Why Is My Cat Only Scratching Its Face? — Causes and Treatment Timing for Feline Notoedric Mange

Skin & CoatDiseasesMeongsiljang Veterinary Advisory Board

We’ve compiled the early signs of feline scabies, caused by Notoedres cati mites burrowing into the face and causing intense itching, along with accurate treatment methods used at veterinary clinics.

What Is Feline Notoedric Mange?

A veterinarian examining the crust at the tip of a cat's ear

Feline notoedric mange is a parasitic skin disease caused by the mite Notoedres cati, which burrows into the stratum corneum and basal layer of the cat’s skin, causing intense itching and thick crusts. Early treatment is key. The condition typically starts at the tips of the ears and face, then spreads to the neck and front legs, and can further extend to the paws and perineal area. If left untreated, secondary bacterial infections may develop in scratch wounds, or the lesions may spread across the entire body. While mild, localized infections may resolve on their own, treatment with anti-mite medication usually requires at least three applications at four-week intervals, so complete recovery can take several weeks.

Causes and Transmission Routes

The cause is a tiny mite called Notoedres cati. Female mites burrow into the skin and lay eggs, leading to thickened skin (hyperkeratosis), inflammation, and itching. It is highly contagious and spreads through direct contact with infected cats, particularly among littermates. As a result, it is commonly found in environments where cats live in close quarters and frequently interact, such as multi-cat households or shelters. While contact with human skin can cause temporary dermatitis (an itchy rash), the mites cannot reproduce on humans, so the condition does not persist. Rare cases of transmission to dogs have also been reported.

Key Symptom Checklist

According to veterinary textbooks, the symptoms follow a characteristic pattern, starting at the tips of the ears (pinnae) and spreading to the face and neck.

Severe itching: The pet repeatedly scratches its face with its front paws or rubs against furniture, and the scratched areas quickly become wounded.

Thick, dry crusts: Dry, hard crusts and scale-like flakes accumulate on the ear tips and face.

Hair loss: Hair loss begins on the face and front legs.

Thickened skin: In chronic cases, the facial skin becomes thick and wrinkled, resembling leather.

Inflammation around the nails: Inflammation around the nails (paronychia) may also occur.

An illustration of a cat with scabs and hair loss on its ears and face.

See a Vet Immediately If You Notice These Signs

If you notice crusts lasting more than 24 hours on the tips of the ears or face, accompanied by severe scratching, take your cat to the vet immediately. This is especially urgent if there is oozing from the wounds, a foul odor, or if fever and loss of appetite are present, as these signs indicate a secondary bacterial infection has developed. In multi-cat households, it is safest to have all cats examined, even those showing no symptoms.

Diagnostic Methods

The first test a veterinarian typically performs is a skin scraping. Using a scalpel, the vet gently scrapes the scabbed area to collect samples, which are then examined under a microscope for mites. Notoedres cati mites are smaller than Sarcoptes scabiei (the canine scabies mite) and have their anus positioned toward the dorsal side, allowing experts to distinguish them easily. Additional tests, such as cytology or fungal culture, may be conducted to check for secondary bacterial or fungal infections. If the mites cannot be detected due to severe scratching, the diagnosis is made based on the pattern of symptoms and the response to treatment.

Treatment Methods

The cornerstone of treatment is the use of miticide medications. Veterinary dermatology textbooks recommend using selamectin spot-on treatments either alone or in combination with sarolaner, and note that isoxazoline-class drugs (fluralaner, afoxolaner, and lotilaner) are also safe and highly effective. These spot-on treatments are typically administered at four-week intervals for a minimum of three doses. Additionally, combination products such as eprinomectin plus fipronil, and moxidectin plus imidacloprid, have proven efficacy. Your veterinarian will determine the appropriate medication and dosing schedule based on your pet’s weight, and if a secondary bacterial infection is present, antibiotics and keratolytic shampoos will be used concurrently.

A veterinarian applying a topical medication to the back of a cat's neck.

Home Care Points

During treatment, environmental disinfection is just as important as the medical care itself. While mites have a short lifespan indoors, preventing reinfection requires washing mats, blankets, and cushions in hot water (60°C or higher), and soaking combs and scratching posts in boiling water before drying them. Keep the infected cat separated from other cats, and use separate carriers and food bowls. Always wash your hands after handling your cat, and if you develop red rashes on your face or arms, consult a dermatologist.

Preventing Recurrence and Precautions for Multi-Cat Households

Stopping medication early just because symptoms have disappeared can allow newly hatched mites to spread again. Mite treatments are typically administered at four-week intervals for at least three rounds, so it’s safest to follow your veterinarian’s prescribed schedule and continue treatment until a full recovery is confirmed. In multi-cat households, the most effective way to prevent recurrence is to treat all cohabiting animals, including those showing no symptoms.

Reviewed by a veterinarian

Dr. Tony — Punnawat Phongkittirak

Veterinarian

A veterinarian who majored in veterinary medicine at Khon Kaen University, Thailand, and completed the IVSA program at North Carolina State University in the United States. Drawing on clinical experience at animal hospitals, he works in the pet healthcare field and is dedicated to building a digital care environment that connects pet parents with veterinarians.

Frequently Asked Questions

Can cat mites be transmitted to humans?

Notoedres cati can temporarily transfer to human skin, causing itchy rashes on the arms and wrists. However, the mites cannot reproduce on humans, so the rash usually resolves on its own over time. Always wash your hands thoroughly with soap after handling an infected cat.

I have a puppy at home. Can it be transmitted to my dog?

Notoedres cati can occasionally be transmitted to dogs as well. However, since dogs are not the primary host, the symptoms are usually mild. As a preventive measure, veterinarians may recommend using tick preventatives on dogs that live in the same household.

Can I use the scabies ointment sold at pharmacies?

Using human scabies medication on cats can be dangerous. Feline scabies must be treated with medications specifically prescribed by a veterinarian for your cat, and self-treatment should be avoided. There are safe options, such as lime sulfur, that can be used even on young animals, so please consult your veterinarian to choose the appropriate treatment.

How long does it take to fully recover?

Mite treatments are typically administered every four weeks for at least three doses, so the treatment process alone takes about two to three months. Even after your pet’s skin shows noticeable improvement, it’s important to continue the medication through the full schedule set by your veterinarian to prevent recurrence. Additionally, it will take some time for new hair to fully grow back in areas where scabs have fallen off.

Does a cat develop immunity after contracting the disease once?

Even after a full recovery, cats can become reinfected if they’re exposed to infected cats or contaminated environments. That’s why it’s important to maintain regular parasite prevention, especially for cats that spend a lot of time outdoors or live in multi-cat households.

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References

[1] Little SE, The Cat: Clinical Medicine and Management, 2nd Edition, Chapter on Parasitic Skin Diseases, 2020

[2] Miller WH, Griffin CE, Campbell KL, Muller & Kirk's Small Animal Dermatology, 7th Edition, Chapter 6: Parasitic Skin Disease

[3] Foley RH, A notoedric mange epizootic in an island's cat population, Feline Practice, 1991