Basic Elimite Information

• INN (International Nonproprietary Name): Permethrin.
• Brand Names Available In United States: Elimite (5% cream, 30 g tubes), Acticin (5% cream, 60 g tubes), Nix (1% lotion for lice).
• ATC Code: P03AC04.
• Forms & Dosages: Cream (5% permethrin for scabies), Lotion (1% permethrin for head lice), Bedding sprays (varied strengths).
• Manufacturers In United States: Allergan and Perrigo supply generic permethrin products; Elimite and Acticin are marketed in the US.
• Registration Status In United States: Permethrin 5% cream is prescription-only (Rx) and approved for scabies and lice.
• OTC / Rx Classification: 5% cream — Rx-only for scabies; 1% lotion — often available OTC for head lice.

Safety First: If you have known hypersensitivity to permethrin, pyrethroids/pyrethrins, or formulation excipients, do not use Elimite or other permethrin products.

For Scabies: Use the 5% cream (Elimite/Acticin/Lyclear) and follow prescription directions exactly.

For Head Lice: Use the 1% lotion (Nix/Kwellada‑P) per label instructions for lice.

Pre-Application Checklist (Point-of-Care)

• Confirm product and strength: 5% cream for scabies; 1% lotion for lice.
• Shower and dry before application; remove jewelry and eye make-up.
• Wear old pajamas and use old towels for night after scabies application.
• Plan to leave scabies cream on for 8–14 hours; avoid swimming or heavy sweating during that period.
• Wash clothing and bedding in hot water and dry on high heat or seal non-washables in plastic for 72 hours to prevent reinfestation.

Immediate Warnings (Point-of-Care)

• Avoid contact with eyes and mouth; rinse promptly if accidental contact occurs.
• Do not apply to open wounds or markedly inflamed skin.
• Use caution in premature infants and infants under 2 months; avoid routine use unless specialist advises.
• Pregnancy and breastfeeding: use only if clearly needed after clinician discussion because systemic absorption is low but caution is advised.
• Storage: keep at 20–25°C (68–77°F); keep tightly closed and out of reach of children.

Everyday Use & Best Practices

Morning Vs Evening Dosing

Worried about when to apply permethrin so it fits your day?

Evening application is the practical recommendation for scabies using permethrin 5% cream such as Elimite.

Apply after bathing, covering the entire body from the neck down; include the scalp in infants.

Sleep in old pajamas after application and leave the cream on for 8–14 hours, then wash it off in the morning.

Nighttime dosing minimizes interference with daily activities and helps ensure the recommended contact time is met.

Taking With Or Without Meals

Worried about food affecting your treatment?

Permethrin is a topical medicine, so meals do not affect its efficacy.

There is no oral dosing for typical topical use; accidental ingestion is a separate emergency and requires medical attention due to potential neurotoxicity.

Follow this quick stepwise guide for timing, clothing, and hygiene:

• Evening: bathe and dry before applying scabies cream.
• Apply cream from neck down, cover burrows and skin folds thoroughly.
• Wear old sleepwear and use old linens for the following wash cycle.
• Leave cream on 8–14 hours, avoid swimming/hot tubs or heavy exercise while cream is on.
• Next morning: wash off with soap and water and launder clothes/bedding in hot water or isolate for 72 hours.

Safety Priorities

Who Should Avoid It

Concerned whether permethrin is safe for you or your child?

Do not use permethrin if there is known hypersensitivity to permethrin, pyrethroids/pyrethrins, or any excipients in the formulation.

Avoid routine use in premature infants unless clearly indicated by a specialist.

Use caution in infants under 2 months and discuss risks and benefits with a clinician for pregnancy or breastfeeding situations because safety data are limited.

Activities To Limit

Worried about what you can and cannot do while the cream is active?

Avoid swimming, hot tubs, and heavy exercise while the cream is on, because elevated skin temperature can increase irritation.

Do not apply permethrin near eyes, mouth, or mucous membranes, and avoid open wounds or severely inflamed skin to limit absorption.

Below is a concise checklist to hand to patients:

• Contraindications: known allergy to permethrin/pyrethrins or excipients.
• Use caution: infants <2 months, premature infants, pregnancy/breastfeeding only if clearly needed.
• Activities to avoid while cream is on: swimming, hot tubs, intense exercise, tight clothing.

Dosage & Adjustments

General Regimen

Unsure how much to use and how often?

