Permethrin comes as a cream to apply to the skin. Over-the-counter permethrin comes as a lotion to apply to the scalp and hair. Permethrin cream is usually applied to the skin in one treatment, but occasionally a second treatment is necessary. Permethrin lotion is usually applied to the skin in one or two treatments, but occasionally three treatments are necessary. If live mites are seen two weeks (14 days) after the first treatment with permethrin cream, then a second treatment should be applied. If live lice are seen one week after the first treatment with over-the-counter permethrin lotion, then a second treatment should be applied. Follow the directions on your prescription label or the package label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use permethrin exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
Permethrin should only be used on the skin or hair and scalp. Avoid getting permethrin in your eyes, nose, ears, mouth, or vagina. Do not use permethrin on your eyebrows or eyelashes.
If permethrin gets in your eyes, flush them with water right away. If your eyes are still irritated after flushing with water, call your doctor or get medical help right away.
To use permethrin cream, follow these steps:
Apply a thin layer of cream all over your skin from your neck down to your toes (including the soles of your feet). Be careful to apply cream in all skins folds, such as between your toes and fingers or around your waist or buttocks.
For treatment of babies or adults over 65 years of age, the cream should also be applied to the scalp or hairline, temples, and forehead.
You may need to use all of the cream in the tube to cover your body.
Leave the cream on your skin for 8-14 hours.
After 8-14 hours have passed, wash off the cream by bathing or showering.
Your skin may be itchy after treatment with permethrin cream. This does not mean your treatment did not work. If you see live mites 14 days or more after treatment, then you will need to repeat the treatment process.
To use the lotion, follow these steps:
Wash your hair with shampoo and rinse with water. Do not use a conditioner or a shampoo that contains a conditioner because your treatment will not work as well.
Dry your hair with a towel until just damp.
Shake permethrin lotion well right before use to mix the medication evenly.
Use a towel to cover your face and eyes. Be sure to keep your eyes closed during this treatment. You may need to have an adult help you apply the lotion.
Apply permethrin lotion to your hair and scalp area. Begin to apply the lotion behind your ears and at the back of your neck and then cover all of the hair on your head and scalp.
Keep the lotion on your hair and scalp for 10 minutes after you finish applying permethrin lotion. You should use a timer or clock to track the time.
Rinse your hair and scalp with warm water in a sink. You should not use a shower or bathtub to rinse the lotion away because you do not want to get the lotion over the rest of your body.
Dry your hair with a towel and comb out tangles.
You and anyone who helped you apply the lotion should wash your hands carefully after the application and rinsing steps.
A lice comb may also be used to remove the dead lice and nits (empty egg shells) after this treatment. You may also need to have an adult help you to do this.
If you see live lice on your head 7 days or more after treatment, repeat this entire process.
After using permethrin, sanitize all the clothing, underwear, pajamas, hats, sheets, pillowcases, and towels you have used recently. These items should be washed in very hot water or dry-cleaned. You should also wash combs, brushes, hairs clips and other personal care items in hot water.
Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.