🧴 Permethrin Cream 5%
🔹 1. Prescription / Indication:
Permethrin 5% cream is a prescription-strength topical medication used for:
- Scabies (Sarcoptes scabiei infestation)
- Crusted (Norwegian) scabies – in combination with oral agents
- Occasionally used in lice-resistant cases (off-label)
🔹 2. Description:
- Form: White to off-white cream
- Strength: Contains 5% w/w Permethrin
- Route: Topical application
- Odorless, non-greasy, smooth texture
- Used externally only
🔹 3. Composition:
| Component | Concentration | Purpose |
|---|
| Permethrin | 5% w/w | Kills mites by neurotoxicity |
| Cream base | — | Vehicle for application |
🔹 4. Advantages:
- Highly effective against scabies with a single application in most cases
- Well tolerated even in infants >2 months
- Minimal systemic absorption
- Less risk of toxicity compared to older agents like lindane
🔹 5. Nature / Drug Class:
- Class: Topical scabicide and pediculicide
- Type: Synthetic pyrethroid
- Mechanism: Disrupts sodium channels in mites → paralysis and death
🔹 6. Common Packaging:
- 15 g to 60 g tubes
- Labeled with:
- “Permethrin 5% Cream”
- “For External Use Only”
- “Scabies Treatment”
🔹 7. Storage:
- Store at room temperature (15–30°C)
- Protect from heat and light
- Keep tightly closed and away from children
- Do not freeze
🔹 8. Patient Advice / How to Use:
🧼 For Scabies Treatment (Standard Use):
- Take a bath and dry skin thoroughly
- Apply cream evenly over the entire body from neck down (for adults)
- In infants & elderly: apply to scalp, face (avoiding eyes), ears, and soles
- Leave cream on for 8–14 hours (usually overnight)
- Wash off with soap and water
- Repeat after 7–14 days if symptoms persist or reinfection suspected
⚠️ Important Advice:
- Do not apply to mucous membranes, eyes, or mouth
- Wash clothing, bedding, and towels in hot water
- Itching may persist for 2–4 weeks post-treatment – not a sign of treatment failure
- May cause mild burning, stinging, or skin irritation
- For crusted scabies: may require repeated applications and oral ivermectin
🔹 9. Purpose / Clinical Use:
| Condition | Permethrin Strength | Notes |
|---|
| Scabies (standard) | 5% cream | First-line treatment |
| Crusted scabies | 5% cream | With oral ivermectin (combined therapy) |
| Head lice | 1% lotion | Preferred form for lice, not 5% cream |
