Permethrin cream is one of the most effective treatments at killing scabies. In the post below I will be detailing how to use Permethrin cream properly. If you want to know where and how you can get Permethrin Cream for your scabies treatment, you can read my guide by clicking here.
If you browse through the internet, you’re going to find a lot of people saying Permethrin doesn’t work.
After talking with my doctor, dermatologist and even using Permethrin myself a few times, I figured out why it doesn’t work for a lot of people: Because most people don’t know how to use Permethrin cream properly.
The first time I used Permethrin it was effective and my scabies itch went away…for a few days. Then it came back. I went back to the doctor and showed him and he gave me a second tube of Permethrin cream, only this time I did my own research. I found out that my doctor had actually given me the wrong directions.
So the second time around, I did as much research as possible and applied it again properly (I’ll talk about this below). It worked. And I can’t be 1,000% sure that it was only the Permethrin that killed my scabies, as I combined it with several other treatments, but what I do know is that this collection of treatments cured me, and I believe Permethrin did 80% of the work.
(If you’re interested in the additional treatments I used, you can read the full guide here).
How to use Permethrin cream correctly:
1. Start from the chin
You are not supposed to use Permethrin on your scalp or your face. Remember – Permethrin is an insecticide poison and is not actually good for you! So be careful when using it. The correct method is to apply it from the chin down only. The exception is the ears – make sure you cover on and behind the ears.
2. Get it everywhere!
You need to apply it everywhere on your body, because scabies mites can live anywhere!
Some common places people miss are:
- Under the armpits.
- In the bellybutton.
- Between the butt cheeks (yes, they can live there too).
- The soles of the feet.
- The groin area and genitals.
- In between the fingers and toes (favourite hiding spot for scabies. Hit these areas hard!)
3. Make sure you get it under the nails (very important!)
Why is it so important to get the cream under your fingernails? Because this is one of the most common places scabies are found.
Scabies causes you to scratch wherever scabies are burrowing. Naturally, mites get caught under your fingernails and that’s how they spread easily to other parts of the body. In your sleep it’s probably quite common to scratch yourself with your toenails too.
Therefore, make sure you get Permethrin under your nails. The easiest way to do this is to put some Permethrin cream in your palm and then scratch your palm lightly so it gets deep under the nail. Do this for both hands and both feet. Super important!
4. Don’t forget your back
A lot of people miss the back as it’s quite hard to apply the cream there, but scabies is very common on the back so it’s important to cover it fully. It helps to have someone rub on your back for you so you don’t miss any spots (make sure they use a glove so the scabies don’t spread to them).
5. Leave the cream on for 8-12 hours
The cream needs at least 8 hours to work. The best plan is to apply it before you go to bed, throw on some cottons and then wash it off in the shower the following morning.
Some people leave it on for 24 hours thinking it will be more effective, but this is not true. What will happen if you leave permethrin cream on too long? Well, because permethrin is an insecticide, and toxic, it will actually damage your skin and slow the healing process. Don’t leave permethrin cream on for too long, definitely not more than 12 hours. The scabies will be dead long before then.
6. DON’T WASH YOUR HANDS!
This is a really common mistake and probably the main reason Permethrin treatment doesn’t work for many people.
If you wash your hands after applying the cream, you’ll be washing all the treatment out from your fingernails and between your fingers. Obviously this means the treatment will not work! This is something doctors don’t seem to explain too well when telling patients how to use Permethrin cream properly.
If you do accidentally wash your hands (it happens), make sure you apply the cream on your hands again thoroughly. Once the cream is on, you shouldn’t be washing your hands for at least 8 hours.
7. Do a second application after 7 days
While some doctors will tell you to only apply Permethrin once, it is much more effective to apply it twice or more. This was one new thing I found out when researching online about how to use Permethrin cream.
The second application should be done 7 days after the first. This allows for any new mites to hatch, as scabies are much harder to kill when still in their protective eggs.
Some people actually prefer to do it sooner, even every day, so a common question is whether it is bad to use permetherin two days in a row. The answer is yes.
Again, remember permethrin is a poison. In fact, if you ingest a large amount of it, it can be lethal. When we apply permethrin to our skin, what we are doing is applying just enough poison to our skin that it will kill little scabies mites, but won’t kill us. Of course, that doesn’t mean it is not damaging to the skin. Applying anything toxic to the skin is bad for us. Therefore it’s best to wait at least 5-7 days before the second application, and in the meantime, support your skin with a good moisturizer and things like aloe vera. I used this aloe vera gel daily and still do today. Your skin is an important organ, make sure your protect it!
