8 ways to cure scabies 

with the Healthy Skin Program

5% Permethrin cream for scabies

The most common topical treatment in the USA

How to use 5% permethrin cream

How often to apply

Important — use an oral medicine, too!

What if permethrin “doesn’t work”?

Where to get 5% permethrin cream

1% permethrin for head lice (NOT scabies)

Many names for permethrin cream

5% permethrin cream comes under many different names. In the USA it is just called “Permethrin Cream, 5%”. But it also goes by Lyclear, Elimite and other names. As far as I know they are all basically the same thing. Just check and make sure whatever you buy is 5%, not 1%. 5% is for scabies, 1% is for head lice. It can be confusing because Elimite makes both 1% and 5% products.

How to use 5% permethrin cream

Treat persons older than 2 months with 5% permethrin cream. See my page here for treating infants and children.

Treatment should be applied late in the afternoon or evening, left on overnight (8–12 hours) and washed off in the morning. You can use it during the day if you want to…having it on overnight is simply for convenience.

It must be applied from head-to-toe (including head and face), ensuring the whole body is covered but avoiding the eyes and mouth. 

Make sure that the cream covers between the fingers and toes, soles of feet, under nails, behind ears, the groin, bottom and genitalia.

Scabies mites can appear in your face or scalp. This isn’t common so many doctors don’t believe it happens. They may tell you you don’t have scabies or that the mites can’t be in your hair.  You can treat your scalp or face with 5% permethrin, but keep it out of your eyes, nose, mouth and ears.

How often to apply

For any normal case of scabies, apply 5% permethrin once a week. Why? Because after an egg hatches the hatchling crawls up to the surface of the skin and hangs out for 10 to 14 days maturing. Then they mate and the pregnant female burrows under your skin and starts laying more eggs. By using any of the topical treatments once a week you never allow them to mature enough to mate.

You may read or be told to use it every two weeks, but that is bad advice. Waiting that long can allow surviving mites to start a new generation…it would be like starting over from scratch.

I have a schedule here showing how often to apply 5% permethrin.

Important — use an oral medicine, too!

I used 5% permethrin cream twice (a week apart) but my scabies came roaring back a few weeks later.

To get cured I had to both use permethrin once a week (for five weeks) and also take oral ivermectin. I am convinced doing this is what cured my stubborn case of scabies. If any mites are “hiding out” under hard skin so the permethrin cream can’t touch them, the oral ivermectin can sneak up and get ‘em from inside. You can also consider oral moxidectin (which is not approved by the FDA in humans yet).

You can remove and soften thick, hard skin by using a special lotion. Read how to do this here.

What if permethrin “doesn’t work”?

You can switch to one of the other topical treatments: 0.9% spinosad lotion, 10% sulfur lotion or 25% benzyl benzoate lotion. 1% ivermectin lotion has also been used to successfully treat scabies, but hasn’t been approved by the FDA yet.

Also, make sure you aren’t reinfecting yourself. Treat your laundry to kill stay mites and eggs before you re-use it.

Make sure anyone else who might have it gets treated, too. Some folks get scabies and don’t itch at all. Get folks you are close to treated with a topical lotion and/or oral ivermectin. Two treatments a week apart is best, but try to get them to do at least one treatment.

Where to get 5% permethrin cream

Prescription 5% permethrin cream is ridiculously expensive in the USA. Looking at GoodRX.com I see it is $22-$45 for a 60 gram (two ounce) tube. Two ounces really wasn’t enough to cover my body thoroughly. I used it twice (a week apart) the first time I tried it and my scabies came roaring back a few weeks later. Then I did the Healthy Skin Program, but I needed to apply it five times to do that so… 

I made my own 5% permethrin lotion and used it, but this is not an FDA approved practice. I am not recommending doing this, I am just telling you what I did.

You can order a 5% permethrin cream called Lyclear from England for about $11  for a 30 gram tube (one ounce), plus about $12 shipping. If you order several tubes the shipping cost per tube goes down. And you’ll need to fill in a short form stating your age and a few other details. They don’t require a prescription. Shipping takes 9 or 10 days to the USA.

eBay also offers Lyclear 5% permethrin lotion. Today I see it is about $25 or $30 for 30 grams (one ounce) including shipping. 

If you see something called Scabimite, notice it is sold in 10 gram tubes for around $16. That works out to over $45 per 30 grams. Ridiculous. And if it is shipping from Indonesia, it will take 12 to 40 days to arrive.

1% permethrin for head lice (NOT scabies)

1% permethrin is ONLY used to treat head lice infection — NOT scabies mites. It acts by destroying both the lice and their eggs. Because the lice are on the surface of your scalp, the 1% directly attacks the lice and kills them.

Scabies requires a 5% cream because the scabies mites are under your skin. Skin is a very good barrier. Only a tiny bit of the 5% permethrin penetrates the skin to hit the scabies mites. 1% permethrin will not kill the scabies mites under your skin.

US Brand Name of 1% permethrin

  • Acticin
  • Elimite
  • Nix Creme Rinse

Canadian Brand Name of 1% permethrin

  • Nix
  • Nix Dermal Cream

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