Acticin: Targeted Relief from Persistent Scabies Infestations
Acticin (permethrin) 5% cream is a topical scabicidal medication prescribed for the eradication of Sarcoptes scabiei var. hominis, the mite responsible for human scabies. This formulation represents a first-line therapeutic option in dermatology, leveraging its potent acaricidal and ovicidal properties to disrupt the mite’s nervous system, leading to paralysis and death. Its efficacy is well-documented in clinical literature, offering a high cure rate with a single application in most cases when used as directed. The cream base is designed for optimal cutaneous absorption while minimizing systemic exposure, making it a cornerstone treatment for both classical and crusted (Norwegian) scabies presentations. This product card provides a comprehensive overview for healthcare professionals and informed patients, detailing its proper use, pharmacological profile, and essential safety information.
Features
- Contains 5% permethrin, a synthetic pyrethroid, as the active pharmaceutical ingredient.
- Formulated in a vanishing cream base (emollient type) for ease of application and patient comfort.
- Exhibits both acaricidal (kills mites) and ovicidal (kills eggs) activity.
- Typically supplied in 60-gram tubes, sufficient for a single adult application.
- Works through a neurotoxic mechanism, sodium channel modulation, specific to invertebrates.
Benefits
- Provides highly effective eradication of scabies mites and their eggs, resolving the infestation.
- Alleviates the intense pruritus (itching) and associated discomfort caused by the mite burrows and the host’s immune response.
- Halts the progression of the infestation, preventing complications such as secondary bacterial infections (e.g., impetigo) from excessive scratching.
- Reduces the risk of transmission to close contacts and within communal living environments.
- Requires only a single application in most treatment protocols, promoting patient adherence.
- Offers a favorable safety profile with minimal systemic absorption when used topically as directed.
Common use
Acticin cream is primarily indicated for the treatment of scabies infestations. It is the treatment of choice for most patients, including children older than 2 months of age. Diagnosis should be confirmed by a healthcare provider, typically through identification of burrows, mites, eggs, or fecal matter (scybala) via skin scraping and microscopic examination. It is also used prophylactically for close contacts of confirmed cases to prevent outbreak spread. Off-label, it may be employed in the treatment of pediculosis pubis (pubic lice).
Dosage and direction
For scabies treatment: Thoroughly massage the cream into the skin from the head to the soles of the feet, paying particular attention to areas between fingers and toes, under fingernails, wrists, axillae, external genitalia, and gluteal folds. In infants and young children, also apply to the scalp, temples, and forehead, avoiding the eye and mouth regions.
- Adults and children: A single application is usually sufficient. The cream should be left on for 8 to 14 hours (typically overnight) and then removed by washing thoroughly with soap and warm water.
- Re-treatment: A second application 7-14 days after the first may be recommended by a physician if live mites are observed again, though this is not typically necessary.
Precautions
- For external use only. Acticin is not for ophthalmic, oral, or intravaginal use.
- Avoid contact with eyes, nose, mouth, and other mucous membranes. If contact occurs, rinse thoroughly with water.
- Transient burning, stinging, or tingling may occur after application; this is usually mild.
- If severe irritation or sensitization develops, the product should be washed off promptly and not reapplied. Consult a physician.
- Use with caution in patients with known sensitivity to chrysanthemums or other pyrethroid or pyrethrin compounds.
- Inform your physician if you are pregnant, planning to become pregnant, or are breastfeeding.
Contraindications
Acticin is contraindicated in patients with a known hypersensitivity to permethrin, any other pyrethroid, pyrethrin, or to any component of the cream formulation.
Possible side effect
Most side effects are localised and related to the skin application site. The most common include:
- Pruritus (itching)
- Erythema (redness)
- Edema (swelling)
- Mild burning or stinging sensation
- Numbness or tingling (paresthesia)
- Rash
These effects are generally mild and transient. An exacerbation of pruritus immediately after treatment can occur due to the inflammatory reaction to dead mites and should not be considered a treatment failure or adverse reaction. Allergic contact dermatitis is rare.
Drug interaction
No specific drug interactions with topically applied permethrin have been formally established due to negligible systemic absorption. However, patients using other topical medications, creams, or ointments on the same area of skin should consult their physician or pharmacist, as the Acticin cream base may affect the absorption of other products or vice versa.
Missed dose
As Acticin is typically applied as a single dose, the concept of a “missed dose” does not directly apply. If the application is washed off prematurely (e.g., before 8 hours), consult your physician for advice on whether re-application is necessary. Do not apply a double amount to make up for a prematurely washed-off dose.
Overdose
Topical overdose would involve applying excessive amounts of cream. This could potentially increase the risk of systemic absorption and adverse effects, though significant systemic toxicity is unlikely due to low percutaneous absorption. Symptoms of oral ingestion (accidental or intentional) may include nausea, vomiting, abdominal pain, headache, dizziness, and fatigue. In severe cases, CNS effects such as excitation, convulsions, or muscular fibrillation could occur due to permethrin’s neurotoxic properties. In case of accidental ingestion, contact a poison control center or emergency room immediately. Treatment is supportive and symptomatic.
Storage
- Store at controlled room temperature, between 20°C to 25°C (68°F to 77°F).
- Keep the tube tightly closed in its original carton to protect from light.
- Keep out of reach of children and pets.
- Do not freeze.
- Do not use after the expiration date printed on the tube and carton.
Disclaimer
This information is intended for educational and informational purposes only and does not constitute medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Never disregard professional medical advice or delay in seeking it because of something you have read here. The author and publisher are not responsible for any specific health or allergy needs that may require medical supervision and are not liable for any damages or negative consequences from any treatment, action, application, or preparation to any person reading or following the information in this document.
Reviews
- “As a dermatologist, permethrin 5% cream remains my first-line therapy for uncomplicated scabies. Its efficacy and safety profile are excellent. Patient education on proper application is key to success.” – Dr. E. Lawson, MD, Dermatology.
- “After weeks of misery and misdiagnosis, a single overnight treatment with Acticin resolved the relentless itching for my entire family. It was incredibly effective.” – Verified Patient.
- “Extensive clinical trials and meta-analyses consistently show permethrin to be superior to other topical agents like crotamiton and lindane (now rarely used) in terms of cure rates. It is the gold standard.” – Clinical Pharmacologist Review.
- “The itching got slightly worse for a day after using it, which my doctor said was normal, but then it completely disappeared. Make sure you wash all bedding and clothes on a hot cycle as instructed.” – Verified Patient.
- “While highly effective, treatment failure can occur due to improper application, re-infestation from an untreated contact, or, rarely, resistance. A second application is a standard approach in these cases.” – Infectious Disease Specialist Report.