If your doctor has diagnosed your red, itchy rash as a scabies infestation, what happens next? For starters, you (plus all household members and any sexual partners) will need to use a medicated cream or lotion to destroy the skin mites causing the infection. But you’ll also need to do some cleaning—specifically laundry and other fabrics—because the scabies mite can live for up to three days in clothing, bedding and even carpeting. Here’s how to rid your household of scabies for good. Scabies Treatment Step One: Medicated Creams A microscopic mite called Sarcoptes scabei causes scabies. The mite burrows into the upper layer of human skin to feed and reproduce, which causes an itchy, red rash to develop. Scabies spreads by skin-to-skin contact, so people who live in close quarters, such as students in dormitories or patients in nursing homes, face a higher risk of becoming infested. Many adults spread scabies through sexual contact, so you should notify your partner(s) if you receive a scabies diagnosis. If you get scabies, you’ll have to use a prescription cream or lotion to destroy the mites under your skin. In fact, most doctors recommend treating everyone in the household (and your sexual partners), even if they don’t show signs of a scabies infestation. A person with scabies can spread the mite before they develop symptoms, so it’s best to treat everyone in the home to avoid possible reinfestation later. The most common treatment for scabies is 5% permethrin cream, though your doctor has many options available and will choose the best treatment for your particular case. Pregnant women and infants as young as 2 months old can safely use permethrin cream for scabies. Wearing clothing treated with permethrin spray (a mosquito and tick repellent) is ineffective in treating a scabies infestation. Always follow your doctor’s instructions and the prescribing materials when using scabies medicine. In general, for best results when using permethrin cream: Shower or bathe and dry off thoroughly before applying the cream. Apply the medication in the evening, before bedtime, since it must remain on the skin for eight to 14 hours. For older children and adults, apply a thin layer of cream to all skin surfaces from the neck to the soles of the feet. For scabies in babies under age 2 and adults older than 65, also apply the cream to the scalp or hairline, forehead and temples, being careful not to get any of the cream in the eye. Never apply permethrin cream to the face, eyelids, or around the mouth area. After eight to 14 hours, bathe or shower to remove the cream from your skin. If instructed, repeat this process again in one week. The itching may increase in the hours or days following scabies treatment with permethrin cream. Your doctor may give you prescriptions for other medications to ease the itching or calm the rash. If you are still itching two weeks after treatment, contact your doctor. Scabies Treatment Step Two: Laundry No home remedies for scabies have proven effective for destroying the mites under the skin, but you should take several steps to remove the mites from your environment. The first thing to do is your laundry. Scabies mites can survive for several days in fabrics, so you will need to thoroughly clean all of your clothes, bedding and other linens like towels. Washing can dislodge mites from the fabric, and high heat can destroy the mites entirely. Wash clothes, sheets, blankets, towels, and other fabric materials in the hottest possible water (taking care to avoid damaging clothing). Dry all items in a dryer on the highest possible setting. Scabies Treatment Step Three: Vacuuming Scabies mites also can survive in carpeting, throw rugs and even upholstered furniture. To remove these mites, you should thoroughly vacuum all carpets, throw rugs (even better: launder any throw rugs that can go in the washing machine) and furniture. Immediately empty the vacuum canister or throw the bag away. Wear gloves and empty the vacuum outdoors, directly into the trash bin. What About Fido? If you have dogs or cats, you need not worry about your scabies mites infesting them. Human scabies cannot live in the skin of pets. Never apply a human scabies treatment like permethrin cream to a dog or cat! If you think your pet is infested with a skin mite, see a veterinarian.