Comprehensive medication guide to Permethrin including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$30 copay for the Rx 5% cream on most commercial plans and Medicaid (Tier 1–2 formulary); OTC 1% lotion generally not covered unless prescribed.
Estimated Cash Pricing
$9–$21 retail for 1% OTC lotion; ~$91–$93 retail for Rx 5% cream; as low as $5.50–$28 with GoodRx or SingleCare coupons depending on formulation.
Medfinder Findability Score
65/100
Summarize with AI
On this page
Permethrin is a synthetic pyrethroid antiparasitic medication used topically to treat scabies and head lice. It is FDA-approved for the treatment of Sarcoptes scabiei (scabies) in the 5% cream formulation and pediculosis capitis (head lice) in the 1% lotion formulation. It is also used off-label for pubic lice.
Permethrin is available as a prescription 5% cream (generics, formerly branded as Elimite and Acticin) and as an over-the-counter 1% lotion (brand: Nix). It is safe for use in adults, children 2 months and older, and pregnant women (CDC-preferred treatment for scabies in pregnancy).
Permethrin is considered first-line therapy by the CDC, AAP, and AAFP for both scabies and head lice, valued for its excellent safety profile, high efficacy, and ovicidal (egg-killing) activity. It is not a controlled substance and can be prescribed by any licensed healthcare provider.
We have a 99% success rate finding medications, even during nationwide shortages.
Need this medication?
Permethrin is a neurotoxin that targets the nervous systems of arthropods — specifically, the voltage-gated sodium channels in the nerve cell membranes of lice, mites, and other insects. It binds to these channels and prevents them from closing properly, causing the nerve to fire continuously (sustained depolarization).
This uncontrolled nerve firing leads to muscle paralysis and ultimately respiratory paralysis in the affected mite or louse. The result is death of the parasite. Permethrin also has strong ovicidal activity against scabies mite eggs, making a single application often curative.
Permethrin is safe for humans because less than 2% is absorbed through intact skin, and human enzymes rapidly break it down into inactive metabolites before it can accumulate to toxic levels. Human sodium channels are also less sensitive to permethrin than those of insects and mites.
5% — cream
Prescription only. For scabies treatment in adults and children 2 months+. Apply from neck to soles of feet; leave on 8-14 hours; wash off. One application usually curative.
1% — lotion
Over-the-counter (OTC). For head lice in adults and children 2+ years. Apply to washed, towel-dried hair and scalp; leave 10 minutes; rinse and comb. May repeat in 7-9 days.
As of 2026, permethrin is not listed on the FDA's national drug shortage database in the US. However, localized pharmacy-level stockouts are a common complaint — particularly for the prescription 5% cream used to treat scabies. The OTC 1% lotion for head lice is more widely available through retail channels.
Permethrin is a low-volume drug that pharmacies don't stock in large quantities. Community outbreaks of scabies or lice in schools, nursing homes, shelters, and correctional facilities can rapidly deplete local pharmacy stock. The UK experienced a more severe shortage in 2023, and emerging permethrin resistance is increasing treatment demand globally.
If you're having trouble finding permethrin at a local pharmacy, medfinder contacts pharmacies near you to find which ones can fill your prescription, then texts you the results — saving you hours of phone calls.
Permethrin is not a controlled substance and has no DEA scheduling requirements. Any licensed prescriber in the US can prescribe it without special registration or limitations. The OTC 1% lotion requires no prescription at all.
Primary care physicians (family medicine, internal medicine)
Dermatologists
Pediatricians (for children 2 months and older)
OB/GYNs (preferred for pregnant patients)
Nurse practitioners (NPs) and physician assistants (PAs) — in all 50 states
Urgent care providers
Infectious disease specialists (for complex or crusted scabies cases)
Permethrin is widely available through telehealth services since scabies and lice are diagnosed clinically. Platforms like Teladoc, MDLive, and PlushCare can issue prescriptions for permethrin 5% cream in most states within hours.
No. Permethrin is not a controlled substance and has no DEA scheduling. Any licensed healthcare provider — including primary care physicians, nurse practitioners, physician assistants, dermatologists, and pediatricians — can prescribe it without any special DEA registration or restrictions.
Permethrin prescriptions can be called in, e-prescribed, or issued via telehealth in all 50 states. There are no limits on the number of refills (though typically only one or two applications are needed), and pharmacies are not required to verify patient identity against DEA databases. The OTC 1% formulation requires no prescription at all.
Permethrin is well-tolerated with minimal systemic side effects due to its low (<2%) skin absorption. The most common reactions are local and temporary:
Burning and stinging at application site (~10% of patients)
Itching (pruritus) — can persist up to 4 weeks after scabies treatment; does not indicate treatment failure
Redness (erythema) at application site (1–2%)
Numbness or tingling (paresthesia)
Mild skin rash at the application site
Severe allergic reaction (hypersensitivity) — rare; signs include hives, swelling, difficulty breathing, dizziness. Discontinue immediately and seek emergency care.
Contraindicated in patients with known allergy to pyrethrins, pyrethroids, or chrysanthemums.
Know what you need? Skip the search.
Oral Ivermectin (Stromectol)
Prescription oral tablet for scabies (200 mcg/kg x2 doses). Similar efficacy to permethrin at 2 weeks. Second-line or for treatment failure, crusted scabies, or institutional outbreaks.
Crotamiton (Eurax)
Prescription topical cream/lotion for scabies. Applied on 2 consecutive nights. Less effective than permethrin but provides antipruritic relief. Useful when permethrin is unavailable or fails.
Spinosad (Natroba)
Prescription topical for head lice. Effective against permethrin-resistant lice. Single application often curative. First-choice for suspected permethrin resistance.
Malathion 0.5% (Ovide)
Prescription topical for head lice. CDC-recommended when permethrin resistance is suspected. Apply to dry hair for 8-12 hours. Highly flammable — no hair dryers during use.
Prefer Permethrin? We can find it.
All systemic medications
minorPermethrin has no known severe, serious, moderate, or mild drug interactions with any other medications when used topically. Less than 2% is absorbed through intact skin, making clinically meaningful systemic interactions extremely unlikely.
Permethrin remains the gold standard for treating scabies and head lice in 2026 — highly effective, very safe, affordable, and available in both prescription and OTC formulations. The main challenges patients face are occasional pharmacy stockouts and, globally, emerging resistance in scabies cases.
If you've been prescribed permethrin and can't find it at a local pharmacy, try independent pharmacies, ask the pharmacist to order from their wholesaler (1–2 business days), or consider mail-order options. Always treat all household contacts simultaneously and wash clothing and bedding in hot water.
For help finding which pharmacy near you has permethrin in stock right now, medfinder contacts pharmacies on your behalf and texts you the results.
Medfinder Editorial Standards
Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
ChatGPT
Claude
Perplexity
Grok
Gemini