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Permethrin Relief: Girl Scratching Scabies Rash

How to Use Permethrin Cream for Scabies

Struggling with scabies? Harness the power of Permethrin cream for an efficient solution. Just apply it where needed; no complex steps are required. Here’s a practical tip: gently massage the cream into your skin, starting from the head down to the soles of your feet. Pay extra attention to skin creases, hands, feet, between fingers and toes, arms, and groins. Delve into the details of how to use Permethrin Cream for scabies and master the entire process to bid farewell to scabies for good. Furthermore, within this step-by-step guide, we answer the most common questions that often linger in the minds of patients.


What is Permethrin Used For?

Permethrin is utilized in treating common skin conditions such as scabies and head lice. Available under the brand names “Acticin” and “Elimite” in the United States and marketed as “Nix Cream Rinse” and “Nix” in Canada, the effectiveness of Permethrin has earned it the esteemed status of being the FDA’s first-line recommended treatment for scabies. Now, let’s delve into its applications and gain insights into its mechanism of action:

Permethrin’s Action Mechanism

Permethrin, known as a scabicide and pediculicide, disrupts sodium transport in arthropods, leading to depolarization and eliminating eggs, lice, and mites. This is crucial in treating scabies and head lice.

Head Lice Solution: Permethrin 1%

In its 1% lotion form, Permethrin actively eliminates both lice and their eggs, providing a potent solution for head lice treatment.

Scabies Treatment: 5% Permethrin Cream

The 5% cream variant, available as a cream, specifically targets and kills scabies mites and their eggs, actively eradicating the responsible mites. The United States Food and Drug Administration (FDA) has approved it as a first-line treatment, offering a comprehensive solution for scabies rash.

How to Apply Permethrin Cream Effectively?

To get rid of scabies, Permethrin cream stands out as the best medicine for scabies infestation. Now, let’s delve into a comprehensive, step-by-step guide for applying Permethrin cream optimally:

3.1 Preparing for Permethrin Application:

  • Start by trimming fingernails and toenails, preventing mites from finding refuge underneath.
  • While a shower beforehand is optional, ensure your skin cools down sufficiently before applying the cream.

3.2 Applying Permethrin Cream:

  • Begin by massaging Permethrin cream into every skin surface, from your jawline down to the soles of your feet.
  • Pay meticulous attention to skin creases, hands, feet, between fingers and toes, underarms, and the groin.
  • For individuals over 2 years old, apply the cream to the entire body, excluding the head and face.
  • For infants, young children, or those with little hair, ensure thorough coverage on the neck, scalp, hairline, temples, and forehead.
  • Utilize a toothpick to apply the cream beneath fingernails and toenails.
  • Remember to record the application time for reference.
  • Leave the cream on for a minimum of 12 hours, ideally applying it before bedtime for an overnight treatment.
  • Minimize contact with mucosal sites during the application of topical permethrin.
  • Ensure not to apply to broken skin or areas with infections.
  • Exercise caution to prevent cream contact with the eyes; immediate rinsing is essential if it occurs.
  • It is recommended that all members of your household receive treatment on the same day and at the same time to avoid re-infection. Additionally, it is advisable to refrain from skin-to-skin contact with others until treatment is complete.

3.3 Post-Application Care:

  • After the application, avoid washing your hands within 8 hours; reapply the cream after using the toilet or washing your hands and feet.
  • If you continue washing clothes, don a new pair of disposable gloves.
  • Shower after the cream has been on your skin for at least 12 hours.
  • Consider a reapplication in the same manner one week later.

3.4 Clothing and Environment Clean-Up:

Beyond the application, proper cleaning of clothes and the living environment is vital in the scabies treatment process. Explore the steps for a thorough clean-up to eradicate any remaining mites:

  • Machine wash clothes and bed linens from the past three days on a normal cycle at 60°C.
  • For items, you cannot wash them, deploy insecticide powder or aerosolized insecticide, or seal them in a bag for a minimum of 48 to 72 hours.
  • Additionally, vacuum fabric items such as sofas, fabric chairs, carpets, and rugs that cannot undergo washing.

