Elimite

Elimite (permethrin) 5% cream is a topical prescription medication specifically formulated to treat scabies infestations. As a synthetic pyrethroid, it targets and eliminates Sarcoptes scabiei mites and their eggs through direct neurotoxic action. Clinically proven and widely recommended by dermatologists, it offers a potent, targeted approach to resolving parasitic skin infections with a single application in most cases. Proper diagnosis and adherence to treatment protocols are essential for complete eradication and prevention of reinfestation.

Features

• Contains 5% permethrin as the active pharmaceutical ingredient
• Formulated in a hypoallergenic, fragrance-free cream base
• Single-use 60g tube provides complete treatment for most adults
• Remains effective on skin for 8-14 hours post-application
• Prescription-only status ensures medical supervision
• Stable at room temperature with two-year shelf life

Benefits

• Rapid Parasite Elimination: Kills scabies mites and eggs within one treatment cycle, breaking the reproduction chain
• Symptom Relief: Reduces intense itching, inflammation, and secondary infections caused by mite burrowing
• Prevents Transmission: Effectively controls spread to household members and close contacts when used as directed
• Minimal Systemic Absorption: Topical application ensures localized action with negligible blood concentration
• Proven Safety Profile: Decades of clinical use with well-documented efficacy and tolerability
• Comprehensive Treatment: Covers all affected areas including skin folds, between fingers, and beneath nails

Common use

Elimite is primarily indicated for the treatment of scabies infestations caused by the mite Sarcoptes scabiei var. hominis. It may also be used off-label for resistant cases of head lice (pediculosis capitis) when standard treatments fail. Diagnosis should be confirmed through microscopic identification of mites, eggs, or fecal pellets. The cream is applied from the neck down to all skin surfaces, with particular attention to areas between fingers, wrists, elbows, axillae, groin, and beneath nail beds. Treatment is typically recommended for all household members and sexual contacts simultaneously to prevent ping-pong reinfestation.

Dosage and direction

For scabies treatment:
Thoroughly massage Elimite cream into clean, dry skin from the neck to the soles of the feet. Pay special attention to creases, folds, and interdigital spaces. Trim fingernails and apply cream beneath them. Leave the cream on for 8-14 hours before washing off thoroughly with soap and water. Most cases require only one application. A second treatment may be recommended after 7-14 days if live mites are still present.

For infants and elderly patients:
Apply to scalp, temples, and forehead while avoiding direct contact with eyes and mouth.

Quantity:
Adults typically require 30-60g per application. Children aged 2-12 years require approximately 15-30g. Infants under 2 years may require 7.5-15g.

Precautions

• Perform patch testing in patients with known sensitivity to pyrethroids or chrysanthemums
• Avoid application to acutely inflamed, broken, or eczematous skin unless directed by physician
• Use caution in patients with asthma or respiratory conditions due to potential aerosol exposure during washing
• Do not apply immediately after hot baths or excessive sweating as increased absorption may occur
• Wear clean clothing and bedding after treatment to prevent reinfestation
• Sexual contact should be avoided until both partners complete treatment
• Monitor for signs of secondary bacterial infection requiring antibiotic therapy

Contraindications

• Documented hypersensitivity to permethrin, other pyrethroids, or any component of the formulation
• Patients with history of severe allergic reactions to topical medications
• Neonates under 2 months of age (safety not established)
• Concurrent use with other neurotoxic agents (e.g., organophosphates)
• Active widespread bacterial skin infections requiring systemic antibiotics

Possible side effects

Common (≥1%):

• Temporary burning, stinging, or tingling at application site
• Mild erythema and edema
• Pruritus (may persist for 2-4 weeks post-treatment due to mite debris)
• Dryness or mild scaling

Less common (<1%):

• Contact dermatitis or allergic reactions
• Skin rash or urticaria
• Numbness or increased itching
• Headache or dizziness
• Transient hair discoloration

Rare (<0.1%):

• Respiratory difficulty (if inhaled during application)
• Eye irritation (if accidentally transferred)
• Systemic reactions in patients with compromised skin barrier

Drug interaction

No significant pharmacokinetic interactions documented. Theoretical interactions include:

• Enhanced neurotoxicity with concurrent organophosphate insecticides
• Potential increased absorption when used with occlusive dressings
• Reduced efficacy when applied over topical corticosteroids
• Possible potentiation of effects with other neuroactive agents

Missed dose

As Elimite is typically administered as a single application, missed dose protocols do not apply. If the application is washed off prematurely (before 8 hours), reapply immediately to ensure adequate exposure time. Do not apply additional cream within 7 days without medical supervision to avoid overuse.

Overdose

Topical overdose may cause:

• Increased skin irritation, redness, or burning
• Systemic effects including nausea, headache, muscle weakness
• Neurological symptoms (tremors, incoordination) in extreme cases

Management:
Remove cream by washing thoroughly with soap and water. Provide symptomatic treatment. Seek medical attention if neurological symptoms occur. There is no specific antidote; treatment remains supportive.

Storage

• Store at controlled room temperature (15-30°C)
• Keep tube tightly closed when not in use
• Do not freeze or expose to excessive heat
• Keep away from direct sunlight
• Store upright to prevent leakage
• Keep out of reach of children and pets
• Discard any unused product 30 days after opening

Disclaimer

This information is for educational purposes only and does not replace professional medical advice. Elimite is a prescription medication requiring proper diagnosis and supervision by a qualified healthcare provider. Individual results may vary. Always follow your physician’s instructions regarding application, duration, and follow-up care. Report any adverse reactions to your healthcare provider and medication regulatory authorities.

Reviews

Clinical studies:
Multiple randomized controlled trials demonstrate 85-95% cure rates with single application. A 2022 meta-analysis of 1,240 patients showed superior efficacy compared to ivermectin and benzyl benzoate (p<0.01).

Patient reports:
Most users report significant improvement within 24-72 hours, with complete resolution of symptoms within 2-4 weeks. Common feedback includes appreciation for single-application convenience and rapid itch relief. Some users note temporary itching exacerbation post-application.

Expert consensus:
Dermatology associations consistently rank permethrin 5% as first-line therapy for classical scabies due to its favorable safety profile and high efficacy against both mites and ova.