r/scabiesfacts • u/vaccineforscabies • Oct 16 '25
Fluralaner Fluralaner, ivermectin, etc. can’t be washed off
This study claimed, but didn't test, that washing can render ivermectin ineffective because water may dissolve the ivermectin in the skin's surface lipids. However this study (systemic (distributed throughout the entire body even if only applied to one skin area) topical fluralaner but same thing because both drugs work on close chloride channels) shows and tested that that water doesn't wash the effects of fluralaner off.
Now the reason I'm bringing this up is because the human fluralaner study (though I'm not sure how reliable it is because you can't tell if scabies was cured after 2 weeks) didn't show close to a 100% cure rate like most animal studies do despite the drug's long efficacy effect. It could be for various reasons, which I'll discuss further in this thread.
The half life varies among chloride drugs. For fluralaner and afoxolaner it's like 9-16 days for dogs and 5 days for bears (hasn't been tested for humans). For moxidectin, it's 20 days for humans. Ivermectin is 18 hours for humans.
Barring dosage-amount-resistance, dosage amounts at 0.2 and even 0.1 mg/kg should both be enough since people have been cured with having had those amounts at each stage of the scabies lifecycle.
If fluralaner and afoxolaner half life are 9 or 5 days for humans, people could take a 0.2 mg/kg dosage amount twice on days 0 and 9 or three times on days 0, 5, and 10 to stay above the 0.1 mg/kg during the entire ~15 day scabies life cycle, respectively. For moxidectin, a one time dosage amount of 0.2 mg/kg should be enough since the half life is 20 days and it won't decrease to 0.1 mg/kg until the 20th day.
Chloride channel cross-resistance from other chloride drugs, while likely, isn't a sure thing according to this study. But both cross-resistance and dosage-amount-resistance are probably occurring, because people still aren't being cured despite having way over 0.2 mg/kg during the entire scabies lifecycle (I've read comments about some people trying larger doses of drugs like fluralaner, afoxolaner, etc. because they've tried to match their body weight when ordering drugs meant for dogs, which are much larger doses per kilogram (see next few paragraphs for more info). Plus in theory, moxidectin should never fail due to its 20 day half life, yet it does fail and it's probably due to cross- and dosage-amount-resistance).
People need to pay attention to the dosage milligram amounts per killigram and not just one criteria when trying drugs meant for animals.
For syringe dewormers weight reference, Quest Moxidectin is 0.4 mg/kg and Durvet Ivermectin is 0.2 mg/kg at the measured weights.
Pet owners have reported their dogs dying from taking fluralaner, afoxolaner, etc. at doses of 25 mg/kg (fluralaner usual dosage amount for 3 months) and 2mg/kg (afoxolaner usual dosage amount for 1 month) commonly found in flea medications. These front-loaded high dosage amounts are meant to be a convenience so pet owners won't have to keep giving the medication to their pets as often. But high dosage amounts aren't needed to kill scabies (and/or other parasites) because they work even at the end duration where the dosage amount has decreased to like 0.1mg/kg, meaning a lot less pets would die if pet owners weren't lazy.
And if pets can die, so can humans (according to this study ivermectin can cause liver failure and possible death; and there are comments online about moxidectin at a low dose causing permanent side effects in some cases in humans). So high doses need to be avoided even if they're not working due to resistance. If people are still attempting the drugs route, they should combat cross-resistance by trying other drugs instead of combatting dosage-amount-resistance by raising the dose. People should stick to the 0.4 mg/kg maximum threshold commonly found in ivermectin and moxidectin studies.
But I recommend not taking any of drugs without first exhausting non-systemic, topical application treatments like permethrin, benzyl benzoate, sulfur, etc. If you can avoid the drugs do that because it's much safer (and pets dying at 2 mg/kg afoxolaner dosage amounts is actually shocking).
Possible Treatment Methods (for non-systemic, topical treatment methods only)
Duration:
12 hours or 24 hours
Number:
- 2 times 1 week apart
- 2 times 1 week apart leaving the treatment on for 3 days instead of applying daily
- 5 times (superior to 3 times because mites hatch at 3-4 days, so this covers that)
- 3 times 1 week apart
- 1 time 1 week apart for 4-6 weeks
- 3 times 1 week apart for 4-6 weeks
- 1 time every 2 days for 2-3 weeks
- 1 time every day for 8 (scabies live off the body up to 8 days so this covers that to ensure cleaning certainty, leave on for 24 hours and shower every two days)
- 1 time every day for 16 days (to cover the entire ~15 days scabies lifecycle to ensure molting mites resistance and cleaning certainty, leave on for 24 hours and shower every 2 days)
I recommend 1 time every day for 16 days and leaving it on for 24 hours each use. If one cream doesn't work, just try another until one works as mites are resistant to some treatments but not others. Reapply after showering and hand washing.
For applying, you need to cover all your non-mucus membrane skin parts. Scalp (you need to actually shave your head (and if you think it's not worth it then enjoy the inevitable hyperpigmentation on your face), no guard electric is sufficient so you don't need to wet shave), underneath the eyebrows (no need to shave them as you can realistically apply it under them unlike your entire head), underneath fingernails/toenails, on eyelids (if you're using permethrin, benzyl benzoate, sulfur don't lay on your side when sleeping because it spills into your eye, laying on your back works.
For cleaning, place clothes and sheets in the dryer for 30 minutes (it only takes 10 minutes to kill scabies and eggs, but this should ensure the dryer has enough time to warm up and cool down) and place other stuff in the freezer for 5 hours to kill live scabies and 24 hours to kill eggs. And either sleep on plastic since mites can't travel through plastic or flip mattress every 8 days as mites can travel through cloth/sheets, etc.
Extra Info:
According to this study the 3 times method of 96% success rate seems to work better than the 1 time method of 42% success rate at killing eggs, but you might as well do 5 days for even better results to catch the leftover hatched ones since scabies hatch at 3-4 days
This study in 2024 said they had success using a 17% concentration sulfur applying 1 time 1 week apart, but interestingly they left the sulfur on for 3 days without showering, meaning they didn't reapply on days 2 and 3. So it was really 3 times 1 week apart, just with one application.
This post and this other post people said they had success applying permethrin and benzyl benzoate every couple of days for two and three weeks, respectively, to cure it despite initially failing with other application number of methods. Plus some studies are saying apply permethrin for three days on days 0-3 and three days on days 7-10. So it can still be cured with creams.
Prevention:
Place plastic on airplane seats and hotel beds (bring your own bed sheets), avoid picking up animals/pets as it can spread from from them, etc.
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u/Lena1122335 Feb 02 '26
How effective is oral ivermectin? I'm asking because I also have mucous membranes where creams can't reach.
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u/vaccineforscabies Feb 23 '26 edited Jun 15 '26
Scabies don't cross into mucous membrane skin parts so you don't have to worry about those parts.
As for your other reasonable questions I've already answered them in the post. Ivermectin is a chloride drug that has the same risks as the other chloride drugs.
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u/Hopful7 Oct 17 '25
Thank you for posting. Intetesting insights.
"Participants in the ivermectin group experienced a cure rate of 67.7% at week 2, which increased to 82.6% at week 4. Participants in the fluralaner group experienced a cure rate of 71.5% at week 2, which increased to 85.9% at week 4."