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Other · Synthetic pyrethroid insecticide/acaricide — Na+ channel blocker (invertebrate-specific neurotoxin)

Scaboma (Permethrin)

Also sold as: Scaboma, Nix, Elimite, Kwellada-P, Lyclear

Pregnancy

Cat B

Lactation

Safe

Schedule

OTC

Forms

Cream 5% (scabies) +2

Indications

Scabies (Sarcoptes scabiei) — first-line treatment
Head lice (Pediculosis capitis) — 1% cream rinse
Body lice (Pediculosis corporis)
Pubic lice (Phthirus pubis)

Adult Dosing

Scabies (5% cream)

Apply 5% cream to entire body from neck downward (include all skin folds, between fingers, under nails, genitalia, buttock cleft); leave for 8–14 hours overnight; wash off. Repeat application after 7 days.

Treat all household contacts simultaneously. Wash all clothing/bedding/towels at 60°C on day of treatment. Itch may persist 2–4 weeks after successful treatment (dead mite hypersensitivity) — does not mean treatment failure.

Head lice (1% cream rinse)

Apply to clean, damp hair, leave 10 minutes, rinse. Repeat after 7–10 days.

Maximum daily dose: Topical — apply to entire body once; do not repeat within 7 days

Pediatric Dosing

Age Range: Scabies 5%: ≥2 months. Head lice 1%: ≥2 months.

Dose: Same application method as adults. For infants (2–12 months): apply 5% cream to scalp and face also (avoiding eyes and mouth) — scabies can affect the head in infants.

For infants: include face, scalp, and neck in 5% cream application. Adults/older children: neck downward only.

Renal Dose Adjustment

CrCl / eGFR	Dose Adjustment
Any CrCl	Topical use — negligible systemic absorption

Calculate eGFR / CrCl →

Hepatic Adjustment

No adjustment required for topical use

Pregnancy & Lactation

Pregnancy: Category B

Generally considered safe in pregnancy — topical, minimal systemic absorption. Permethrin 5% is the preferred treatment for scabies in pregnancy. WHO and SIGN guidelines support use in pregnancy.

Lactation: Safe

Topical use — negligible systemic absorption. Generally considered compatible with breastfeeding. Avoid applying to breast/nipple area.

Top Drug Interactions

Interacting Drug	Effect	Severity
No significant drug interactions	Topical permethrin does not interact with systemic medications	Minor

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Side Effects

Common

Pruritus (itching — may worsen initially; persists 2–4 weeks post-treatment due to dead mite reaction)
Skin burning/stinging/tingling (application site)
Erythema
Rash

Serious / Discontinue If

Allergic contact dermatitis (rare)
Neurotoxicity (only in massive ingestion — not with topical use at recommended amounts)

Contraindications

Known pyrethrin/permethrin hypersensitivity
Infants < 2 months (insufficient safety data)

Available Indian Brands

Brand	Manufacturer	Price (approx)
Scaboma 5% lotion	Hegde & Hegde	60mL ₹85
Nix 1% cream rinse	Omega/Pfizer	60mL ₹95
Kwellada-P 5%	Reed & Carnrick India	60mL ₹92

Monitoring Required

Clinical response at Day 14 (re-examine skin for new burrows/papules)
Persistent itch assessment (normal up to 4 weeks — not treatment failure)
Household contact treatment compliance

Patient Counseling Points

Apply from neck to toes (adults/children) — or head to toes in infants; do not miss any area including between fingers, under nails, belly button, genitals
Leave on for 8–14 hours (overnight) — do not wash off early
Repeat application after exactly 7 days — one course is usually not enough
Treat ALL family members and close contacts on the same day — even if they are not itching
Wash all bedding, towels, clothing, and soft toys at 60°C on the day of treatment; dry on high heat
Itching may continue for 2–4 weeks after successful treatment — this is normal (dead mite reaction), NOT treatment failure
Do not apply to eyes or inside mouth; avoid applying near nose

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Clinically reviewed by: Dr. Padmavathi Rao, MD (Dermatology), Senior Consultant Dermatologist

Last reviewed: 2026-04-01

References

SIGN Scabies Guidelines 2023
WHO Scabies Treatment Guidelines
BNF — Permethrin
Cochrane — Permethrin for Scabies
Indian Dermatology Online Journal — Scabies Management

Disclaimer: This information is for clinical reference only. It is not exhaustive and does not substitute clinical judgement. Always verify current dosing against the manufacturer's prescribing information and current treatment guidelines. Drug prices are approximate and may vary.