarcoptes scabiei. The mites burrow into the top layer of skin and lay eggs, causing an intense itchy rash. Scabies can affect any part of the body, including the scalp and head area. Treating scabies on the head and scalp requires using medications that kill the mites and eggs while being gentle enough for sensitive skin.
How is scabies transmitted to the head?
Scabies mites are transmitted through prolonged physical contact with an infected person. When an uninfected person has skin-to-skin contact with someone who is infested with scabies, the mites can crawl from the infected host onto the new person. Mites can spread to any part of the body, including the head, through this contact.
Sharing personal items like clothing, towels, bedding or hair brushes with an infected person also allows mites to spread. Children are particularly susceptible to getting scabies on the scalp or head from head-to-head contact at school or daycare.
What are the symptoms of scabies on the head?
When scabies mites infest the scalp and head, they cause severe itching, which tends to be worse at night. Other symptoms can include:
- Pimple-like rash on the scalp, neck, and ears
- Tiny burrows visible on the scalp
- Sores and crusting due to scratching
- Tiny dark specks (mite feces) in the burrows
- Swollen lymph nodes around head and neck
- Hair loss if scratching is severe
Young children may be irritable and have trouble sleeping if they have scalp scabies. Secondary bacterial infection can occur if sores from scratching get infected.
Medications that kill scabies mites on the scalp and head
To fully eliminate a scabies infestation, medications are needed to kill the mites. Some options include:
Permethrin cream
Permethrin is a topical insecticide cream. It is the most common first-line treatment for scabies in adults and children over 2 months old. Permethrin kills the mites and eggs by disrupting their nervous systems.
To treat head scabies, permethrin cream should be massaged thoroughly into the scalp, temple areas, neck, and behind the ears. It needs to be left on for 8-14 hours before washing off. Often a repeat application one week later is needed to kill any newly hatched mites.
Ivermectin
Ivermectin is an oral anti-parasitic medication. It can be prescribed in a single dose to treat scabies. Ivermectin paralyzes and kills the mites feeding on skin.
For head scabies, ivermectin taken by mouth eliminates mites across the whole body. It may be combined with a topical treatment like permethrin cream for severe infestations.
Lindane shampoo
Lindane shampoo is an insecticide specifically approved for treating head lice and scabies on the scalp. It should be massaged into the hair and scalp and left on according to directions, then thoroughly rinsed out.
Lindane is recommended as an alternative treatment if permethrin fails. But it should be avoided in infants, pregnant women, and people with seizures or extensive sores, as it can be toxic in high amounts.
Sulfur ointment
Sulfur is a topical scabies treatment that disrupts mite metabolism and kills them. It is gentle and non-toxic. Sulfur ointment can be applied to the scalp in a thin layer and left on overnight before shampooing out.
Two or three applications of sulfur ointment may be needed to fully eliminate the infestation. Sulfur has a strong odor but is particularly useful for infants and as an adjunct treatment.
Crotamiton lotion
Crotamiton lotion (Eurax) also has anti-scabies properties to eradicate infestations. For scalp application, the lotion should be massaged thoroughly into the affected areas and washed off after 24 hours. Crotamiton is repeated in 1 week.
This medication kills scabies mites but does not destroy eggs. Using it along with other treatments like permethrin can improve clearance.
Essential oils
Some natural essential oils like clove, tea tree, and neem oils have anti-parasitic, anti-inflammatory, and soothing properties for scabies symptoms. Diluting the oils in a carrier oil and applying them to the scalp may help relieve itching and irritation.
However, essential oils alone are not proven to kill all the mites. They should be used along with other recommended scabies treatments.
Tips for treating head scabies effectively
When using medications to treat scabies on the scalp and head, there are some important tips to remember:
- Carefully follow the application instructions for any topical medication used. Leave the treatment on for the recommended duration before rinsing off.
- Apply creams thoroughly from the scalp down to the neck, behind the ears and to the forehead. Scabies can spread to the face too.
- Use medications on the entire body, not just the head, to ensure all mites are eradicated.
- Repeat application in 1 week as prescribed to kill any newly hatched mites.
- Treat all family members and close contacts simultaneously to prevent reinfestation even if they have no symptoms yet.
- Wash clothes, bedding and towels in hot water and dry on high heat to remove mites.
- Disinfect combs, brushes, hats, headphones and other items worn on the head.