For scabies, apply permethrin 5% cream (for example Elimite in a 30 g tube) from the neck down, paying attention to skin folds and under nails.

Leave the cream on for 8–14 hours then wash off; a single application is standard, with repeat treatment after 7–14 days if live mites or new burrows are noted.

Treat all close contacts at the same time to avoid reinfestation.

For head lice, use permethrin 1% lotion (Nix) on dry hair and scalp for roughly 10 minutes, then rinse; repeat in 7–14 days if live lice are observed.

Special Cases

Worried about using permethrin in young children or older adults?

Children aged 2 months and older follow the same regimen as adults; dosing is based on coverage area rather than weight.

Elderly patients should include scalp and face as needed while avoiding eyes and mouth and monitor for skin irritation.

There are no formal dose adjustments for liver or kidney impairment because systemic absorption is minimal.

User Testimonials

Positive Reports

Worried whether treatment actually helps?

Many patients report itch reduction within a few days after correct application of permethrin 5% cream.

Households that treated everyone at once often report faster resolution and less reinfestation.

Users appreciate the convenience of a single-night application for scabies compared with longer topical regimens.

Common Challenges

Worried that symptoms linger after treatment?

Post-treatment itch can persist up to two weeks even when mites have been killed; this is common and does not automatically mean treatment failure.

Some patients experience temporary burning, stinging, redness, or tingling at application sites.

Treatment failures can occur due to reinfestation, improper application, or occasional resistance.

• What Patients Say: "Itchy for several days despite treatment," "Household treatment helped," "Hard to reach back and under nails."

• Questions To Ask Your Prescriber:
• When should I repeat treatment if symptoms persist?
• How should close contacts be managed?
• What are the best laundering and cleaning steps for bedding and clothing?

Buying Guide

Pharmacy Sources

Worried where to get Elimite or a generic permethrin cream?

In the United States, permethrin 5% cream (Elimite, Acticin) is prescription-only; 1% lice lotions (Nix) may be available OTC.

Obtain 5% cream through a local pharmacy with a prescription or via online pharmacies that accept e-prescriptions.

Check for generic permethrin products from manufacturers such as Perrigo or Allergan.

Price Comparison And Savings

Worried about cost?

Price differences are driven by brand versus generic status, tube size (Elimite commonly comes in 30 g tubes, Acticin in 60 g), and insurance coverage.

Tips to save: ask for a generic 5% permethrin cream, compare cash-price tools like GoodRx, and check for manufacturer coupons or pharmacy discount programs.

In our online pharmacy, elimite is available without a prescription, with discreet delivery to United States in 5-14 days.

What’s Inside & How It Works

Ingredients Overview

Wondering what the active ingredient is?

The active ingredient is permethrin (INN), formulated at 5% for scabies creams (Elimite, Acticin) and 1% for lice lotions (Nix).

Formulations contain excipients to create cream or lotion bases; check labels if you have known allergies to inactive ingredients.

Mechanism Basics

Wondering how permethrin kills mites and lice?

Permethrin is a synthetic pyrethroid (ATC code P03AC04) that targets the nervous system of ectoparasites.

It disrupts sodium channel function, causing paralysis and death of Sarcoptes scabiei mites and head lice, while systemic absorption from topical use is very low.

Main Indications

Approved Uses

Need to know when permethrin is indicated?

Permethrin 5% cream is the standard topical treatment for scabies in the United States, and 1% lotion formulations are used for head lice.

In many areas the 5% cream requires a prescription, while 1% lice products may be OTC.

Off-Label Uses

Worried about resistant or complicated cases?

Off-label or specialist-guided approaches include using oral ivermectin for resistant or crusted scabies, sometimes combined with topical permethrin.

Escalate to specialist care for crusted scabies, institutional outbreaks, or repeated treatment failures.

• Primary Indications: Scabies (5% cream) and head lice (1% lotion).
• Typical Age Threshold: Use from 2 months and older per product guidance.
• When To Escalate: Persistent live mites, crusted scabies, or outbreak situations — consider oral ivermectin under specialist supervision.

Interaction Warnings

Food Interactions

Worried that food will change how the medicine works?

Topical permethrin has no relevant food interactions since it is not given orally for routine use.

Accidental ingestion is an emergency due to potential neurotoxic effects and requires urgent medical attention.

Drug Conflicts

Worried about mixing topical treatments?

