Why is permethrin used in scabies treatment?

Scabies is caused by mites that burrow into the outer layer of skin. Permethrin cream acts on the mites and is used as a whole-body treatment according to the instructions supplied for the person’s age and circumstances. It does not instantly remove the itch: itching can continue for a while after the mites have been treated because the skin is still reacting. New burrows or a fresh rash can suggest ongoing infestation, reinfection, or incorrect application, so the pattern matters. Close contacts may need assessment and treatment at the same time.

Apply permethrin exactly as directed, covering the specified skin areas and leaving it on for the stated time before washing it off. Ask a clinician about the correct approach for young children, pregnancy, breastfeeding, or inflamed skin. Wash clothing, towels, and bedding as advised, and avoid sharing them. Treating only the areas that itch can leave mites elsewhere on the body. Do not repeatedly reapply because itching alone has continued; obtain advice first. Read more about [Permethrin](/materials/permethrin/) and [Scabies Treatment](/treatments/medical-dermatology/scabies-treatment/).

Seek medical advice if symptoms are worsening, new burrows appear after treatment, or household contacts develop itching. Prompt review is needed for pus, increasing warmth, spreading redness, fever, or painful crusting, which can indicate a secondary skin infection. Urgent care is appropriate for facial swelling, breathing difficulty, or a severe widespread reaction after applying the cream.

Ask which body areas to cover, whether everyone in the household needs treatment, when clothing and bedding should be handled, and what to do if itching continues. Confirm when a repeat application is appropriate and how to recognise treatment failure.