Home remedies to soothe scabies symptoms on the scalp
While home remedies cannot cure scabies, they can temporarily provide soothing relief for an itchy, inflamed scalp when used along with prescribed medications. Some options include:
Cold compresses
Applying cold compresses or ice packs to the scalp can ease inflammation and itchiness. Wrap ice cubes or a cold pack in a towel and apply for 5-10 minutes several times a day.
Cool water rinses
Rinsing the scalp with cool water can momentarily stop itching and irritation. Add a teaspoon of baking soda or colloidal oatmeal to the water for extra relief.
Aloe vera gel
Pure aloe vera gel has soothing properties when applied to the scalp after shampooing and rinsing out scabies medications. Let the gel sit for 30 minutes before rinsing out.
Anti-itch creams
Over-the-counter anti-itch creams containing pramoxine, hydrocortisone, or menthol can temporarily control itching when applied sparingly to the scalp. This gives the skin a chance to heal.
Wet wraps
Wrapping dampened gauze or a cool towel around the head for short periods can help distract from itching.
When to see a doctor
Consult a doctor or dermatologist if:
- Symptoms do not improve within 1-2 weeks of self-treatment
- The rash spreads or becomes infected
- New burrows or pimples keep appearing
- You experience hives, trouble breathing, or other signs of allergic reaction
The doctor can prescribe stronger medications, investigate any underlying conditions, and provide guidance on properly treating the infestation.
Risk factors for developing head scabies
Certain factors put people at increased risk of getting scabies on the scalp or face:
- Young children in daycares or schools where scabies spreads easily
- Healthcare workers exposed to infected patients
- Nursing home residents in close contact
- People with weakened immune systems
- Individuals in crowded living conditions
- Family members or sexual partners of someone with scabies
Poverty can also contribute to outbreaks due to challenges with hygiene, sanitation, and access to treatment. Head scabies tends to affect infants and children most commonly.
Complications of scabies on the head
Scabies leads to very itchy rashes that can cause complications if scratched excessively. Potential problems include:
- Skin infections – Scratching can break the skin and allow bacterial penetration.
- Abscesses – Deep skin infections can form pockets of pus under the skin.
- Cellulitis – Bacteria spreads into deeper tissue causing swelling, redness, and pain.
- Scarring – Scratching can damage the skin permanently, leaving scars.
- Hair loss – Excessive scratching and hair removal efforts can lead to bald patches.
- Headache and lymphadenopathy – Infested lymph nodes swell as they react to the mites.
- Encrusted scabies – Thick crusts form from the mites in immunocompromised people.
Treating scabies quickly reduces the risk of complications. Seeking medical care at the first signs can prevent escalation of symptoms.
Prevention tips for head scabies
Preventing scabies on the scalp involves breaking the cycle of transmission between people and killing mites before they spread. Recommendations include:
- Avoid skin contact with anyone showing signs of scabies.
- Wash hands frequently with soap and warm water.
- Avoid sharing personal items like brushes, towels, clothes and bedding.
- Disinfect surfaces in shared living spaces.
- Use insect repellent containing permethrin on clothes and camping gear.
- Get prompt treatment if any signs or rash appear.
- Carefully follow decontamination instructions after treatment.
- Examine household members and treat anyone showing symptoms.
Children or immunocompromised individuals are at higher risk and need extra precautions. Teaching kids not to share items and to ask for help when itchy can aid early diagnosis.
Scabies facts and statistics
- Up to 300 million cases of scabies occur worldwide each year. (American Academy of Dermatology)
- Scabies outbreaks commonly occur in schools, nursing homes, and refugee camps. (WHO)
- Kids get scabies most often, with a peak between ages 5-10 years old. (Parasites & Vectors)
- Scabies infestations can persist for months if untreated. (Lancet)
- Crusted scabies is a severe, highly contagious form that occurs in immunocompromised people. (American Journal of Tropical Medicine and Hygiene)
- Overcrowding, homelessness, poverty, and lack of access to healthcare increase scabies transmission. (PLOS Neglected Tropical Diseases)
- Bedding, clothing or furniture exposed to scabies mites remains infective even after 1-2 days at room temperature. (Parasitology Research)
Conclusion
Scabies often spreads to the head in children via head-to-head contact at school. Fast treatment is important to avoid complications and transmission to others. Permethrin cream, ivermectin, lindane, sulfur ointment, and crotamiton lotion are effective prescription medications to kill the mites on the scalp and rest of the body. Home remedies like cold compresses, oatmeal baths and aloe vera provide soothing relief for symptoms. But diligent cleaning and proper medication use is key for getting rid of head scabies once and for all.
