If 5% permethrin cream has not worked 4x/6 wks, what is the next step to get rid of possible scabies. env & fam treated. treatment was done correctly.

Scabies: Permethrin treatment needs to be repeated one week after the initial treatment. There are oral treatments for scabies, like ivermectin. However, the itch of scabies can last up to 6 weeks after proper treatment. As long as you are not seeing new lesions, the scabies is treated and the itch will eventually resolve. A cortisone cream can help with itching but not on days using permethrin.

Ivermectin: Try ivemectin 200mcg/kg once, repeat in two weeks. Presume you actually have scabies.

See your doctor : Or health dept. A prescription medicine (lindane)may help if not resolved, but must be used correctly bc of risk of seizures.