Scabies medication: what works and how to use it

Scabies is caused by tiny mites that burrow into the skin and cause intense itching. The good news: there are simple, effective treatments. This page explains the main medicines, how to use them, and what to do at home so you don’t get reinfested.

Main medicines and how they work

Permethrin 5% cream is the most common first-line treatment. You spread it over your whole body from the neck down, leave it on for about 8–14 hours (often overnight), then wash it off. Most guidelines recommend repeating the application once after 7 days to catch any newly hatched mites.

Ivermectin is an oral pill used when creams aren’t practical or for outbreaks and crusted (severe) scabies. Typical dosing is about 200 mcg/kg as a single dose, often repeated after 1–2 weeks. Ivermectin usually requires a prescription and is not advised in pregnancy or in very small children—check with your doctor.

For infants, pregnant people, or others who can’t use permethrin or ivermectin, topical sulfur ointment (often 5–10%) is a safer alternative in many cases. Some countries also use benzyl benzoate or malathion; these can irritate sensitive skin, so follow a clinician’s advice.

How to treat contacts and your home

Treat everyone in the household at the same time, even if they have no symptoms. Scabies spreads easily through close contact and shared bedding. Washing bedding, clothes, and towels in hot water (60°C) and drying on high heat kills mites. Items that can’t be washed can be sealed in plastic bags for at least 72 hours—mites usually die off without human skin exposure.

Itching can keep going for a few weeks after successful treatment. That’s called post-scabetic itch and it’s not always a sign of treatment failure. You can use short-term topical corticosteroids or oral antihistamines to ease itching, but talk with your provider if new burrows or fresh rash appears.

Follow-up matters: if symptoms don’t improve after two weeks, or if you have many crusted lesions, see a doctor. Crusted scabies needs more aggressive therapy and sometimes specialist care. Always get a proper diagnosis before starting treatment—rash and itch can come from other causes.

Want to buy medication online? Use only licensed pharmacies and get a prescription when required. If you have questions about a specific medicine or how to use it safely with other drugs, ask a clinician—especially for pregnancy, nursing, or young children.

When you treat properly and handle bedding and contacts at the same time, you stand a very good chance of clearing scabies and stopping it from coming back.