Permethrin ®
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Reviewed on Jan 30, 2026. by Dr Alexandra Cristina Cowell Writer & Clinical Content Reviewer Next review due on January 15, 2029.
Dr Alexandra Cristina Cowell

Last updated on Jan 30, 2026.

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Permethrin Permethrin

What is Permethrin?

Permethrin is a topical cream that’s used to clear up scabies. Scabies is caused by tiny mites that are invisible to the human eye, which burrow into the outer layer of skin. They can cause rashes, itching and sores. Permethrin kills off these mites and destroys their eggs so your symptoms don’t get any worse, allowing your skin to heal.

How does Permethrin work?

Permethrin is a type of insecticide – a substance designed to kill insects and mites (in this case, scabies mites). It specifically works by stopping sodium (an essential mineral) from moving across the mites’ nervous system. This prevents them from being able to function properly and they expire.1

How do Permethrin doses work?

Permethrin cream comes in one dosage, which is 5% w/w. That means every gram of cream contains 50 mg of active ingredient. It’s available in a 60 g tube, which should be enough for both applications of treatment.

What is the active ingredient in Permethrin?

Permethrin is a generic medicine that’s named after its active ingredient: permethrin. It’s an insecticide that’s toxic to mites and lice. It works by inhibiting the nervous system of the lice or mites.1

Treated trusted source:

  1. Nanda, J. Patel, P. Juergens, A.L. (2024). Permethrin. StatPearls. Treasure Island (FL): StatPearls Publishing.
Dr Alexandra Cristina Cowell 23938
This page was medically reviewed by Dr Alexandra Cristina Cowell on January 15, 2026. Next review due on January 15, 2029.

How we source info.

When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.

Permethrin Permethrin

How to take Permethrin

Always follow your prescriber’s instructions when you’re using Permethrin for scabies. Usually, you’ll apply half a tube (30 g) across your entire body – from your hairline to the soles of your feet. Thoroughly massage the cream into your skin after application, and leave it on for 8-14 hours (usually overnight). Then, wash the cream off in the shower or bath. One week after the first application, if your doctor recommends it, you may repeat this process. This ensures any mites that hatch from surviving eggs are also destroyed, to prevent scabies coming back.

Dr Alexandra Cristina Cowell 23938
This page was medically reviewed by Dr Alexandra Cristina Cowell on January 15, 2026. Next review due on January 15, 2029.

How we source info.

When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.

Permethrin Permethrin

Permethrin isn’t suitable for everyone, and there are some things that you need to be aware of when taking it.

Here’s all the official info on it. If anything is unclear, let our clinician know, and they can talk with you about it.

Permethrin Permethrin

Permethrin: FAQ

Have something specific you want to know? Search our info below, or ask our experts a question if you can’t find what you’re looking for.

Are there any Permethrin alternatives?

Answer:
Yes – if Permethrin hasn’t been effective (or if you can’t use topical treatment), Ivermectin could be a good alternative, although it’s used off-label for scabies. It’s an oral tablet that kills scabies mites in a similar way to Permethrin: by paralyzing the mites so they die off. But it won’t eliminate the mites’ eggs, so a second dose is needed to kill off any newly hatched mites.

How effective is Permethrin for scabies?

Answer:
Permethrin is a clinically proven treatment for the treatment of scabies. Research shows that Permethrin effectively clears up scabies in over 90% of people that use a single application – and this response rate can be improved by using Permethrin a second time.1

Do I need a prescription for Permethrin?

Answer:
Yes, Permethrin 5% cream for scabies is a prescription-only treatment. A healthcare professional will need to check that it’s the right treatment for you before you use it.

How long does it take Permethrin to work for scabies?

Answer:
You’ll apply Permethrin and leave it on for between 8 and 14 hours (usually overnight), and then wash it off. In over 90% of cases this is enough to clear up scabies – but it’s sometimes recommended to apply a second treatment a week later to ensure any newly hatched mites are also destroyed.

But the rash and itching caused by scabies can last for a few weeks after the mites are destroyed, as your skin needs time to heal. Speak to your doctor if your skin is still itching two to four weeks after using Permethrin.2

What should I do if I make a mistake when taking Permethrin?

Answer:
If you apply more Permethrin cream than you’ve been told to, wash it off with warm, soapy water. If you notice any signs of skin irritation, speak to your doctor right away.

If you forget to apply Permethrin cream, don’t apply more than you’ve been instructed to make up for it.

Does Permethrin cause side effects?

Answer:
Permethrin carries some risk of side effects, the same as any treatment you may use. It’s very rare, but if you experience any breathing difficulties after applying Permethrin, get medical attention right away; it could be a sign of an allergic reaction.

The most common Permethrin side effects (affecting up to one in ten people) include:

  • Itching

  • Reddening of skin

  • Tingling, pricking, or burning sensation on the skin

  • Dry skin


This isn’t a complete list of all the possible side effects associated with Permethrin. If you’ve got any questions or concerns, check out the patient package insert or speak to your physician.

Can I get Permethrin through private health insurance?

Answer:
If a doctor has prescribed Permethrin to treat scabies, you should be able to get it through most health insurance providers. But you should always check your insurer’s formulary to see which medications they cover, and get in touch with them to see if you need prior authorization. This is a conversation between your doctor and health insurance provider to make sure Permethrin is a medical necessity.

If they do offer coverage, your insurance may only cover part of the cost of treatment – or only cover it if you obtain it from specific healthcare providers. But if you can’t get Permethrin through your health insurance, you should be able to get it from an online pharmacy service (if it’s a suitable treatment for you).

Treated trusted source:

  1. Cox, N.H. (2000). Permethrin treatment in scabies infestation: importance of the correct formulation. The British Medical Journal. 320(7226). pp. 37-38.
  2. NHS. (2023). Scabies. Nov 21.

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