How Do I Use Permethrin Cream? A Comprehensive Guide
Permethrin cream is used to treat scabies and lice; application involves applying a thin layer to the entire body from the neck down (or according to specific instructions for lice), leaving it on for the prescribed duration (typically 8-14 hours for scabies), and then washing it off thoroughly. It’s crucial to follow your doctor’s instructions precisely and repeat treatment as directed.
What is Permethrin Cream and Why is it Prescribed?
Permethrin cream is a medication containing the synthetic pyrethroid permethrin, a powerful insecticide and acaricide. It’s primarily prescribed to treat two common parasitic infestations: scabies and lice (including head lice, body lice, and pubic lice, also known as crabs).
Scabies: This intensely itchy skin condition is caused by tiny mites (Sarcoptes scabiei) that burrow into the skin to lay their eggs. Permethrin cream paralyzes and kills these mites and their eggs.
Lice: These small, wingless insects feed on human blood and cause intense itching. Permethrin cream works by disrupting the nervous system of lice, leading to their death.
Permethrin is preferred due to its effectiveness, relatively low toxicity when used as directed, and its availability as a topical cream, making it easy to apply.
Preparing for Permethrin Cream Application
Proper preparation is key to maximizing the effectiveness of permethrin cream and minimizing potential side effects.
- Shower or Bathe: Before applying the cream, thoroughly cleanse your body with soap and water. This removes dirt, oil, and any previously applied lotions or creams, allowing the permethrin to penetrate the skin effectively.
- Dry Thoroughly: Ensure your skin is completely dry before applying the cream. Moisture can dilute the medication and reduce its efficacy.
- Gather Supplies: Have everything you need readily available:
- Permethrin cream (prescribed amount)
- Clean towels
- Clean clothing for after the treatment
- Gloves (optional, but recommended for caregivers applying the cream to others)
- Protect Others: Inform household members and close contacts about your treatment. They may need to be treated as well, even if they don’t have symptoms, to prevent re-infestation. Discuss this with your doctor.
The Application Process: Step-by-Step
Applying permethrin cream correctly is essential for its effectiveness.
- Apply a Thin Layer: Squeeze a small amount of cream onto your fingers and apply a thin, even layer to the entire body from the neck down.
- Areas to Cover: Pay particular attention to:
- Between fingers and toes
- Under the fingernails and toenails
- Wrists
- Armpits
- Genital area
- Buttocks
- Feet
- For Infants and Young Children: The cream should also be applied to the scalp, face, and neck, avoiding the area around the eyes and mouth. Consult your pediatrician for specific instructions.
- Leave On for Prescribed Time: Allow the cream to remain on the skin for the amount of time specified by your doctor, typically 8 to 14 hours for scabies. For lice, the duration may vary – follow the instructions carefully.
- Wash Off Thoroughly: After the prescribed time, thoroughly wash off the cream with soap and water.
- Change and Wash Bedding and Clothing: Immediately after washing off the cream, put on clean clothing. Wash all bedding, towels, and clothing that you have used in the past few days in hot water and dry them on high heat to kill any remaining mites or lice and their eggs.
- Repeat Treatment: A second application of permethrin cream is often recommended one week after the initial treatment to kill any newly hatched mites or lice. Follow your doctor’s instructions.
Common Mistakes to Avoid
Avoiding these common errors will increase the likelihood of successful treatment.
- Not Applying to the Entire Body: Applying the cream only to itchy areas can leave mites or lice alive in other parts of the body, leading to re-infestation.
- Washing Off Too Soon: Removing the cream before the prescribed time can reduce its effectiveness.
- Not Treating Household Members: If one person in a household has scabies or lice, it’s likely that others are also infected, even if they don’t have symptoms. Treat everyone simultaneously.
- Not Washing Bedding and Clothing: Failure to thoroughly wash bedding and clothing can lead to re-infestation.
- Using Too Much Cream: Applying a thick layer of cream doesn’t make it work better and can increase the risk of side effects.
- Re-treating Prematurely: Itching can persist for several weeks after successful treatment. Don’t re-treat unless your doctor advises you to do so.
