Scabies is a common, contagious skin condition caused by tiny mites that burrow into the skin and trigger intense itching and a rash.1 No over-the-counter products are approved to treat scabies, but 5% permethrin cream is an FDA-approved prescription treatment that can be safely used at home.2
Key Takeaways
Scabies requires treatment of the entire body.
Permethrin 5% cream is FDA-approved with a prescription.
It is recommended for household members and close contacts to get treatment, even if they don’t show symptoms.
What is scabies?
Scabies is a contagious skin condition caused by microscopic mites that burrow into the upper layer of the skin, leading to intense itching and a red, bumpy rash. The itching is often worse at night, and small lines or burrows may appear between the fingers, around the wrists, elbows or waistline.3
Scabies spreads easily through prolonged skin-to-skin contact or by sharing bedding, towels or clothing with someone who is infested. Because the mites can live for a few days on fabrics, treating both the skin and environment is key to preventing reinfestation.4
Left untreated, scabies can cause ongoing discomfort or skin infections and can easily spread to others, which is why prompt treatment is important to stop the cycle and relieve symptoms.5
Why is permethrin cream prescribed for scabies treatment?
Permethrin 5% cream is a prescription-only, FDA-approved treatment for scabies. The cream works by killing both the mites and their eggs on the skin.6 Studies show it is both safe and effective for most patients.7,8
Permethrin is available in lower concentrations for head lice, but only the 5% cream is strong enough to treat scabies.9
How to Apply Permethrin Cream
To apply permethrin 5% cream:10,11
It is recommended you do not shower immediately before using the cream.
Spread a thin layer of the cream over your entire body from the neck down, not just where the rash is located.
Make sure to include the soles of your feet.
Pay close attention to skin folds, such as between fingers and toes, around the waistline and the buttocks.
For infants and individuals over 65, it's also important to apply the cream to the scalp, hairline, temples and forehead.
You may need to use the entire contents of the tube to adequately cover all necessary areas.
Leave the cream on your skin for a duration of eight to 14 hours.
Rinse off the cream by taking a bath or shower.
It’s normal to experience itching after treatment — this doesn’t necessarily mean the medication didn’t work. However, if live mites are still visible 14 days or more after application, a second round of treatment may be required.
When to Apply Permethrin Cream
Most people apply permethrin 5% cream at bedtime, then wash it off in the morning. This makes it easier to keep the cream on the skin for eight to 14 hours.12
Additional Tips for Using Permethrin Cream
There are a few ways to make permethrin cream treatment more comfortable and the overall treatment more effective:
If your skin becomes more irritated, you may use a gentle, fragrance-free moisturizer to sooth your skin post-treatment.13
Avoid scratching, which can worsen irritation or increase your risk of infection. If this is a struggle, ask your medical provider if an antihistamine or calamine lotion would reduce itching.14,15
Wash your bedding, towels and clothing, as mites can live on these surfaces for a few days.16
Avoid contact with other people and warn household members or close contacts that they may also need treatment.17
After Application
Once treatment is complete, you may continue to itch for two to four weeks, even if the permethrin 5% cream is successful. The itching is a reaction to mite debris and healing; it’s not necessarily a sign of treatment failure. Existing rashes may also remain for up to four weeks.18
If new burrows, rashes or live mites appear during this time, your healthcare provider may recommend a repeat treatment. Because scabies spread easily, cleaning your home environment and treating close contacts helps prevent the mites from returning.19
Possible Permethrin Side Effects
Some people may experience mild side effects on areas where the cream is applied, such as:20
Itching
Redness or rash
Temporary, mild burning or stinging
When to Seek Medical Advice
If you think you have scabies, seek medical advice as soon as possible to begin treatment and help prevent spreading it to others.21 After treatment, you should seek medical advice if:22
Your skin has not healed within four weeks.
You develop signs of an infection such as redness or sores with pus.
You notice any other side effects from the treatment.
How RedBox Rx Can Help
RedBox Rx makes receiving a permethrin 5% cream prescription for scabies easy and affordable.
Benefits of RedBox Rx include:
Transparent, flat rates for medication starting at $35 per treatment.
$39 consultation with a U.S. licensed medical professional.
No insurance required. HSA and FSA eligible.
No office wait times or scheduling issues that are typical with physical medical practices.
FREE shipping directly to you.
Get started with treatment for scabies by completing our short online assessment.
