Scabies is relentless. The itching peaks at night and no amount of washing touches it, because the mite lives under the skin.
Ivermectin is swallowed, so it reaches the mite from the inside — no need to cover every inch of skin with cream.
Without prescription, plain packaging. Treat the whole household at once.
Occasionally head lice, where topical treatment has failed
Scabies is the most common reason people look for it, particulary when creams have not worked or when a whole household needs treating at the same time.
Which channel do human nerves not have?
The selectivity here is unusually clean.
Parasites carry a particular type of chloride channel in their nerve and muscle cells. Ivermectin binds to it and holds it open.
Chloride floods in, the cell can no longer fire, and the parasite is paralysed. It cannot feed, move or hold position, and it dies.
Mammals do not have that channel in their peripheral nerves at all. The similar channels that do exist sit in the brain, protected behind a barrier the drug does not normally cross.
Two separate layers of protection, which is why it is generally well tolerated at standard doses.
Empty stomach, with one exception
Swallow tablets whole with a full glass of water.
On an empty stomach — roughly an hour before food or two hours after.
A second dose a week or two later is usual for scabies.
Do not take extra on your own judgement.
The repeat dose matters. The first dose kills active mites but not the eggs. Those hatch a week or so later, and without the second dose you are straight back where you started.
Scabies: treat everyone, same day
Partial treatment is the single reason scabies keeps circulating through a household for months.
Everyone in the household treated on the same day, symptoms or not
Close contacts and partners too
Bedding, towels and clothing from the last few days washed hot
What cannot be washed, sealed in a bag for several days
Mattresses and upholstery vacuumed
Someone can carry mites for weeks before itching starts. Treating only the person who itches guarantees it comes back.
Itching after treatment is normal
This confuses almost everyone, and it leads to unnecessary repeat treatment.
The itch is an allergic reaction to the mites and their debris, not evidence that they are alive. Dead mites and their waste stay in the skin until it sheds.
So the itching can carry on for two to four weeks after successful treatment. Easing steadily, not stopping overnight.
Moisturiser and an antihistamine at night help. What should worry you is itching that is getting worse after a few weeks, or new burrows appearing — that suggests treatment failure or reinfection.
Possible side effects
Dizziness
Nausea
Headache
Muscle aches
Temporary rash or itching
Mild fever
Occasional diarrhoea
With a heavy worm burden, symptoms can briefly intensify as the parasites die. That reaction settles on its own.
Seek help for severe dizziness, confusion, visual changes or a rapidly spreading rash.
Worth being careful about
Tell someone about liver problems, any neurological condition, and any possibility of pregnancy or breastfeeding.
And if you have spent time in regions where certain other parasites are common, say so before treatment — in a small number of situations the order of treatment matters a great deal.
Ordering without prescription: how it works
Household treatment means several people on the same day, which usually means ordering enough in one go.
Pick the strength and the pack size, put in a delivery address, confirm. Couple of minutes, any time of day, no queue and no conversation accross a counter.
It goes out in plain packaging. No pharmacy name on the outside, nothing that hints at what is inside. How long delivery takes depends on where the parcel is headed.
On price it comes down to strength and pack size. Larger packs generally work out better per unit.
Delivery goes anywhere in the UK, in plain outer packaging with no logo and no product name on it. How long it takes depends on where it is heading and which service you picked. Prices are in pounds.
