⚡ Quick Answer — What is Permiforce Cream?
Permiforce Cream is permethrin 5% topical cream in a 30 g tube — the WHO and CDC first-line treatment for scabies (Sarcoptes scabiei). Apply head-to-toe (neck-down in adults; whole body including face and scalp in infants) at bedtime, leave on 8–14 hours, wash off in the morning. Repeat application after 7 days. Treat all household members and close contacts simultaneously even if asymptomatic. Itch may persist 2–4 weeks after successful treatment (post-scabietic itch — not failure). Safe in pregnancy and in children from 2 months.
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What is Permiforce Cream?
Permiforce Cream is a permethrin 5% w/w topical cream for the treatment of scabies and other ectoparasitic skin infestations, supplied in a 30 g tube by a WHO-GMP-certified manufacturer. Permethrin is a synthetic pyrethroid scabicide and pediculicide that has been the global first-line scabies treatment for over three decades. It appears on the WHO Model List of Essential Medicines and is recommended as preferred therapy by the CDC, the European Academy of Dermatology and Venereology, and most national clinical guidelines.
How does permethrin 5% work?
Permethrin binds to voltage-gated sodium channels in the parasite’s nerve cells, holding them open and preventing repolarisation. The mite is paralysed and dies. Mammalian sodium channels are conformationally different and recover from permethrin binding very quickly — this selectivity is why permethrin is highly toxic to arthropods but has an excellent safety profile in humans (systemic absorption from intact skin is < 2 % of the applied dose).
Indicaties
- Scabies (Sarcoptes scabiei var. hominis) — first-line topical treatment in adults, children, and infants over 2 months
- Crusted (Norwegian) scabies — combined with oral ivermectin under medical supervision
- Pubic lice (Pthirus pubis) — applied to affected areas
- Body lice (Pediculus humanus corporis) — usually adjunct to clothing/bedding hygiene
For head lice, the lower-strength Perlice Cream (permethrin 1% lotion) is the appropriate formulation.
How to apply Permiforce Cream — scabies protocol
| Stap | Wat te doen |
|---|---|
| 1. Bath / shower | Have a warm bath or shower; dry the skin thoroughly. Skin must be cool and dry — heat increases absorption. |
| 2. Cover entire body | Apply a thin layer to the whole body from the neck down (in infants and the very elderly, also include face, ears, and scalp — avoiding eyes and mouth). Pay particular attention to between fingers and toes, under fingernails / toenails (cut them short first), wrists, elbows, armpits, breasts, waistline, buttocks, genitals, and behind ears. Mites preferentially burrow in these warm, folded sites. |
| 3. Leave on 8–14 hours | Apply at bedtime; sleep with cream on. Do not wash hands or any treated area during the contact period — re-apply if you do. |
| 4. Wash off | In the morning, wash off thoroughly with soap and water. |
| 5. Repeat after 7 days | A second full-body application 7 days later is recommended to kill mites that hatched from eggs after the first treatment (permethrin is less ovicidal than against active mites). |
Quantity guide per application
| Patient | Approximate amount |
|---|---|
| Adult, average build | ~30 g (one full tube) |
| Older child | ~15–20 g |
| Young child (1–5 years) | ~7–10 g |
| Infant (2–12 months) | ~3–5 g — apply to whole body including face/scalp under medical guidance |
For a couple or a household of four, plan on 2 tubes per application × 2 applications = 4 tubes total.
Bijwerkingen
Permethrin 5% cream is well tolerated. Reactions are usually local and mild:
- Mild burning, stinging, or tingling on application (especially on excoriated skin)
- Transient itching that may worsen briefly during treatment (dying mites release allergens)
- Skin redness, dryness, or mild irritation
- Rare: contact allergy; severe burning; rash
Post-scabietic itch — itching can persist for 2–4 weeks after a successful course because the dead mites and faeces remain in the skin and the immune response continues. This is niet treatment failure. Use a fragrance-free emollient and a short course of a sedating antihistamine at bedtime if it disturbs sleep. Persistent burrows or new lesions after 2 weeks suggests true treatment failure or re-infection — re-treat and review contacts.
Pregnancy, breastfeeding, and children
- Zwangerschap: permethrin is regarded as the safest scabicide in pregnancy at any trimester (systemic absorption < 2 %); first-line per BNF, CDC, and Australian Therapeutic Guidelines.
- Borstvoeding: compatible. Wash off before breastfeeding and avoid applying to nipple area.
- Children ≥ 2 months: safe; in infants and young children apply to the whole body including the face and scalp (avoiding eyes and mouth).
- Infants < 2 months: use under specialist guidance only.