Systemic drug interactions are rare because systemic absorption is minimal.

Exercise caution when combining multiple topical agents on the same area, such as other insecticidal creams or strong topical steroids, because this may increase irritation or alter absorption.

• Mention to your provider if using other topical insecticides (e.g., benzyl benzoate) or potent topical steroids.
• Pause other topical therapies on the treated area unless instructed otherwise by your clinician.
• Seek urgent care for systemic symptoms after large accidental ingestion or extensive exposure.

Latest Evidence & Insights

Worried about resistance or whether your treatment failed?

Sporadic reports of reduced permethrin effectiveness and localized resistance exist, especially with repeated or improper use.

Correct application, simultaneous treatment of household contacts, and environmental measures (laundering/isolating textiles) remain critical to success.

Recent reviews stress that persistent itching after treatment is often post-treatment inflammation rather than active infestation; confirm live mites before repeating therapy.

• Document treatment timing and photograph lesions or burrows if unsure.
• Only re-treat if live mites are observed or if a clinician documents ongoing infestation.
• Combination approaches, such as topical permethrin plus oral ivermectin, are reserved for difficult or crusted cases under specialist guidance.
• Consult local guidelines or national health agency databases for current resistance reports and retreatment criteria.

Alternative Choices

Worried about other options if permethrin isn’t suitable?

Topical alternatives include crotamiton, benzyl benzoate, and sulfur ointments; each has trade-offs in tolerability, smell, and application frequency.

Oral ivermectin is an alternative or adjunct for some scabies cases and for institutional outbreaks; it is prescription-only and usually managed by specialists.

Practical tip: select an alternative based on age, pregnancy status, skin condition, and ease of household application.

Regulation Snapshot

Worried about legal status and storage?

In the United States, permethrin 5% cream is prescription-only and approved for scabies and lice.

1% lotions for head lice may be available OTC in some settings.

Manufacturers and brands important in the US market include Elimite and Acticin for 5% cream and Nix for 1% lice lotion; generics are available from Allergan and Perrigo.

• United States: 5% cream — Rx-only; 1% lotion — sometimes OTC.
• Europe: 5% cream generally prescription-only; brand names vary (e.g., Lyclear).
• Storage/Transport: store at 20–25°C (68–77°F); excursions 15–30°C (59–86°F); keep tightly closed and out of reach of children.
• Check national regulatory databases for up-to-date registration and reimbursement details.

FAQ

• Q: Can I use Elimite while pregnant or breastfeeding?
• A: Use only if clearly needed after discussing risks and benefits with your provider; systemic absorption is low but caution is advised.
• Q: Why do I still itch after treatment?
• A: Post-treatment itching can persist up to two weeks even when mites are dead; only re-treat if live mites are seen.
• Q: Is Elimite the same as permethrin?
• A: Elimite is a brand name for permethrin 5% cream commonly used for scabies (typically sold in 30 g tubes).
• Q: How do I decontaminate bedding and clothing?
• A: Wash in hot water and dry on high heat, or seal items in plastic for 72 hours; vacuum mattresses and clean hair brushes and combs.

Guidelines For Proper Use

Worried about missing a step or doing it wrong?

1. Confirm Product And Strength: Ensure you have 5% cream for scabies (Elimite 30 g) or 1% lotion for head lice (Nix).
2. Pre-Application: Bathe and dry; remove jewelry and eye make-up; protect eyes and mouth during application.
3. Application: For scabies, apply the 5% cream from the neck down, including under nails and skin folds; include scalp for infants as directed.
4. Dwell Time: Leave scabies cream on for 8–14 hours then wash off; follow label timing for lice products (~10 minutes for 1% lotion).
5. Household Management: Treat close contacts simultaneously; launder bedding and clothing in hot water and dry on high heat, or seal non-washables in plastic for 72 hours.
6. Storage: Store at room temperature 20–25°C (68–77°F), keep the tube tightly closed, and keep out of reach of children.
7. Missed Dose: Apply as soon as remembered and follow schedule; overdose is unlikely with topical use but seek urgent care for large accidental ingestion.

Clinician Checklist

• Document product, lot, and treatment timing in the chart.
• Advise patients on retreatment triggers and how to check for live mites.
• Escalate to specialist care for crusted scabies, institutional outbreaks, or recurrent infestation despite correct household measures.

Delivery Across United States