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Permethrin Cream 5% for Scabies

Examples

Generic Name Brand Name
permethrin 5% Elimite

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 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.

National Institutes of Health information available online: www.nlm.nih.gov/medlineplus/druginfo/meds/a698037.html.

Why It Is Used

Permethrin cream (Elimite) is one of the first medicines doctors prescribe to cure a scabies infestation. 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.1

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 effective.2 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 or sulfur) to cure this form of scabies.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call911or other emergency services right away if you have:

Call your doctor right away if you have:

  • Hives.
  • Painful burning and stinging of your skin.

Common side effects of this medicine include:

  • Temporary redness of the skin.
  • Itching.
  • Mild burning or stinging.

Having scabies can cause your skin to itch, swell, and turn red. These problems may feel worse right after you apply this medicine.

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. You only need to use the medicine again if you can see live mites on your skin 14 days after you have been treated. 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 scabies.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Citations

  1. American Academy of Pediatrics (2012). Scabies. In LK Pickering et al., eds., Red Book: 2012 Report of the Committee on Infectious Diseases, 29th ed., pp. 641–643. Elk Grove Village, IL: American Academy of Pediatrics.

  2. Chosidow O (2006). Scabies. New England Journal of Medicine, 354(16): 1718–1727.

By Healthwise Staff
Primary Medical Reviewer Adam Husney, MD - Family Medicine
Specialist Medical Reviewer John Pope, MD - Pediatrics
Last Revised January 23, 2013

WebMD Medical Reference from Healthwise

Last Updated: January 23, 2013
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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