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What Are the Pros and Cons of Using Permethrin for Scabies?

Mary McMahon
Updated Mar 03, 2024
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Permethrin for scabies can be a highly effective treatment with a low risk of side effects, but there are some concerns patients should consider. This medication is gentle enough to be used on pregnant and breastfeeding women, but overuse of permethrin can create skin irritation, so it is only suitable for one use. If a scabies infestation is persistent, it may be necessary to explore other options to treat the parasitic infection. Patients also need to follow directions carefully when they use permethrin for treating scabies.

This medication comes in the form of a skin cream that must be massaged thoroughly into the whole body and left on for eight to 14 hours. Many patients put it on before they go to bed to allow it to soak in overnight, and it can help to wear pajamas, gloves, and socks to avoid smears. Patients will need to wash with mild soap to remove the medication and must also wash all bedding, clothing, cushions, and other soft objects around the house in hot water to eliminate the scabies. Rugs and upholstery should also be carefully cleaned.

The benefit of permethrin for scabies is that the cream is usually very gentle and can be used on almost all patients. Even young children with sensitive skin can usually use the medication safely. Other scabies medications are harsher and may cause side effects like rashes and skin irritation. When a doctor wants to prescribe an effective treatment, this is often the first choice for patients with scabies.

Some patients experience permethrin allergies. These people shouldn't use permethrin for treating scabies because they can develop hives and burning, itching skin irritation. This medication is also extremely toxic for cats and should not be used in an environment where cats might have access to it. Furthermore, multiple uses of the drug can cause skin irritation. Patients should treat permethrin for scabies as a single-use medication for their safety.

It is important to be aware that patients may notice some itching and skin irritation after using permethrin for scabies. This does not mean they are reacting to the medication or that the medication didn't work. As the scabies die off and the body recovers, the generation of new cells will create an itching, uncomfortable feeling. Patients may find it helpful to take oatmeal baths or soak in baking soda to reduce the itching and soften their skin. This will allow dead skin to exfoliate and can get rid of the itching.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Mary McMahon
By Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a The Health Board researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Discussion Comments
By anon944551 — On Apr 08, 2014

I’ve had scabies, and I’m still scared in case I still have them, but I'm waiting because what’s the worst that can happen? They’re harmless, but I must admit, they’re creepy little things, but no need to panic. I’ve given up making a fuss and scrubbing, etc. Just try what your doctor gave you. Suck it up and keep telling yourself it’s all in your head.

If you still have stuff after two weeks try another. It’s not easy. Believe me, I’ve cried over this. Nothing works apart from stuff that’s available from doctor or over the counter.

I’ve tried clove oil, but it just stinks and stings! I’ve tried bleach baths, which just sting and smell strong, I’ve tried lots different soaps, etc., but I gave up.

Just stick to legal and tested stuff and do it one at time. That’s what I’m doing. Boil and wash everything and tumble dry it, but bag all clothes, curtains, blankets, etc in trash bags and tie them. Check for holes, etc., and do it bag by bag, slowly. Try to live a normal life because it’s not easy. I’m keeping my son out of nursery until I know for sure they are gone!

By anon334720 — On May 15, 2013

I used permethrin five days in a row and still I feel the mites jumping on my face now and then, especially in the early evening (I have demodex mites). I have never really felt itchy but just feel them crawling and pinging (maybe jumping or coming out of their burrows?). Surely I can't still be imagining that?

I would just be glad to be rid of these things as I have tried so many remedies (this being the most effective so far) and don't know what to do next. I would be grateful for any ideas.

By anon327939 — On Apr 01, 2013

@literally45: You didn't pay enough attention to your doctor, then. Permethrin likely killed your scabies, however they are still in your skin and need to be purged by the body, along with all of their feces they left behind. The corpses of the scabies and their waste products will still cause an itching sensation for up to two weeks. You should, however, should be feeling relief from the crawling sensation they were generating.

By bluedolphin — On Jan 07, 2013

@literally45- Some mites develop immunity to permethrin causing the cream to be ineffective.

By ysmina — On Jan 07, 2013

@literally45-- Actually, permethrin cream might have worked for you. You need to give it more time to be sure. It's normal to have itching and even some new spots appear for a while after using the cream. With me, I think I continued to itch for another two weeks, although the permethrin had treated my scabies. So it's too soon to decide whether it has worked or not.

I have heard of people using permethrin more than once but I think they do that on their own, without the approval of their doctor. You can do it, but at your own risk. You might end up irritating your skin with it.

I think it's better to use permethrin once but keep it on as long as possible before washing it off. It will just give the medicine more time to kill the mites. This might also irritate skin though, so again, do it at your own risk.

Overall, my view is that permethrin is a really effective treatment and much safer than some of the alternatives, even some natural treatments.

By literally45 — On Jan 06, 2013

I was prescribed permethrin by my doctor and used it several days ago. I applied it before going to bed and took a shower in the morning. Things seemed better for about half a day and then I started itching again. The next day, there were new scabies bumps on my skin.

Clearly, the permethrin didn't work but I have no idea why. My doctor said it's very effective. I kind of want to use it again but I know I'm not supposed to. I wonder if I didn't keep it on long enough the first time I used it.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a...

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