After your second application of permethrin, all scabies mites on your skin should now be dead. Congratulations!
While permethrin treatment is sufficient for most people, some people still seem to fail to eliminate scabies with permethrin alone. This is why I recommend using a combination of treatments in conjunction with Permertherin to maximize your chances of curing scabies.
I spent many hours reading studies while I had scabies to determine what the optimal treatment would be. After trialing lots of different things, I finally came up with a treatment plan that was both safe and effective, and based on actual science and proven research. I’ve written up the entire treatment plan in my article How To Get Rid Of Scabies: The Ultimate Guide, which details each treatment, the studies behind it, and how to use it. If you are suffering from scabies, I really believe it will help you and encourage you to check it out. You can click here to go there now.
Wishing you back to good health soon!
Remember, if you cannot get permethrin cream from your doctor, you can make it very affordably with standard permethrin from Amazon. This is a great option if you need to treat your whole family. I have a full guide on how to buy and mix your own permethrin here.
Thanks a million.
It really worked.
What’s the best way to clean the oil up with in the bathtub and sink.
No secret really, just hot water and and a good scrub.
I use Dawn dish soap to clean up the oil in the bathtub and sink.
BillieAnn K Isomura says
I use a sponge soft sandpaper already in the outside of a sponge and I am able to get all the oils in the out landing of the bathtub and squeeze the sponge with soap and water so all excises comes out of the sandpaper sponge and ready for use the next time.
Thanks for taking the time to do this, Jon.
Cindy K Westlake says
I only left the cream on for 6 and a half outs yesterday. Should i redo it today??
Should be fine. Do it again in 5-7 days.
I’m still itching 4 days after treatment. Not as bad though, but still itchy. I had them on my scalp too. I know it says it’s rare to have them there, but my body finds a way to go big or go home. I’m going to reapply the cream on the 7th day after treatment. But the itching, will it ever stop?!
Keep treating, it will heal!
My doctor wants me to apply the cream to my scalp… I guess I should do it if the doc says so?
Tasha DeRuiter says
I got over zealous and applied the permethrin cream and then hours later applied the homemade lotion, do you know if it will affect the effectiveness of the permethrin?
No idea. But in my opinion it would be best not to do that – apply them on separate days.
Thank u for ur insight and tips. We had an exposure so I treated everyone in the house and steamed cleaned the furniture and clothes. yesterday was the second round of permethrin we washed today. I cleaned the house again but found my oldest child infested in the scrotum area, he didn’t put cream there…… So I smothered his scrotum and thighs but should I put it all over him again for a second day in a row? Also does the permethrin kill on contact or will our home be infested? … I have no more money to clean, or even buy milk after the the last week…. Please advise me on how to fix this, any advise is appreciated . As of right now I have him sitting on a chair and manage a dirty look of two while walking by… (It was his friend who exposed us)…My daughter layed where he sat should I have reapplied cream to her? Thank u
Yes it’s important to apply absolutely everywhere. It would be safest to reapply everywhere, but really it’s up to you. As long as the second application is perfect you may be okay.
Unsolicited Advice says
Reading the phrase “I smothered his scrotum and thighs” made me so uncomfortable, I can’t imagine how he felt.
If the kid’s old enough to be self- conscious about his genitals, maybe let him apply the cream himself
Bruh, once you have kids, you learn to call the anatomical parts by their correct name – and never even flinch. That’s just what grown ups do.
Shall I apply on my scalp. The doctor told me to use Bendatine shampoo! I used it because I feel some itching in my scalp..
Not sure what betadine will do for scabies, I’ve never seen it mentioned anywhere.
Lynn Garcia says
Is it turn you can’t see scabies I see black pepper specks especially after I sprayed some oxy clean on sheets where I had blood then u could see them or am I dealing with scabies and something else
Scabies are too small to see without a microscope. If you can see them it’s something else.
Actually with the s21 ultra which magnifies up to 100x, you can see them. They are like the tiniest little white things, slightly oblong, skinny, and when poisoned, they will do what looks like sit-ups over and over. About have the size of a needle head. Reddit has a video of a guy showing one, so I bought an s21 ultra and found one right after applying scalex for birds last night. (Scalex btw actually works for hamsters if done right, but for me it just gave me diarrhea, so I went with the permethrin in vergetable glycerine after washing it off).
