OriginalDrugs

Permethrin (Elimite) Cream

  • Generic name: Permethrin
  • Brand names: Elimite, Acticin, Nix Dermal Cream, Lyclear
  • Class: Antiparasitic, Pediculicide, Scabicidal agent

Permethrin 5% cream is a topical scabicidal agent for the treatment of infestation with Sarcoptes scabiei (scabies). It is available in an off-white, vanishing cream base. Each gram of 5% cream contains permethrin 50 milligrammes.

The U.S. Centers for Disease Control and the American Social Health Association consider a topical 5% permethrin to be one of most effective treatments for scabies.

Permethrin cream is considered safe in children and infants as young as 2 months old1. This scabicidal agent is highly effective, minimally absorbed, and minimally toxic.

How does Permethrin work for scabies?

Permethrin, a pyrethroid, is active against a broad range of pests including lice, ticks, fleas, scabies mites, and other arthropods. It works by paralyzing and killing the mites and their eggs.

Permethrin acts on the nerve cell membrane to disrupt the sodium channel current by which the polarization of the membrane is regulated. Delayed repolarization and paralysis leads to the death of the pests.

Permethrin is more effective than crotamiton (Eurax), lindane, and ivermectin2.

How to apply Permethrin?

A single application of permethrin 5% cures most scabies infestations. Itch decreases within 24 hours, though sometimes itching persists for up to several weeks after treatment. It means that the body is still reacting to the dead mites and their feces.

  • Apply a thin layer of the cream to all body parts from the neck down to the soles of the feet (scabies does not usually infect the head).
  • Treat infants also on the hairline, neck, scalp, temple, and forehead.
  • Usually 30 grams is sufficient for an average adult.
  • Apply to a dry skin and rub it in well. Leave permethrin on for 8 to 14 hours, then wash it off completely.
  • Do not apply cream to mucous membranes, open cuts or wounds. Doing so could cause too much agent to be absorbed by your body, which could be very dangerous.
  • Reapply to areas of the body, which have become moist following application.
  • All the clothes, towels, and bed linen should be washed thoroughly.

How many times to apply Permethrin?

One application is usually sufficient to get rid of scabies. Permethrin cures about 90% cases of scabies after one application3. A second application is often recommended one week later to assure complete eradication.

Permethrin is suitable for adults and children older than 2 months of age. Sulfur (7%) is a safe alternative for young infants.

References

  • 1. Albakri L, Goldman RD. Permethrin for scabies in children.
    Can Fam Physician. 2010 Oct;56(10):1005-6.
  • 2. Strong M, Johnstone P. Interventions for treating scabies. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD000320.
  • 3. Schultz MW, Gomez M, Hansen RC, et al. Comparative study of 5% permethrin cream and 1% lindane lotion for the treatment of scabies. Arch Dermatol. 1990 Feb;126(2):167-70.

Last updated: February, 2015

Good to know

Elimite cream 5%
  • Permethrin topical is available under the brands Acticin and Elimite in a 5% cream formulation and over-the-counter under the brand Nix in a 1% creme-rinse liquid.
  • Permethrin 5% strength kills the scabies mite.
  • Nix (permethrin 1%) is used to treat head lice only, and is not strong enough to cure scabies.