Question:

Dear Pharmacist,

I wonder if this instruction: “apply all over the body from head downward to toes” in the package insert of Permethrin cream, Lindane, Benzyl Benzoate or other topical products for killing scabies includes the application of those products on genitalia area,rectal area and nipple as well in women. Should the user avoid these parts or is it okay to apply?

Answer:

All of the scabicides including Pyrethrins (Permethrin) Lindane 1% lotion and Benzyl Benzoate should be applied to all skin from the neck down.  This includes behind the ears, the nipples, the groin, male and female external genitalia, perianal skin, palms and soles, and the webbed skin between fingers and toes. 

It is important to apply these products to dry skin.  Wet skin allows for more rapid absorption, which could lead to toxicity Apply no sooner than 1 hour after a bath or shower to allow skin to dry completely.

These scabicides should not be applied to any mucous membranes, including the inner parts of the vagina, the urethral meatus (opening of the penis) or the anus. Uncircumcised males should discuss application of Lindane to the foreskin and underlying skin with their doctor prior to application. 

This answer was prepared in part by Bethany Loader, A Pharm.D candidate from The NetWellness.org College of Pharmacy.

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