Wrong. I use hobbie glasses. 5x. Mag. I can see them come up out of hole. That’s where you get the Morse code looking dots. By the entrance exit marks. You can tell how big one is by the straight cut (with a round dot beside it) they only make hole big enough for them! They start small. !
Marie Sharon Black says
So what is the black pepper specks? I see them on my body too!
Probably the scabbies. They start small. Kinda round. But more oval. With nasty little diggers! I stir them up by popping my skin and they ll come to their hole. Watch the hair on your arms. And if one’s in there you can see the hair moveing as they go along!
Lori Carlson says
Thx for taking the time to create this helpful very guide . We really appreciate it !
I have some questions .
We both washed our hands after the 1st application of permethrin . Our Dr . wasn’t very explicit . Should we do our hands again now instead of waiting until the 5-7 days
Also , I know I have them on my scalp . Which mixture of natural remedies can I put on my scalp ? Also they feel like they’re on my face . My face has been itching .
Any info on these questions would be appreciated .
Yes do your hands again! If you follow my full guide there’s a mixture you can use on your scalp.
We have crusted scabies. Apparently, have had them for 2 years. They are on the walls, in the freezer, everywhere! Pesticide sprays don’t work. Neither does alcohol. We have huge areas on our bodies that are covered in dead, crusted skin and underneath are so many mites that can only be seen with a macro lens. Dermatologists have patted us on our heads, labeled us as delusional & only prescribed antidepressants. It took an ER P.A. to properly diagnose us but cannot fully treat our infestation. Any suggestions?
Moxidectin it works better than ivermectin and lasts for 3 months
I have been searching everywhere for further info on moxidectin and am coming up with nothing. It was actually the only thing available in the invermectin arena at ANY of my local farm shops. Could you please tell me if you follow the same qty/dosing type schedules for the mox as you do the invermectin? I need to dose myself as well as my critters. What I have says 2% equine oral gel. Anything wisdom you have on it at all would be wonderful! Thank you and thank you, Jon… so much!
Good day sir,
Please how many times can I apply the permethrin cream before am finally cured?.
Thad I’ve been having this problem for years and thought i becoming delusional thanks so much for this article explaining in detail and most of the article I’ve dealt with where can I purchase the cream and more detailed information. Thank you
Cynthia M miccolis says
Hi Jon, I am worried about my 2 cats, one sleeps in the bed with me, but they are inside cats. Will they get scabies, too, and how can I keep from getting scabies. I will have a hard time, with it. Vets services will be needed?
I’ve never treated a pet unfortunately but yes the treatment is similar apparently. I have a post here: https://www.scabieshomeremedies.com/treat-scabies-dogs-animals/
John Smith says
My spouse and I have treated three times with premethrin two weeks apart from each dose. We wash clothes and bedding after each use and have sprayed couch cushions with Neem oil, as well as bagging the cushions in big plastic trash bags and storing in basement for a week now. I have steam cleaned the couch 3 x along with vacuuming and steaming the carpets and kitchen floors. Monday was the third dose. We seem to have eruptions of little read dot/spots not most are not itchy and they come and go and seems to be in different area at any given time. We have both experience a bite feeling that feels like misquote or flea and it will welp up then go away.
The question is, how can we know if it a reaction to medication / normal process of riding the dead mites and debris or still have active infestation. This is driving me mad and I am paranoid to be around people or touch anything. Please advise….
Unfortunately no easy way, just need to wait and see. If you’ve treated properly with perm and ivm then chances are very good they’re dead and you’re experiencing the post scabies symptoms.
John – what happened in the end – did you get rid of em?
Jon sir –
Your work here is Stellar.
I live in my car.
Nonetheless – I have also done tons of research as you described.
In “maintenance mode” ONLY- I have placed ALL my clothes on a 9 day rotation – bagged everything necessary (shorts, white Ts, regul Ts) in separate & individual bags #1-9. Also my towels, and a “top sheet” as well – each bagged 1-9.
Again, this is ONLY maintenance.
My initial research taught me they (S-mites) only live 3 or 4 days without human skin contact.
Ok – I am studying your articles (this one, and the Guide as well).
My goal is… if I can get 100% OUT of my car for at least 7 days – this will be great.
YHWH God will provide – & JC.
The mites will die in 3 or 4 days.
Your “Guide” is Also extremely helpful.
I’ve got to sort-of mastermind how I’m going to do all this – in which order, etc etc.
Ugh – The Whole Thing is just debilitating.
I figured out a short while back, based on research – S-mites don’t like Heat!!
