Eurax (Crotamiton) vs Other Scabies & Lice Treatments: In‑Depth Comparison
Oct, 7 2025
Scabies & Lice Treatment Comparison Tool
Treatment Comparison Overview
This tool helps you understand how Eurax compares to other scabies and lice treatments based on your specific needs.
- Eurax: Prescription-only cream containing crotamiton, effective for both scabies and head lice.
- Permethrin: First-line treatment for scabies with high cure rates.
- Ivermectin: Oral treatment for severe or widespread infestations.
- Natural Remedies: Limited evidence, potential for skin irritation.
Quick Takeaways
- Eurax (crotamiton) works for both scabies and head lice but is slower than permethrin.
- Permethrin 5% cream is the most widely recommended first‑line scabies treatment.
- Oral ivermectin offers a convenient option for extensive infestations.
- Natural options like tea tree oil have limited evidence and may cause skin irritation.
- Choose based on infestation type, skin sensitivity, prescription status, and cost.
What Is Eurax (Crotamiton)?
When treating scabies, Eurax is a prescription‑only topical cream that contains the active ingredient crotamiton (10% w/w). It relieves itching and kills the Sarcoptes scabiei mite, while also being approved for adult head‑lice treatment. The product is applied once, left on the skin for 24hours, then washed off. Clinical trials in 2023 reported an 80‑85% cure rate for scabies when the full regimen is followed.
Key Alternatives on the Market
Below are the most common scabies or lice therapies you’ll encounter in pharmacies or clinics.
- Permethrin - a synthetic pyrethroid sold as 5% cream (e.g., Kwell, Nix).
- Malathion - a phosphorothioate insecticide available as 0.5% lotion (e.g., Lyclear).
- Benzyl benzoate - an oily solution (10‑25%) used in many low‑cost products.
- Ivermectin - an oral antiparasitic (200µg/kg) prescribed for widespread scabies.
- Sulfur ointment - a classic 5‑10% preparation, safe for infants.
- Tea tree oil - a natural essential oil sometimes marketed for lice.
- Scabies - a contagious skin disease caused by the Sarcoptes scabiei mite.
- Head lice - a common infestation of Pthirus pubis nits on hair shafts.
Decision Criteria You Should Use
Before picking a product, ask yourself these questions:
- Infestation type. Does the product treat scabies, lice, or both?
- Prescription vs. over‑the‑counter. Are you comfortable seeing a doctor?
- Speed of action. How quickly must symptoms disappear?
- Skin sensitivity. Any known allergies or eczema?
- Cost and availability. Is the treatment affordable and easy to get?
- Treatment regimen. One‑time application or multiple doses?
Side‑by‑Side Comparison Table
| Product | Active Ingredient | Formulation | Prescription? | Primary Use | Typical Cure Rate | Common Side Effects | Approx. Cost (UK) |
|---|---|---|---|---|---|---|---|
| Eurax | Crotamiton 10% | Cream | Yes | Scabies & head lice | 80‑85% | Mild burning, itching | £22 per tube |
| Permethrin (5% cream) | Permethrin | Cream | Yes (often prescribed) | Scabies (first line), lice | 92‑98% | Transient redness | £15‑£20 |
| Malathion 0.5% lotion | Malathion | Lotion | OTC (UK) | Lice only | 70‑80% | Skin irritation, oily residue | £8‑£12 |
| Benzyl benzoate (10‑25%) | Benzyl benzoate | Oil solution | OTC | Lice & scabies | 65‑75% | Stinging, greasy feel | £5‑£9 |
| Ivermectin (oral) | Ivermectin | Tablets | Prescription | Severe scabies, crusted | 95‑99% | Headache, nausea | £30‑£45 |
| Sulfur ointment 5‑10% | Sulfur | Ointment | OTC | Scabies (infants, pregnant) | 60‑70% | Odor, mild irritation | £3‑£6 |
| Tea tree oil (5% solution) | Terpinen‑4‑ol (main component) | Essential oil | OTC | Lice (alternative) | ~50% | Allergic dermatitis | £10‑£14 |
Best‑Fit Scenarios
When Eurax shines: If you need a single product that covers both scabies and head lice, and you don’t mind a prescription, Eurax is a convenient choice. It’s also a good option for patients who react to pyrethroids (permethrin) because crotamiton works via a different mechanism.
When permethrin beats Eurax: For typical scabies cases, permethrin’s higher cure rate and single‑application protocol make it the preferred first‑line drug. It’s also available in many generic forms, keeping the price low.
When oral ivermectin is worth it: In crusted scabies, widespread infestations, or when topical application is impractical (e.g., bedridden patients), oral ivermectin offers the most reliable eradication.
When cheap OTC options help: For mild lice infestations in school‑aged children, benzyl benzoate or malathion are cost‑effective, though you must repeat the treatment after 7‑10days to kill any newly hatched nits.
When natural remedies might suffice: Tea tree oil can be tried for very early lice cases, but you should be prepared for possible skin irritation and lower success rates.
Practical Tips & Common Pitfalls
- Always read the label for the required contact time. Rushing the wash‑off step reduces efficacy.
- Treat all close contacts simultaneously - scabies spreads through skin‑to‑skin contact, lice through head‑to‑head contact.
- Combine chemical treatment with environmental measures: wash bedding at 60°C, vacuum carpets, and seal non‑washable items in plastic bags for 72hours.
- Don’t reuse the same applicator tip for multiple patients; cross‑contamination can re‑introduce mites.
- If itching persists after two weeks, consult a clinician - residual inflammation can mimic treatment failure.
Frequently Asked Questions
Can I use Eurax for my toddler’s scabies?
Eurax is licensed for patients over 2years old. For infants under 2, sulfur ointment or a pediatric‑dose permethrin cream is usually recommended.
How does crotamiton actually kill the scabies mite?
Crotamiton interferes with the mite’s nervous system and also reduces the itch signal, giving the skin time to heal while the mite dies.
Is a second application of Eurax ever needed?
Guidelines suggest a repeat dose after 7days only if itching continues or a new rash appears, indicating surviving mites or reinfestation.
Why do some doctors still prescribe permethrin instead of Eurax?
Permethrin has a higher documented cure rate, a simpler one‑time regimen, and a long track record of safety, making it the default first‑line therapy in many national guidelines.
Can I treat both scabies and lice with the same product?
Yes, Eurax is one of the few options approved for both conditions. However, if you have only lice, a lice‑specific product like permethrin 1% lotion may be cheaper and equally effective.
Next Steps for Different Scenarios
If you’ve just been diagnosed with scabies: Book a GP appointment, ask for a prescription of permethrin or Eurax, and start treatment within 24hours. Follow the washing instructions and treat close contacts.
If you suspect head lice at school: Check the hair with a fine‑tooth comb. If nits are found, buy an OTC malathion or benzyl benzoate product, or ask your doctor about Eurax if you’d rather cover both lice and possible scabies.
If you have a crusted or widespread infestation: Seek specialist care. Oral ivermectin combined with topical therapy is the current best practice.
If cost is a major concern: Sulfur ointment and benzyl benzoate provide the lowest price points, though you may need multiple applications.
Regardless of the product you choose, remember that clean bedding, towels, and personal items are essential to prevent a cycle of reinfestation.
Mark Quintana
October 7, 2025 AT 18:17Make sure to wash all sheets, pillowcases and blankets at least 60 °C after treatment. That heat kills any lingering mites or lice eggs that might survive on fabric. Also clean stuffed toys by sealing them in a plastic bag for a few days. Doing all this reduces the chance of re‑infestation.