Permethrin: uses, application and safety

Permethrin is a topical medicine used to kill scabies mites and selected external parasites on the skin.

For scabies, it is commonly supplied as a cream applied over the areas directed by a clinician or product instructions. It is intended for external use and should not be swallowed.

Permethrin acts on the nervous system of susceptible mites and parasites. It treats the infestation on the skin, but itching can continue after treatment because the skin may remain inflamed while it settles.

Permethrin is used mainly for scabies and may have other prescribed uses against external parasites. The exact body coverage, contact time and need for repeat application depend on the product and diagnosis. See [Scabies Treatment](/treatments/medical-dermatology/scabies-treatment/) for the clinical treatment context.

If permethrin is unsuitable, a clinician may consider another treatment. Managing close contacts and laundering or sealing recently used clothing, towels and bedding may be part of a plan, because reinfestation can occur when an affected household is not managed together.

Apply the cream exactly as directed, including less obvious areas named in the instructions, and wash it off at the stated time. Avoid eyes, mouth and broken skin unless specifically instructed. Tell a clinician about pregnancy, young children, severe skin inflammation or a previous reaction.

New itching or burrows after treatment should be assessed in context rather than judged immediately. Irritation, burning or redness can occur. Seek medical advice for breathing difficulty, facial swelling, extensive blistering or worsening skin pain, and do not repeat applications without guidance.