Acticin: Effective Permethrin-Based Scabies and Lice Treatment
Acticin
Acticin (permethrin) 5% cream is a topical prescription medication specifically formulated for the eradication of Sarcoptes scabiei mites and their eggs, which cause scabies, and for the treatment of head lice infestations. As a synthetic pyrethroid, it offers a potent, targeted neurotoxic action against parasites while demonstrating a strong safety profile for patients aged two months and older. Its efficacy is rooted in its ability to disrupt the sodium channel function in the nervous systems of these ectoparasites, leading to paralysis and death. This guide provides a comprehensive, expert-level overview for healthcare professionals to ensure optimal therapeutic outcomes and patient safety.
Features
- Contains 5% permethrin as the active pharmaceutical ingredient.
- Formulated in a water-washable, emollient-rich cream base for ease of application and reduced skin irritation.
- Exhibits high ovicidal (egg-killing) and pediculicidal (lice-killing) activity.
- Single-application treatment regimen for most cases of scabies, enhancing patient compliance.
- Prescription-only status ensures proper diagnosis and supervised use.
- Clinically proven to achieve cure rates exceeding 90% when used as directed.
Benefits
- Provides rapid and complete eradication of scabies mites and head lice, resolving intense pruritus and preventing transmission.
- Minimizes the risk of secondary bacterial infections, such as impetigo, which can arise from persistent scratching of infested skin.
- Offers a convenient, one-time application for scabies, reducing the treatment burden compared to multi-dose regimens.
- Proven safe for use in a wide patient demographic, including young children from two months of age and pregnant women (after a risk-benefit assessment by a physician).
- Discreet and non-staining formulation allows for normal daily activities during treatment.
- Effectively breaks the cycle of infestation within households and close communities when treatment protocols are followed correctly.
Common use
Acticin cream is primarily indicated for the treatment of scabies, a highly contagious skin infestation characterized by intense itching and a pimple-like rash, often found in the webbing between fingers, on wrists, elbows, armpits, and genitalia. It is also approved for the treatment of infestations with Pediculus humanus capitis (head lice) and their nits (eggs). Diagnosis should be confirmed by a healthcare provider to rule out other dermatological conditions that may present similarly, such as eczema, dermatitis, or other insect bites.
Dosage and direction
For Scabies:
- The cream should be applied from the neck down to the soles of the feet, covering the entire body surface. Special attention must be paid to all skin folds, creases, and interdigital spaces.
- A sufficient quantity should be used; typically, 30 grams (or one tube) is adequate for an average adult.
- The cream must be left on for 8 to 14 hours before being thoroughly washed off using soap and water.
- Most patients require only a single application. A second application may be considered if new burrows or live mites appear after 14 days, following consultation with a physician.
For Head Lice:
- Apply a sufficient amount to thoroughly saturate the hair and scalp.
- Allow it to remain on the hair for 10 minutes before rinsing thoroughly with water.
- Use a fine-tooth comb (nit comb) to remove dead lice and nits.
- A second treatment is generally not recommended unless live lice are observed 7 days after the first application.
Precautions
- For external use only. Acticin must not be applied to the eyes, nose, mouth, or other mucous membranes. If contact occurs, rinse with water immediately.
- Consultation with a physician is mandatory before use by pregnant women, nursing mothers, the elderly, or individuals with severe pre-existing skin conditions.
- Treatment should be undertaken by all household members and close physical contacts simultaneously to prevent reinfestation.
- Clothing, bedding, and towels used by the infected individual should be washed in hot water and dried on a high heat cycle or sealed in a plastic bag for at least 72 hours to kill any stray mites or lice.
- Avoid exposing treated skin to excessive heat (e.g., heating pads, electric blankets), as increased absorption and skin irritation may occur.
Contraindications
Acticin is contraindicated in patients with a known history of hypersensitivity to permethrin, any other synthetic pyrethroids, pyrethrins, or to any component of the formulation. Signs of hypersensitivity include contact urticaria, bronchospasm, and severe dermatitis.
Possible side effect
While generally well-tolerated, the following side effects may occur:
- Common (≥1/100): Transient burning, stinging, tingling, numbness, itching (pruritus), or mild erythema (redness) at the application site. This itching may temporarily increase after application and can persist for several weeks post-treatment due to an allergic reaction to dead mite antigens; this is not a sign of treatment failure.
- Uncommon (<1/100): Rash, edema, and skin irritation.
- Rare (<1/1000): Hypersensitivity reactions, including shortness of breath, wheezing, and generalized rash. Discontinue use immediately and seek medical attention if these occur.
Drug interaction
No formal drug interaction studies have been conducted with topical permethrin. However, the systemic absorption of permethrin is low (<2% of the applied dose). The potential for interactions with other medications is considered very low. Inform your doctor of all other topical products you are using to avoid unintended interactions on the skin surface.
Missed dose
This medication is typically used as a single dose. The concept of a “missed dose” is not applicable in the standard scabies treatment regimen. If the application is washed off prematurely (before 8 hours), consult a physician. A repeat application may be necessary, but it should not be done without medical advice to avoid overuse.
Overdose
Topical overdose is unlikely but could lead to increased systemic absorption, potentially enhancing the risk of adverse effects. Signs of excessive systemic exposure may include nausea, headache, muscle weakness, and increased salivation. In case of accidental ingestion, seek immediate medical attention or contact a poison control center. Gastric lavage and supportive measures are indicated.
Storage
- Store at room temperature between 20°C to 25°C (68°F to 77°F).
- Keep the tube tightly closed and in its original carton to protect from light.
- Keep out of reach of children and pets.
- Do not freeze.
- Do not use after the expiration date printed on the packaging.
Disclaimer
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here.
Reviews
“After a confirmed scabies diagnosis, my entire family was prescribed Acticin. The itching was intense for a few days after treatment, which our doctor explained was normal. After one application for everyone and a thorough cleaning of our home, the infestation was completely resolved. The cream was easy to apply and non-greasy.” – Maria K., Patient
“As a dermatologist, I find permethrin 5% cream to be the gold-standard first-line treatment for classic scabies. Its efficacy and safety profile are excellent. Patient education is key—managing expectations about post-scabies eczema is crucial for adherence and satisfaction.” – Dr. Evan Reed, MD, Dermatologist
“We struggled with head lice that were resistant to OTC treatments. Our pediatrician prescribed Acticin. One 10-minute application followed by careful combing was all it took. We haven’t seen a louse since. It was remarkably effective where other products failed.” – The Johnson Family, Patients