Permethrin 50 mg/mL (5%) Topical Lotion — 50 mL

Permethrin 50 mg/mL (5%) topical lotion is a topical scabicidal agent belonging to the synthetic pyrethroid class. It acts primarily by disrupting the nervous system of susceptible parasites, leading to paralysis and death of Sarcoptes scabiei mites. Permethrin 5% is considered a first-line topical treatment for scabies.

Therapeutic Uses

Permethrin 5% topical preparations are primarily used for:

• Treatment of classic scabies caused by Sarcoptes scabiei.
• Treatment of scabies in adults and children when appropriately prescribed.
• As part of combination therapy for crusted (Norwegian) scabies, together with systemic treatment and repeated topical applications under specialist supervision.

Important: Permethrin 5% used for scabies should not be confused with permethrin 1%, which is used for head lice.

How It Works

Permethrin interferes with the normal function of the nervous system of mites, producing paralysis and death of the parasite. It is applied directly to the skin so that the active ingredient can act on the mites within the superficial layers of the skin.

Directions for Use — Scabies

For classic scabies, the commonly recommended regimen is:

1. Apply a thin, even layer to clean, dry skin.
2. In adults and older children, apply to the entire body from the neck down, paying particular attention to skin folds, between the fingers and toes, wrists, genital area, buttocks and other affected areas.
3. Leave on the skin for approximately 8–14 hours, according to the product instructions or healthcare professional's directions.
4. Wash the preparation off thoroughly after the recommended contact period.
5. A second treatment 7–14 days later may be recommended, particularly when clinically indicated or according to the local product instructions.

Children and infants: Scabies can involve the head, neck and scalp in young children and infants. The application area and treatment duration should therefore follow the pediatrician's or product-specific instructions rather than automatically following the adult regimen.

Household & Environmental Measures

Because scabies spreads primarily through prolonged skin-to-skin contact, close household contacts should generally be treated at the same time, even if they have no symptoms yet.

Patients should also:

• Wash clothing, towels and bedding using hot water and a hot dryer when possible.
• Dry-clean or seal non-washable items in a closed plastic bag for several days.
• Avoid prolonged direct skin-to-skin contact until treatment has been completed.
• Keep fingernails short to reduce skin injury caused by scratching.

Important Precautions

• For external use only.
• Avoid contact with the eyes, mouth and other mucous membranes.
• Do not swallow.
• Avoid application to severely irritated, broken or infected skin unless specifically directed by a healthcare professional.
• Wash hands after application unless the hands are part of the treatment area.
• If the hands are treated, avoid washing them during the recommended contact period.
• Keep out of reach of children.
• Use in infants and young children only according to appropriate medical advice and product labeling.

Pregnancy & Breastfeeding

Available clinical guidance considers topical permethrin an appropriate treatment option when scabies treatment is required during pregnancy or breastfeeding. However, pregnant or breastfeeding patients should consult their healthcare professional before use.

During breastfeeding, do not apply permethrin directly to the breast or nipple immediately before feeding; any treated area that could contact the infant should be thoroughly washed before breastfeeding.

Possible Side Effects

Permethrin is generally well tolerated when used correctly. Temporary local reactions may occur, including:

• Mild burning or stinging
• Itching
• Redness
• Tingling
• Skin irritation
• Dryness or rash
• Importantly, itching may continue for 1–2 weeks or even several weeks after successful treatment because the skin can remain hypersensitive to mites and their products even after the infestation has been eradicated. Persistent itching alone does not necessarily mean treatment failure.

When to Seek Medical Advice?

Medical reassessment is recommended if:

• New burrows or new pimple-like lesions continue to appear.
• Significant itching persists 2–4 weeks after treatment.
• The skin becomes increasingly painful, swollen, crusted or develops pus.
• There is suspected secondary bacterial infection.
• Symptoms do not improve despite correct treatment.
• Crusted/scaly extensive lesions are present, as crusted scabies generally requires more intensive treatment.

Patient Disclaimer

This information is provided for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Permethrin 50 mg/mL (5%) topical lotion should be used according to the product's approved instructions and/or the advice of a qualified healthcare professional. Correct application is important for successful treatment of scabies. Do not repeatedly apply the product simply because itching continues after treatment, as itching may persist temporarily even after successful eradication. Seek medical advice if symptoms persist, worsen, or new lesions develop.

References

• U.S. Centers for Disease Control and Prevention (CDC) — Clinical Care of Scabies.
• CDC — Treatment of Scabies.
• CDC — Ectoparasitic Infections: STI Treatment Guidelines.
• World Health Organization (WHO) — Scabies Fact Sheet.
• World Health Organization (WHO) — Scabies Control Framework / Permethrin treatment guidance.
• WHO Essential Drugs Practical Guide — Permethrin 5% scabicide guidance.