Permethrin Cream – An Effective Scabies Treatment?

One of the first lines of treatment for scabies is permethrin cream 5%.   Also known as Elimite, it is fairly effective at killing the mite.  The 5% version is usually available via prescription, but I have seen it on Amazon.  But if your insurance covers prescriptions, use that at your local drug store instead.  It’s $20 on Amazon, and you may need more than one tube, especially if you are treating a whole family at once.  Your doctor should write you a script for enough for the whole family.  Avoid getting 1% permethrin, as this is not effective at killing the mite.  It works for lice, but it’s not strong enough for scabies.

Permethrin is considered very safe.  It’s the only one that is used for children, nursing women, and pregnant women.  It should not be used on children under the age of 2 months, but older children should be fine.  There are some people who are allergic to it – these are usually people who are also allergic to chrysanthemums and pyrethrin.

Side effects of permethrin cream include temporary redness of skin, itching and burning or stinging.  This is more likely to happen if you overuse it, so be careful to follow the directions your doctor gives you.

Different brands may have different directions, but here is what the National Institute of Health has to say…

  • Read the package directions carefully before using the medicine.
  • 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.
  • Put on clean clothes.
  • After treatment, itching may continue for up to 4 weeks.

So most people only need one application.  Children may need two, and if you have Norwegian or crusted scabies, you may require several treatments.

Now, it is likely that the itching will continue over the next four weeks.  Most people do have a decrease in itching about 24 hours after application.  If the itching intensifies or get worse, see a doctor for further testing.


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