Permethrin Cream or Lotion 5% for Scabies

Search Knowledgebase

Topic Contents

Permethrin Cream or Lotion 5% for Scabies


Generic NameBrand Name
permethrin 5%Nix Dermal Cream, Kwellada-P Lotion

How It Works

Non-prescription permethrin 5% kills the scabies mite. The medicine will come with instructions, and your doctor will also give you a treatment schedule. Follow these instructions for using scabies medicines:

  • Read the package directions carefully before using the medicine.
  • Thoroughly wash and dry skin.
  • Massage the cream or lotion into the skin from the head to the soles of the feet, paying special attention to creases in the skin, hands, feet, between fingers and toes, underarms, and groin. Scabies rarely infests the scalp of adults, although the hairline, neck, side of the head, and forehead may be infested in older people and in infants. Infants should be treated on the scalp, side of the head, and forehead.
  • Leave the permethrin cream or lotion on the skin for 8 to 14 hours.
  • Wash off by taking a shower or bath.
  • Put on clean clothes.
  • After treatment, itching may continue for up to 4 weeks.

Why It Is Used

Permethrin cream or lotion (Nix Dermal Cream or Kwellada-P Lotion) is one of the first medicines doctors prescribe to cure a scabies infestation.1 It is the treatment of choice for children and for women who are pregnant or breast-feeding. Permethrin 5% cream or lotion is considered safe for infants as young as 2 months old.2

Permethrin should be used with caution on people who are allergic to pyrethrin products or chrysanthemums.

How Well It Works

Research has shown permethrin to be more effective than lindane, without the risk of rare yet severe side effects.3 A single application of permethrin cream (Nix Dermal Cream or Kwellada-P Lotion) cures most scabies infestations. Itching usually decreases significantly within 24 hours, though some itching is common for up to several weeks after treatment.

People who have crusted (Norwegian) scabies (rare) may need to apply the medicine several times. It may be necessary to follow the initial permethrin treatment with other scabies medicines (such as lindane or sulfur) to cure this form of scabies.

Side Effects

Permethrin is considered very safe. Possible side effects include:

  • Temporary redness of the skin.
  • Itching.
  • Burning or stinging.

If these side effects persist, call your doctor.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Itching commonly continues for up to several weeks after treatment with a scabies medicine. This doesn't mean that the scabies mites are still alive. It means that the body is still reacting to the mites and their feces.

Unless your doctor recommends it, do not apply permethrin scabies medicine (Nix Dermal Cream or Kwellada-P Lotion) more than once. Overuse of scabies medicines can irritate the skin and may increase the risk of side effects.

Non-prescription permethrin 1% is used to treat lice but is not strong enough to cure scabies.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.



  1. Diaz JH (2010). Scabies. In GL Mandell et al., eds., Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, 7th ed., vol. 2, pp. 3633–3636. Philadelphia: Churchill Livingstone Elsevier.
  2. American Academy of Pediatrics (2009). Scabies. In LK Pickering et al., eds., Red Book: 2009 Report of the Committee on Infectious Diseases, 28th ed., pp. 589–591. Elk Grove Village, IL: American Academy of Pediatrics.
  3. Chosidow O (2006). Scabies. New England Journal of Medicine, 354(16): 1718–1727.


By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Alexander H. Murray, MD, FRCPC - Dermatology
Last Revised May 6, 2011

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.