How It Works
Prescription-strength permethrin 5%
kills the scabies mite. The medicine will come with instructions, and your
doctor will also give you a treatment schedule. The National Institutes of
Health recommends the following use of 5% permethrin cream for scabies:
- Read the package directions carefully before using the
- Thoroughly wash and dry skin.
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
- Leave the permethrin cream on the skin for 8 to 14
- Wash off by taking a shower or bath.
- Put on
- After treatment, itching may continue for up to 4
National Institutes of Health information available online:
Why It Is Used
Permethrin cream (Elimite) is one of
the first medicines doctors prescribe to cure a scabies infestation.1 It is the treatment of choice for children and for women who
are pregnant or breast-feeding. Permethrin 5% cream is considered safe for
infants as young as 2 months old.2
Permethrin should be used with caution on people who are allergic to
pyrethrin products or chrysanthemums.
How Well It Works
Research has shown permethrin to be more effective than lindane,
without the risk of rare yet severe side effects.3 A
single application of permethrin cream (Elimite) cures most scabies
infestations. Itching usually decreases significantly within 24 hours, though
some itching is common for up to several weeks after treatment.
People who have
crusted (Norwegian) scabies (rare) may need to apply
the medicine several times. It may be necessary to follow the initial
permethrin treatment with other scabies medicines (such as ivermectin, lindane,
or sulfur) to cure this form of scabies.
Permethrin is considered very safe.
Possible side effects include:
- Temporary redness of the
- Burning or stinging.
If these side effects persist, call your doctor.
See Drug Reference for a full list of side effects. (Drug Reference is
not available in all systems.)
What To Think About
Itching commonly continues for up
to several weeks after treatment with a scabies medicine. This doesn't mean
that the scabies mites are still alive. It means that the body is still
reacting to the mites and their feces.
Unless your doctor
recommends it, do not apply permethrin scabies medicine (Elimite) more than
once. Overuse of scabies medicines can irritate the skin and may increase the
risk of side effects.
Nonprescription permethrin 1% is used to treat
lice but is not strong enough to cure
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Diaz JH (2010). Scabies. In GL Mandell et al., eds., Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, 7th ed., vol. 2, pp. 3633-3636. Philadelphia: Churchill Livingstone Elsevier.
American Academy of Pediatrics (2009). Scabies. In LK Pickering et al., eds., Red Book: 2009 Report of the Committee on Infectious Diseases, 28th ed., pp. 589-591. Elk Grove Village, IL: American Academy of Pediatrics.
Chosidow O (2006). Scabies. New England Journal of Medicine, 354(16): 1718-1727.