Permethrin

Synthetic, chlorinated long-term pyrethroid.

• Lice: head lice, body lice, clothes lice and their nits.
• Skabies: Recommended by the WHO as first-line therapy for scabies. Approved in Germany for scabies therapy.
• Rosacea (papulo-pustular rosacea): 5% permethrin cream (see recipe below).
• Demodicosis: 5% permethrin cream (formulation see below)

• Notes on teratogenicity: No teratogenicity in animal experiments.
• Pregnancy recommendations: In 2 studies with more than 300 pregnant women no evidence of teratogenic effects of permethrin could be found. Limiting: The majority of pregnant women were exposed beyond the first trimester. 2nd-3rd trimester / perinatal: Previous observations speak against a fetotoxic risk.
• Recommendations for breastfeeding: A toxic risk in case of exposure via breast milk is not to be expected according to previous experience. Recommendation: If permethrin is used, breastfeeding can be continued.

• Lice infestation:
  • Solution: 0.44% solution after washing the head, distribute evenly in the hair, leave on for 30 minutes, then rinse thoroughly, check after 8-10 days.
• Skabies (5% ointment):
  • Adolescents or adults: use once for at least 8 hours, better 12 hours, then wash thoroughly; repeat after 7 days if necessary.
  • Premature babies or newborns: Single use for 6 hours.
  • Infants or toddlers: Single use for 8-14 hours.
• Cheyletiellosis (5% as cream or ointment):
  • Recommended only in case of persistent itching after prior local antiphlogistic therapy.

Solution: 0.44%, ointments: 2.5-5% (e.g. Jacutin® cream)

• 5% Permethrin cream: Rp. Permethrin 5,0 - Ungt. emulsific. aquos ad 100,0
• 5% Permethrin cream with UV protection: Rp. Permethrin 5,0 - titanium dioxide (PH.EUR.) - Ungt. emulsific. aquos ad 100,0
• 5% permethrin cream with UV protection and coverage:: Rp. Permethrin 5,0 - Titanium dioxide (PH.EUR.) - Iron oxide strain trituration (medium) 0,2 - Ungt. emulsific. aquos ad 100,0.
• 5% Permethrin cream with 2,0% Metronidazol Rp. Permethrin 5.0 - Metronidazole (microfine) 2.0 - Ungt. emulsific. aquos ad 100.0.

• Infectopedicul solution (approved and available in Germany).
• InfectoScab 5.0% (approved and available in Germany).
• Lyclear Cream 5% (only available through international pharmacies)
• Nix cream 1% or shampoo (only available through international pharmacies).
• Elimite Cream (only available through the international pharmacy).

1. Chosidov O (2000) Scabies and pediculosis. Lancet 355: 819-826
2. Chouela E et al (2002) Diagnosis and treatment of scabies: a practical guide. At J Clin Dermatol 3: 9-18
3. Ellis E et al (2004) Eosinophilic pustular folliculitis: a comprehensive review of treatment options. At J Clin Dermatol 5: 189-197
4. Folster-Holst R et al (2000) Treatment of scabies with special consideration of the approach in infancy, pregnancy and while nursing. dermatologist 51: 7-13
5. Mamali K et al (2014) Cheyletiella dermatitis. Nude Dermatol 40: 92-94
6. Paasch U, Haustein UF (2001) Treatment of endemic scabies with allethrin, permethrin and ivermectin. Evaluation of a treatment strategy. dermatologist 52: 31-37
7. Yoon KS et al (2003) Permethrin-resistant human head lice, Pediculus capitis, and their treatment. Arch Dermatol 139: 994-1000