Following these meticulous steps, you can effectively eliminate and kill scabies mites and curtail their spread. Don’t hesitate to consult your healthcare provider for any specific concerns or questions about how to use permethrin cream for scabies.

How Many Times Can You Use Permethrin Cream for Scabies?

Your dermatologist typically prescribes two applications of Permethrin cream to the entire body, with a one-week interval between each application (occasionally opting for a third treatment if necessary). Recent studies strongly emphasize the effectiveness of a 5% permethrin cold cream for two consecutive days.

Importantly, be mindful that itching may persist for up to 2 months post-treatment, highlighting the importance of understanding how to use permethrin cream for scabies effectively.

How Long Do You Leave Permethrin Cream on for Scabies?

To maximize the effectiveness of Permethrin cream, it’s best applied during bedtime. Leave the cream on your skin for 8 to 12 hours, allowing it to penetrate burrows or skin thoroughly. Wondering when to wash off the scabies cream? Following this period, take a shower or bath to wash off the cream.

Note that it’s normal for your skin to feel itchy post-treatment. However, this does not necessarily imply that the treatment has failed. Ensure you do not exceed the prescribed amount of medication.

Can You Sleep with Permethrin Cream on for Scabies?

Certainly, it’s safe and advisable to sleep with Permethrin Cream on for scabies. Before bedtime, apply the cream generously, making sure to cover your entire body thoroughly. Allow the cream to work its magic overnight, precisely targeting and eliminating those troublesome scabies mites that have disrupted your life. To ensure their effective removal, leave the permethrin on for 8 to 12 hours. When you wake up, wash it off, change into clean clothes, and enjoy the relief from Permethrin, the miraculous solution. As a safe and effective treatment, it kills scabies mites and provides relief from the burdens caused by these persistent parasites.

What is the Recommended Dosage?

Your healthcare provider typically guides the determination of the appropriate dosage for Permethrin Cream in scabies treatment, taking into account variables such as infestation severity and individual health. For adults and children over 12 years old, applying up to one tube (30g) ensures thorough coverage from head to toe, excluding the head and face. Additionally, children aged 6 to 12 should use up to half a tube (15g), while those aged 1 to 5 and 2 months to 1 year can use up to a quarter (7.5g) and an eighth (3.75g) of a tube, respectively. Gently massage the cream, and after 8 to 14 hours, wash it off during a shower or bath. Typically, 30 grams is sufficient for an average adult, and one application is usually curative. Furthermore, a second application may be advised if live mites persist after 7 days. Always heed healthcare provider recommendations and consult for personalized dosages based on your specific situation.

How Long Does It Take for Permethrin Cream to Work on Scabies?

Wondering how long it takes for Permethrin Cream to work on scabies? It varies. Some feel relief in a few days, while for others, it may take up to four weeks for the skin to heal. If itchiness persists after treatment, don’t worry—it doesn’t mean the treatment failed. If live mites stick around for 14 days or more, consider repeating the process. The medication efficiently kills mites, but itching may linger for weeks. Consult a healthcare provider to check for any remaining mites; sometimes multiple treatments are needed for full clearance. Just remember to use the treatment correctly for the best results and to prevent re-infestation.

Are There Any Side Effects I Should Be Aware Of?

Concerned about potential side effects from Permethrin Cream for scabies? Rest assured, it’s generally safe, and side effects are rare. Using Permethrin Cream for scabies may lead to mild effects like burning, itching, or rash. These symptoms could worsen temporarily post-treatment. More common side effects include mild burning, itching, headaches, dizziness, and stomach discomfort. Severe reactions, like hives or difficulty breathing, require immediate attention.

Safety and efficacy have not been established in children under 2 months of age. For ongoing issues or concerns, consult your doctor. Report any unusual problems to your healthcare provider. You can submit adverse event reports to the FDA through the Med Watch program online at MedWatch: The FDA Safety Information and Adverse Event Reporting Program.


*Meinking TL, Taplin D. Safety of permethrin vs lindane for the treatment of scabies. Arch Dermatol. 1996 Aug;132(8):959-62. [PubMed].

*FDA, Food and Drug Administration, Permethrin Cream 5% Approval package.


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