Elimite (permethrin) 5% cream is a topical prescription medication specifically formulated for the eradication of scabies infestations. As a synthetic pyrethroid, it offers a potent, targeted approach to eliminating Sarcoptes scabiei mites and their eggs, providing relief from the intense itching and skin irritation associated with this parasitic condition. Its neurotoxic action on arthropods ensures high efficacy, making it a first-line treatment recommended by dermatologists worldwide for patients aged two months and older. This guide provides a comprehensive, expert-level overview of its proper use, safety profile, and clinical benefits.

Features

• Active Ingredient: Permethrin 5% w/w
• Formulation: Topical cream for external use only
• Presentation: Single-use tube (typically 60g), sufficient for one full adult application
• Mechanism of Action: Acts on nerve cell membranes of mites, causing paralysis and death
• FDA-approved for treatment of scabies infestations
• Suitable for patients from 2 months of age

Benefits

• Provides rapid and complete eradication of scabies mites and their eggs, breaking the life cycle of the infestation.
• Offers significant relief from the intense pruritus (itching) associated with scabies, often within a few days of application.
• Minimizes the risk of secondary bacterial infections that can occur from excessive scratching of affected skin.
• Features a favorable safety profile with low systemic absorption when used as directed, making it suitable for a wide patient demographic, including young children.
• Requires only a single application in most cases, ensuring treatment compliance and convenience.
• Helps prevent the transmission of scabies to close contacts and household members by effectively eliminating the causative parasite.

Common use

Elimite cream is primarily indicated for the treatment of scabies, a contagious skin infestation caused by the mite Sarcoptes scabiei var. hominis. Scabies is characterized by a pimple-like rash and severe itching, often worsening at night. It is commonly spread through prolonged skin-to-skin contact and can affect individuals of all ages and socioeconomic backgrounds. The medication is applied from the neck down over the entire body, ensuring all skin surfaces are covered, and is left on for 8 to 14 hours before being washed off. It is crucial that all household members and recent close contacts are evaluated and potentially treated simultaneously to prevent reinfestation.

Dosage and direction

For the treatment of scabies, a single application is usually sufficient. Apply a thin layer of Elimite cream to clean, dry skin from the neck to the soles of the feet, paying close attention to areas between fingers and toes, under nails, wrist folds, elbow creases, axillae, belt line, and gluteal cleft. In infants and young children, also apply to the scalp, temples, and forehead, avoiding the area immediately around the eyes and mouth. Massage the cream gently into the skin until it is no longer visible. Leave the cream on for 8 to 14 hours (typically overnight), then wash thoroughly by showering or bathing. Change into clean clothing and bedding after application. A second application may be recommended by a physician 7-14 days later if new burrows or live mites appear.

Precautions

Do not apply to acutely inflamed skin or open wounds. Avoid contact with eyes, nose, mouth, urethral meatus, and other mucous membranes. If contact occurs, rinse thoroughly with water. Use with caution in patients with a history of allergies to pyrethroids, chrysanthemums, or any component of the formulation. If severe irritation or hypersensitivity reaction develops, wash off immediately and consult a physician. This medication is for external use only and should not be ingested. Wash hands thoroughly after application, unless treating the hands for scabies. Pruritus may persist for several weeks after successful eradication of mites; this does not necessarily indicate treatment failure.

Contraindications

Elimite is contraindicated in patients with known hypersensitivity to permethrin, any other synthetic pyrethroid, pyrethrin, chrysanthemums, or any component of the formulation. There are no other absolute contraindications, but it should be used with extreme caution under medical supervision in patients with pre-existing severe skin conditions such as eczema or psoriasis that cover large body surface areas.

Possible side effects

Most side effects are mild and transient, primarily related to local skin reactions. Common side effects include temporary itching, burning, stinging, tingling, numbness, or redness at the application site. Mild rash or skin edema may occur. These symptoms typically subside after the medication is washed off. Less frequently, patients may experience headache, dizziness, or diarrhea. Severe reactions are rare but can include widespread rash, shortness of breath, wheezing, or severe dizziness, which require immediate medical attention. Persistent pruritus post-treatment is common and is often a reaction to dead mites and debris, not an active infestation.

Drug interaction

No significant drug interactions have been clinically established for topically applied permethrin due to its minimal systemic absorption. However, patients using other topical medications, especially those containing corticosteroids or other active ingredients, should consult their physician before simultaneous application, as this may alter the absorption or efficacy of either product. It is generally recommended to avoid applying other topical products to the same area during the treatment period unless directed by a healthcare provider.

Missed dose

As Elimite is typically administered as a single application, the concept of a “missed dose” does not directly apply. If the application was interrupted (e.g., accidentally washed off prematurely), reapply the cream as soon as possible, ensuring it remains on the skin for the full 8-14 hour period. Do not apply double the amount to compensate. If you are uncertain about the adequacy of application, consult your physician for guidance on whether a repeat treatment is necessary.

Overdose

Overdose from topical application is unlikely due to low systemic absorption. However, excessive application could potentially lead to increased skin irritation, redness, or more severe local reactions. If the cream is ingested, seek immediate medical attention or contact a poison control center. Symptoms of ingestion may include nausea, vomiting, abdominal pain, headache, dizziness, and in severe cases, nervous system excitation such as tremors or seizures. Treatment is supportive and symptomatic.

Storage

Store Elimite cream at controlled room temperature, between 20°C to 25°C (68°F to 77°F). Excursions are permitted between 15°C to 30°C (59°F to 86°F). Do not freeze. Keep the tube tightly closed and in its original carton to protect from light. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Discard any unused medication properly after treatment; do not save for future use.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment recommendations tailored to your specific medical condition. Do not initiate, discontinue, or change any medical treatment based solely on the information provided here. The manufacturer and publisher are not liable for any direct or indirect consequences arising from the use or misuse of this information.

Reviews

“After struggling with misdiagnosed scabies for weeks, my dermatologist prescribed Elimite. The itching subsided significantly within 48 hours, and the rash was completely cleared after one application. The process was straightforward, though the itching did linger mildly for about a week post-treatment.” – Sarah K., verified patient

“As a pediatrician, I have prescribed Elimite for numerous young patients and their families. Its safety profile in children over two months is well-established, and a single treatment is usually curative. Parental education on proper application is key to success.” – Dr. Evan R., healthcare provider

“I was hesitant about using a neurotoxin, but my physician explained that topical absorption is minimal. One treatment eradicated a persistent case that OTC remedies had failed to resolve. Follow-up confirmed no live mites.” – Michael T., verified patient