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Scabies is caused by tiny mites which cause intense itching. The itching is actually not from them biting the infected person, but instead simply results from skin reacting allergically to the presence of the mite. They’re so small that you can’t see them with the naked eye. It’s spread by either having close contact with an infected person, or by indirect contact such as sharing clothing or towels. Most people don’t realize they have scabies until a few weeks after they’ve been infected. As a general rule, those living in the same household of an infected person should be treated to avoid ‘back and forth’ spread among household members. 

Scabies generally does not go away without treatment with one of the following medications:


Ivermectin is a pill used to treat scabies. The total dosage required will vary depending on body weight. Ivermectin is generally prescribed in two ‘rounds’. For example, a prescription may consist of a total of 12 pills ­ with six pills to be taken at the same time on day one (‘first round’) and the other six to be taken at the same time one week later (‘second round’).


Permethrin is a prescription cream used to treat scabies. Because the mite does not affect the face and scalp, it just needs to be applied from the neck down once at bedtime. It is then washed off the next morning. 

Patients are usually asked to undergo two ‘rounds’ of treatment. It should be applied as directed on the first evening (‘first round’) and washed off the next morning. This treatment should then be repeated once again 7 days later (‘second round’).

When using Permethrin, it’s important to apply it to all areas from the neck down – including beneath the fingernails, within the skin folds, and within/around the belly button.

What do I need know about cleaning?

It’s important to know that the scabies mites can only live off of the body for a maximum of ­3 days. Therefore, you only need to avoid direct exposure to clothing and linens that you’ve both directly contacted in the past few days and will again directly contact within the next few days. For most patients, this typically consists of bedsheets and towels which should be cleansed with hot water in the washing machine. Thereafter, they should be dried for at least 20 minutes in the hot cycle of a dryer. The best time to wash clothing and linens is the morning after a given round of treatment.

Otherwise, excessive use of bleach or other harsh chemicals to sanitize your clothing is unnecessary.

It also isn’t necessary to ‘steam clean’ furniture and carpet. For these items, simply avoid direct contact with potentially infected items for at least 2­3 days after you’ve been treated. For example, a clean blanket can be laid over a chair or sofa and allowed to remain in place for 3 days.

Remember that your skin may continue to itch for 2­3 weeks even after the scabies mites are gone. If needed, medication can be prescribed specifically to help the itching. Finally, you can return to work or school as soon as the morning after the first round of treatment.

Scabies is caused by tiny mites which cause intense itching. You can often time see the mite with a dermatoscope as a small triangular shape at the end of a burrow in the skin.

“Scrapings from the burrow will demonstrate the mite, eggs, as well as mite feces that were part of the burrow”

Dermoscopy can be used to confirm that the infection has been cleared and the patient is no longer contagious
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