So – daily now, I go to the gym, and stand under the scalding hot water. This “rattles” them up – they don’t like-it.
And it itches. I wait until I feel the sting of the heat rather than the itch.
This seems to maintain things specific the the mites.
But certainly, I want to get out of maintenance mode, and get into Kill and Irradicate mode.
I got Scabies from a rescued cat. I have treated myself twice cleaned everything three times. The cream permethrin has not worked for me, going back to the doctor tomorrow He says that there is nothing to give me in an oral form. The cream has not killed them. They just act like they don’t like it. It seems that they have become immune. I am fasting and supporting my immune system. Is it possible that they are becoming immune to the permethrin cream?
GOSH it is so good to be with people who are suffering this same infestation, and I will be reading your full treatment guide. However no one seems to “see” these (bastards, as you so well put, which is why I began reading the whole article and comments) I too have noticed that at night mostly after applying a sulfur ointment, (only because I’d not properly applied the permethrin) that the top of my feet felt like little bits of sand, and when i looked at several w/ a magnifying glass they were sort of clear/whitish but one side is tan/light brown on some. Perhaps these are dyeing escapees or I have read somewhere that the adults come “out” … for some reason I can’t recall. Will read & apply your full treatment guide. Thank you for sharing all this, it is a comfort to know I am not alone.
I just applied the cream last night you mentioned, from the gum clinic.. I been suffering with the intense itching for 4/6 weeks.. My recent xbf partner led me to believe the rash was monkeypox, and told me to just self isolate, the idiot, me the bigger idiot, for listening to him.. I came online to see when do I apply the 2nd cream next.. But you answered that.. 5/7 days.. So should the house be steam cleaned? I have steam washed boiled 50 degrees plus my clothes bedding etc.. I was concerned about reinfecting myself.. Like my car.. Should I clean the seats and how..
Whatever you do guys don’t wait around if your itching like I did for over a month ( get cream..)
Crazy, especially in the nights, the itching was super intense..
What am I to do if my granddaughter has scabies and her mother is not getting rid of them? They have “treated” over and over. I’ve gotten it twice now. We are active in church and the ministries in the church, including nursery. How long should we be away from people to know we are not spreading it and how do we see my granddaughter with out getting it? Also, I know it’s unusual for it to be on the face, but I think I have had some on my face this last time and I put the cream on my face. So far I’m ok. Hopefully this is the last time.
See a dermatologist if repeated treatments aren’t working. Might not be scabies.
David H says
If U have an iPhone turn on the camera. Go to video on 3d power. I put my hand under the camera & I can see the black scabies.
I am on day 3 after my 3 permethrin 5% treatment.
Has anyone used 10% straight?!!
This is so horrible. I took a scrub brush to clean them off. I went back with the camera & they are still there.
Parts of my skin is thinning out & becoming an abrasion. I see them in the abrasion. I don’t know what to do!
Danielle Clarneaux says
What a great website, just what I was looking for. I’m 73 years old, live alone, hearing impaired so not around many people to catch these buggers. But bugs they are, I just don’t know what. My doc hasn’t checked me out, but I have a feeling these bugs aren’t mites. I have no rash, the bites are tiny, and I can feel the little suckers crawling down my body to get a tasty snack. I feel them on my hairline. in my pubis and other places. They’re in my feces, probably because that’s where some of them live.
They are large enough to be visible but still very tiny, I just bought a magnifying glass to see what I can figure out.
I don’t even itch that much, but just knowing they’re there is driving me nuts.
I wish I could identify so I’d know how to treat. My doc gave me Invermectrin to use but I haven’t had the courage to apply since I’m alone and almost deaf. The itching would drive me nuts, but need to choose either these bugs or the cream.
Thank you for this page, it’s been incredibly educational!
john b says
I’ve been struggling w low amount scabies off and on for a few years, but lost control over the battle a few months ago and went to emergency room- was given permethrin cream and later an on line dr. later gave me prescription for ivermectin. worked at first to some degree. will need another cycle. Over the years, I found some tricks that really work. To kill a red bump or mound/ series of mounds, use strong oregano oil. Will kill quickly, but will burn if you use more than a dab. and will cause a rash if overused on areas like the neck (which I’ve done several times). Another great trick is newskin. That works really quickly. I guess they don’t do well if the mites don’t have access to air and natural oils/ or maybe it makes harder for the mites to break down the skin?
some cool products like an enzyme spray that dissolves their exoskeleton is made by https://www.scabies-killer.com/