Side Effects and Precautions
While permethrin cream is generally safe, some side effects are possible.
- Common Side Effects:
- Itching
- Burning
- Stinging
- Redness
- Rare but Serious Side Effects: Allergic reactions (rash, hives, swelling, difficulty breathing) are rare but require immediate medical attention.
- Precautions:
- Avoid contact with eyes, nose, and mouth.
- Inform your doctor if you are pregnant or breastfeeding.
- Tell your doctor about any other medications you are taking.
- If irritation persists or worsens, stop using the cream and consult your doctor.
- Consult a doctor before using on children under 2 months old.
Following Up After Treatment
It’s important to monitor your symptoms and follow up with your doctor as directed.
- Persistent Itching: Itching can continue for several weeks after treatment, even if the mites or lice are dead. This is due to an allergic reaction to the dead parasites. Your doctor may prescribe medications to relieve itching.
- Re-infestation: If itching persists or new lesions appear after several weeks, you may be re-infested. Contact your doctor for further evaluation and treatment.
- Follow-up Appointments: Attend any follow-up appointments scheduled by your doctor to ensure the treatment was successful.
Frequently Asked Questions (FAQs)
What if I get permethrin cream in my eyes?
Flush your eyes immediately with plenty of water for at least 15 minutes. If irritation persists, seek medical attention. It’s crucial to avoid getting the cream in your eyes due to its potential to cause irritation.
Can I use permethrin cream if I am pregnant or breastfeeding?
Consult your doctor before using permethrin cream if you are pregnant or breastfeeding. While it is generally considered low-risk, your doctor can assess the potential benefits and risks based on your individual circumstances.
How long does it take for permethrin cream to work?
Permethrin cream typically kills mites or lice within a few days of application. However, it can take several weeks for the itching to subside completely. This is due to the allergic reaction to the dead parasites.
Can I use permethrin cream on my pets?
No, permethrin cream for humans is not safe for pets. It can be toxic to animals, especially cats. Consult your veterinarian for appropriate treatments for parasites in your pets.
What should I do if I experience an allergic reaction to permethrin cream?
Stop using the cream immediately and seek medical attention if you experience signs of an allergic reaction, such as rash, hives, swelling, or difficulty breathing. These symptoms can be life-threatening and require prompt treatment.
Can I buy permethrin cream over the counter?
Permethrin cream with a concentration of 5% (used for scabies) is typically only available with a prescription. Lower concentrations (e.g., 1% for lice) may be available over the counter, but it’s always best to consult with a doctor for proper diagnosis and treatment.
How often should I apply permethrin cream?
The frequency of application depends on the condition being treated and your doctor’s instructions. Typically, for scabies, a single application is followed by a second application one week later. For lice, the instructions may vary. Always follow your doctor’s specific directions.
How do I prevent re-infestation after using permethrin cream?
To prevent re-infestation:
- Wash all bedding, towels, and clothing in hot water and dry on high heat.
- Vacuum carpets and upholstery thoroughly.
- Avoid close contact with infected individuals.
- Ensure all household members are treated simultaneously.
- Thorough cleaning is vital to prevent recurrence.
Can I use permethrin cream if I have other skin conditions like eczema?
If you have other skin conditions, consult your doctor before using permethrin cream. It can potentially exacerbate existing skin irritations. Your doctor can advise on whether permethrin is appropriate and how to minimize potential side effects.
What if I accidentally ingest permethrin cream?
Seek immediate medical attention or contact poison control if you accidentally swallow permethrin cream. While it’s intended for topical use, ingestion can cause serious health problems.
Does permethrin cream kill the scabies eggs, or just the adult mites?
Permethrin cream is effective at killing both adult mites and their eggs, making it a comprehensive treatment option for scabies.
Why am I still itching after using permethrin cream?
Itching can persist for several weeks after successful treatment because it’s often an allergic reaction to the dead mites and their waste products left behind in the skin. Antihistamines or topical corticosteroids may help alleviate the itching. Consult your doctor if itching persists or worsens.