Geneesmiddelinteracties
None clinically significant. Topical permethrin has minimal systemic absorption, so no meaningful interaction with oral medications. Avoid using other topical scabicides simultaneously to prevent additive irritation.
Contra-indicaties
- Hypersensitivity to permethrin, other pyrethroids, or any pyrethrin (note: chrysanthemum allergy can cross-react)
- Active inflammatory dermatosis (severe eczema or psoriasis flare) — wait until skin barrier improves or use under specialist guidance
Opslag
Store below 25 °C; do not freeze. Keep tube tightly closed; out of reach of children. Once opened, use within the manufacturer’s stated period (usually 6 months).
Veelgestelde vragen
How fast does permethrin 5% work for scabies?
The mites are killed within hours of the first application — but the itch can persist for 2–4 weeks afterwards because of immune response to retained mite antigens. Cure (no new burrows, no new lesions) is judged at 2–4 weeks, not at day 1.
Why a second application after 7 days?
Permethrin kills active mites efficiently but is less ovicidal. Eggs that survive the first application hatch over the next 1–3 days; the second treatment kills the newly hatched mites before they can lay another generation.
Do I really need to treat everyone in my household?
Yes. Scabies has a 4–6 week incubation period, so close contacts (anyone sleeping in the same household, sexual partners, regular skin-to-skin caregivers) may be infested without itching yet. Treating only the symptomatic person almost guarantees re-infection within weeks.
Permethrin 5% vs oral ivermectin — which is better?
For typical scabies, permethrin 5% is first-line because of its long safety record and low cost. Oral ivermectin (e.g. Iverjohn of Verpin) is preferred when topical compliance is impossible (institutional outbreaks, mass treatment, mobility-limited patients) and is essential for crusted (Norwegian) scabies in combination with permethrin. The two are often used together for severe or refractory cases.
Can I use Permiforce Cream on my face?
In adults, avoid the face routinely. In infants, very young children, and the immunocompromised, the face and scalp must be included because mite burrows can occur there — apply a thin layer carefully, avoiding eyes, nostrils, and mouth.
Why do I still itch a week after treatment?
Post-scabietic itch is the immune response to dead mites, mite faeces, and burrow proteins still present in the skin. It is normal for 2–4 weeks. Use a fragrance-free emollient, a mild topical steroid (1 % hydrocortisone) for inflamed patches, and an antihistamine at night. New burrows or new active lesions after 2 weeks suggests true failure or re-infection — repeat treatment and re-check contacts.
What if I sweat or wash a treated area during the 8 hours?
Re-apply Permiforce Cream to that area immediately. Permethrin needs prolonged contact to be reliably effective.
Is Permiforce Cream safe in pregnancy?
Yes — permethrin 5 % is the preferred scabicide in pregnancy at any trimester. Systemic absorption from intact skin is < 2 % and there is no signal of teratogenicity in the available literature.
Can I treat a baby with scabies using Permiforce?
Yes from age 2 months. In infants apply to the whole body including face and scalp (avoiding eyes and mouth), trim fingernails, and consider mittens to prevent the cream being licked off.
How is scabies different from eczema?
Scabies typically gives severe night-time itching, characteristic burrow lines (small grey-pink threads ~5 mm long, often between fingers, on wrists, around the waist, breasts, or genitals), and itching in close contacts. Eczema is more often patchy, recurrent, with a personal or family history of atopy and no contagion to others. When in doubt, a clinical exam ± dermoscopy or skin scrape confirms.
Other Lice & Scabies Treatments
In households treating concurrent scabies with Permiforce Cream (permethrin 5%) who also need head-lice management, clinicians sometimes consolidate to a single ivermectin-class regimen; Ivrea Shampoo (ivermectine 1% shampoo) provides a scalp-applied option within the same antiparasitic drug family.
- Perlice Cream — permethrin 1 % lotion for head lice
- Iverjohn — oral ivermectin 3 / 6 / 12 mg for scabies, lice and broad antiparasitic use
- Verpin — ivermectin 6 mg tablets, alternative oral regimen
- Ivrea Cream — topical 1 % ivermectin for rosacea / Demodex / off-label small-area scabies
- Scabiheal Lotion — second-line lindane scabicide where permethrin and ivermectin have failed
Medische Disclaimer
This page is for educational purposes and is not a substitute for medical advice. Resistant or atypical infestations, persistent itch despite proper application, infested children < 2 years old, immunocompromised patients (crusted/Norwegian scabies risk), and pregnancy / breastfeeding cases need clinical assessment. Severe widespread skin infection, fever, or systemic symptoms after a course of treatment require urgent medical review. Always discuss treatment in pregnancy or breastfeeding with a clinician.



























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