Scabies
Commonly treated with Permethrin 5% Cream & Ivermectin
Scabies is an intensely itchy skin condition caused by tiny mites that burrow into the top layer of the skin. It spreads easily through close skin-to-skin contact and does not go away on its own without treatment. After a licensed provider reviews your health information, prescription scabies treatment can be prescribed online and shipped from our U.S. pharmacy.
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How It Works
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- Licensed providers review & prescribe
- Our licensed U.S. pharmacists fill your prescription
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Order Scabies Treatment Online
Medically reviewed by David Paul Mackarey, RPh, Pharmacist-in-Charge — Last updated July 15, 2026
Choosing and Using Your Treatment
| Treatment | Choose this if… | How to Take |
|---|---|---|
| Permethrin 5% Cream | First-line topical treatment for most adults with classic scabies. Often combined with oral ivermectin for severe, widespread, or hard-to-clear infestations. | Apply cream from head to toe for 8-14 hours then rinse off re-apply in 1 week if needed. |
| Ivermectin 1.5% Cream | you've had skin irritation with permethrin, didn't fully clear with it, or prefer an ivermectin-based topical. It's prepared by a licensed compounding pharmacy and offers a different active ingredient in the same easy cream format. | Apply to affected areas and leave on for 4-8 hours, reapply as needed. |
| Ivermectin 12mg | Oral option for those who cannot use or did not respond to topical treatment. Often combined with permethrin 5% cream for severe or crusted scabies. | Take 1 capsule by mouth daily |
About Scabies (Sarcoptes scabiei infestation (mite infestation))
Scabies is caused by the human itch mite, Sarcoptes scabiei, a microscopic parasite that burrows just under the surface of the skin to live and lay eggs. The body's allergic reaction to the mites, their eggs, and their waste causes severe itching that is often worse at night. A pimple-like rash and thin, wavy burrow lines commonly appear between the fingers, on the wrists, elbows, armpits, waist, and genital area. Scabies affects people of all ages and backgrounds and is not a sign of poor hygiene. It spreads mainly through prolonged skin-to-skin contact, which is why outbreaks are common in households, nursing homes, and other crowded settings. Prescription medicines called scabicides kill the mites and eggs, and everyone in close contact usually needs treatment at the same time to prevent reinfestation.
Signs & symptoms
- Intense itching, often worse at night
- Pimple-like rash or small red bumps
- Thin, wavy, raised burrow lines on the skin
- Rash between the fingers, on wrists, elbows, waist, or genitals
- Sores from scratching that can become infected
- Thick, crusted patches of skin in severe (crusted) scabies
- Itching that continues for weeks even after successful treatment
Causes & risk factors
- Infestation with the human itch mite (Sarcoptes scabiei)
- Prolonged skin-to-skin contact with an infested person
- Sexual contact with someone who has scabies
- Living in the same household as someone with scabies
- Crowded settings such as nursing homes, prisons, or childcare centers
- Less commonly, sharing bedding, clothing, or towels used by an infested person
Prevention
- Avoid skin-to-skin contact with anyone known to have scabies
- Treat all household members and close contacts at the same time
- Wash bedding, clothing, and towels in hot water and dry on high heat
- Seal items that cannot be washed in a plastic bag for at least 72 hours
- Vacuum furniture, carpets, and car seats after treatment
- Avoid sharing clothing, towels, or bedding with an infested person
- Complete the full prescribed treatment, including any repeat dose
When to see a doctor
Online treatment is a good fit for otherwise healthy adults with typical scabies symptoms — intense nighttime itching and a characteristic rash — especially after a known exposure. See a provider in person if the diagnosis is uncertain, if symptoms have not improved two to four weeks after completing treatment, or for infants, young children, pregnant women, and people with weakened immune systems, who need individualized care. Seek prompt medical attention for signs of a skin infection from scratching, such as spreading redness, warmth, swelling, pus, or fever, and for thick crusted patches of skin, which can indicate crusted (Norwegian) scabies — a severe, highly contagious form that requires closely supervised treatment.
How Scabies Treatment Works
Prescription scabicides kill the mites and, in most cases, their eggs. Because eggs can hatch after the first application or dose, standard treatment includes a repeat treatment about one week later. Itching may continue for several weeks after the mites are gone — this is a normal skin reaction, not necessarily treatment failure.
| Option | How it's used | Typically suits |
|---|---|---|
| Permethrin 5% cream | Applied to the whole body from the neck down, washed off after 8–14 hours, repeated in 7 days | Most adults with classic scabies; first-line therapy |
| Oral ivermectin | Taken by mouth as a single dose, repeated in about 7 days | People who cannot use topical creams, widespread infestations, or outbreak settings |
Steps to Prevent Reinfestation
- Treat all household members and close contacts at the same time, even without symptoms.
- Wash bedding, clothing, and towels used in the 3 days before treatment in hot water and dry on high heat.
- Seal non-washable items in a plastic bag for at least 72 hours; mites cannot survive long away from human skin.
- Complete the full course, including the repeat treatment, exactly as prescribed.
Sources & References
Frequently Asked Questions
How do you get scabies?
Scabies spreads mainly through prolonged, direct skin-to-skin contact with a person who has the mites, including sexual contact. It can occasionally spread through shared bedding, clothing, or towels, though this is less common. Quick contact like a handshake rarely spreads it.
What does a scabies rash look like?
The rash usually looks like small, pimple-like red bumps, sometimes with thin, wavy, raised lines called burrows. It most often appears between the fingers, on the wrists, elbows, armpits, waist, buttocks, and genital area. Scratching can cause sores and scabs on top of the rash.
Can scabies go away on its own?
No. Scabies does not resolve without treatment because the mites continue to reproduce on the skin. Prescription scabicide medication is needed to kill the mites and their eggs, and close contacts usually need to be treated at the same time.
How long does itching last after scabies treatment?
Itching can continue for two to four weeks after successful treatment as the skin reacts to dead mites and their remains. This is normal and does not necessarily mean the treatment failed. If itching persists beyond four weeks or new burrows or bumps appear, contact a healthcare provider.
Does everyone in my household need treatment?
Yes, in most cases. Household members and recent close or sexual contacts should be treated at the same time, even if they have no symptoms, because symptoms can take four to eight weeks to appear after infestation. Treating everyone at once helps prevent the mites from passing back and forth.
How soon after treatment am I no longer contagious?
People are generally considered no longer contagious about 24 hours after starting effective treatment. Bedding, clothing, and towels used in the days before treatment should still be washed in hot water and dried on high heat to prevent reinfestation.
Is scabies caused by poor hygiene?
No. Scabies affects people of all ages, backgrounds, and levels of cleanliness. Washing or bathing does not remove the mites once they have burrowed into the skin, which is why prescription treatment is necessary.
Treatments for Scabies
Find out more information about each treatment.