Permethrin for Scabies – Behind the Controversy, Application Tips, and More

Permethrin is a widely prescribed, effective scabies treatment. In the industrialized world, it is typically the considered to be the best available treatment for scabies. For most patients, it kills the sarcopetes scabiei mite and eliminates the itchiness that accompanies an infection. If you believe you have scabies, get into see a doctor as soon as possible to begin a treatment course.

Behind the Controversy

However, permethrin is a drug that has become a bit controversial in recent years. The fact that it is a pesticide is something that many critics cite as a reason to be skeptical of this scabies treatment. Additionally, it is believed to be a very mild carcinogen (cancer causing substance).

Permethrin — Approved by the EPA

However, according to the EPA, permethrin is safe in small doses for adults. Some critics would be quick to point out that DDT was also once considered safe, but scientific research has come a long way since then, and for the time being, permethrin does seem like it’s okay in small doses.

Occupational handling of permethrin is another matter entirely, as individuals handling permethrin in large quantities can potentially be exposed to permethrin at much higher doses. Still, if the individual who handles the permethrin takes proper precautions, such as wearing basic protective equipment, then the EPA still deems this to be a low-risk activity.

The point is, as of now, permethrin is believed to be perfectly safe in small doses. Moreover, most individuals in the medical community assert that treatment with permethrin is safe.

Permethrin vs. Lindane – A Brief History

Before permethrin was prescribed for scabies, the most commonly prescribed treatment for the affliction was lindane. The problem with scabies treatment via lindane wasn’t that the drug was ineffective. On the contrary, it was quite effective. But the side effects were a problem. Side effects included: skin numbness, anxiety, and tremors.

Additionally, lindane is quite toxic, and patients often had allergic reactions while being treated with it. Consequently, doctors and practitioners began looking for another, effective treatment for scabies that didn’t have a penchant for causing allergic reactions.

Permethrin may still cause some allergic reactions, but those reactions are typically nowhere near as severe as the reactions caused by lindane, which is why permethrin has become the most prescribed treatment for scabies in the industrialized world.

Still, as with all scabies treatments, there is a possibility that the permethrin will cause irritation. But ultimately, the permethrin is considered to be safe and effective.

Applying Permethrin

Taking a shower before applying the medication may be recommended in some cases, but for the most part, it seems that taking a shower prior to application is no longer advisable. Be sure to check with your doctor about this, as a number credible sources provide conflicting instructions.

Permethrin doesn’t need to be applied above the upper-neck, in most cases (infants and patients with crusted scabies are the exception). It should be left on overnight for between 8 and 14 hours. Usually, one treatment for scabies with this medication is sufficient and will kill all of the mites, but sometimes a second treatment may be needed a week or two following the initial treatment. Make sure you check with your doctor for complete application instructions.

Infants and young children will likely need to apply permethrin to their entire bodies, including the face and neck, in order to get rid of the scabies mites. However, permethrin may not be recommended for treating young children and infants, as its safety has been questioned (though it isn’t necessarily contraindicated). Often, a sulfur-based cream is prescribed instead.

Permethrin with Ivermectin

Sometimes permethrin may be prescribed with another treatment for scabies, ivermectin. Ivermectin is prescribed orally. It is particularity effective for treating crusted scabies. Permethrin combined with Ivermectin can be a particularly potent scabies treatment, though it is certainly not necessary for all patients.

Natural Alternatives

Sulfur products, such as Naturasil, are generally considered to be the most effective of the natural scabies treatments. Tea tree oil is another natural remedy for scabies that seems to be becoming increasingly popular.


Permethrin is an effective scabies treatment, though it is not without controversy, due to the fact that it is a pesticide, and likely a weak carcinogen. Still, it’s worth mentioning that permethrin isn’t the only treatment for scabies that is available. Sulfur creams and bath products, sold by Naturasil (available online), are often very effective (and natural) permethrin alternatives.

Permethrin – Related Topics: Home Scabies Treatment – Disinfecting the Household, Tea Tree Oil for Scabies, Natural Treatments for Scabies.

Tags: , ,

Comments are closed.