Permethrin Topical

|Permethrin Topical

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Some commonly used brand names are:

In the U.S.—

  • Acticin Cream
  • Elimite Cream
  • Nix Cream Rinse

In Canada—

  • Nix Cream Rinse


  • Pediculicide
  • Scabicide


Permethrin (per-METH-rin) 1% lotion is used to treat head lice infections. It acts by destroying both the lice and their eggs. The 5% cream is used to treat scabies infections by destroying the mites which cause scabies.

This medicine is available in the following dosage form:

  • Topical
  • Cream (U.S.)
  • Lotion (U.S. and Canada)

Before Using This Medicine

If you are using this medicine without a prescription, carefully read any precautions on the label. For topical permethrin, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to permethrin; to other synthetic pyrethroids, such as those found in household insecticides; to pyrethrins or chrysanthemums; or to veterinary insecticides containing permethrin. Also tell your health care professional if you are allergic to any other substances, such as preservatives or dyes.

Pregnancy—Permethrin has not been studied in pregnant women. However, this medication has not been shown to cause birth defects or other problems in animal studies.

Breast-feeding—It is not known whether permethrin passes into the breast milk. However, animal studies have shown that permethrin can cause tumors. Be sure you have discussed the risks and benefits of the medicine with your doctor.

Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of topical permethrin in children with use in other age groups.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of topical permethrin in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are using any other prescription or nonprescription (over-the-counter [OTC]) medicine that is to be applied to the hair, scalp, or skin.

Other medical problems—The presence of other medical problems may affect the use of topical permethrin. Make sure you tell your doctor if you have other medical problems, especially:

  • Severe inflammation of the scalp—Use of permethrin may make the condition worse

Proper Use of This Medicine

Keep this medicine away from the eyes . If you accidentally get some in your eyes, flush them thoroughly with water at once.

Permethrin lotion which is used to treat lice, comes in a container that holds only one treatment. Use as much of the medicine as you need and discard any remaining lotion properly.

For the treatment of head lice (1% lotion):

  • Shampoo the hair and scalp using regular shampoo.
  • Thoroughly rinse and towel dry the hair and scalp.
  • Allow hair to air dry for a few minutes.
  • Shake the permethrin lotion well before applying.
  • Thoroughly wet the hair and scalp with the permethrin lotion. Be sure to cover the areas behind the ears and on the back of the neck also. Allow the lotion to remain in place for 10 minutes.
  • Then, rinse the hair and scalp thoroughly and dry with a clean towel.
  • When the hair is dry, you may want to comb the hair with a fine-toothed comb to remove any remaining nits (eggs) or nit shells.

Head lice can be easily transferred from one person to another by direct contact with clothing, hats, scarves, bedding, towels, washcloths, hairbrushes and combs, or hairs from infected persons. Therefore, all members of your household should be examined for head lice and should receive treatment if they are found to be infected . If you have any questions about this, check with your doctor.

For the treatment of scabies (5% cream):

  • Read package directions carefully before using.
  • Thoroughly wash and dry skin.
  • Massage the cream into the skin from the head to the soles of the feet, paying special attention to creases in the skin, hands, feet, between fingers and toes, underarms, and groin.
  • Scabies rarely infests the scalp of adults, although the hairline, neck, side of the head, and forehead may be infested in older people and in infants. Infants should be treated on the scalp, side of the head, and forehead.
  • Leave the permethrin cream on the skin for 8 to 14 hours.
  • Wash off by taking a shower or bath.
  • Change into clean clothes.
  • After treatment, itching may continue for up to 4 weeks.

Dosing—Follow your doctor"s orders or the directions on the label . The following information includes only the average dose of permethrin. If your dose is different, do not change it unless your doctor tells you to do so.

  • For topical dosage forms (cream and lotion):
    • For head lice:
      • Adults and children 2 years of age and older—Apply to the hair and scalp one time.
      • Children up to 2 years of age—Use and dose must be determined by your doctor.
    • For scabies:
      • Adults and children 2 months of age and older—Apply to the skin one time.
      • Children up to 2 months of age—Use and dose must be determined by your doctor.

Storage—To store this medicine:

  • Keep out of the reach of children.
  • Store away from heat and direct light.
  • Keep this medicine from freezing. Do not refrigerate.
  • Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

To prevent reinfection or spreading of the infection to other people, good health habits are required. These include the following:

  • Machine wash all clothing (including hats, scarves, and coats), bedding, towels, and washcloths in very hot water and dry them by using the hot cycle of a dryer for at least 20 minutes. Clothing or bedding that cannot be washed should be dry cleaned or sealed in an airtight plastic bag for 2 weeks.
  • Shampoo all wigs and hairpieces.
  • Wash all hairbrushes and combs in very hot soapy water (above 130 °F) for 5 to 10 minutes and do not share them with other people.
  • Clean the house or room by thoroughly vacuuming upholstered furniture, rugs, and floors.
  • Wash all toys in very hot soapy water (above 130 °F) for 5 to 10 minutes or seal in an airtight plastic bag for 2 weeks. This is especially important for stuffed toys used on the bed.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor if any of the following side effects continue or are bothersome:

Less common or rare

Burning, itching, numbness, rash, redness, stinging, swelling, or tingling of the scalp

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Revised: 05/02/2000

The information contained in the Thomson Healthcare (Micromedex) products as delivered by is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

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