The use of neem tree (Azadirachta indica) for treating scabies is primarily rooted in traditional medicine, especially in India and other parts of South Asia. Neem leaves, oil, and extracts have long been used in Ayurvedic and folk medicine for various skin ailments, including scabies. The rationale for this use is based on neem’s known antiparasitic, antimicrobial, and anti-inflammatory properties, which are believed to help soothe itching and reduce the mite population responsible for scabies.

Some small-scale scientific studies and in vitro experiments provide partial validation of these traditional claims. For example, research has shown that neem extracts can exhibit acaricidal (mite-killing) activity and may help reduce the symptoms of scabies in animal models and small human trials. However, these studies are often limited by small sample sizes, lack of rigorous controls, or methodological weaknesses. To date, large-scale, high-quality clinical trials in humans are lacking, and neem is not included in mainstream medical guidelines for scabies treatment.

In summary, while there is a solid traditional foundation and some preliminary scientific support for neem’s use against scabies, the evidence is not robust enough for neem to be considered a first-line or stand-alone treatment in modern clinical practice. It may, however, serve as a complementary or alternative remedy in settings where conventional treatments are unavailable or unaffordable.