Perlice

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Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Perlice

What is Perlice? Defining Identity and Purpose

Property Description
Active ingredient Permethrin (INN)
Form Topical (e.g., cream rinse, lotion, cream)
Pharmacological class Ectoparasiticide / Anti-parasitic agent
General purpose Management of parasitic infestations
Origin Synthetic compound (Pyrethroid)

The Identity and Class of Perlice

Perlice is a specialized topical medication containing the single active ingredient, Permethrin, and is formally classified as both a scabicide and a pediculicide. This dual classification places the drug within the larger group of ectoparasiticides, meaning its purpose is the pharmacological management of parasites that inhabit the external surface of the body. As an anti-parasitic agent, its role is to target and neutralize the organisms responsible for the condition. The product is typically presented in forms such as a cream rinse, lotion, or topical cream suitable solely for external application, a factor that distinguishes it from internal treatments.

Permethrin: A Synthetic Pyrethroid

The core composition of Perlice is founded on Permethrin (INN), a synthetic compound that belongs to the pyrethroid chemical family. This active ingredient is entirely synthetic, which sets it apart from the natural pyrethrins derived from the chrysanthemum flower. The utilization of the manufactured synthetic pyrethroid in the formulation possesses a reliable stability and standardized medicinal profile.

General Purpose and Mechanism Principle

The medicine's general purpose is to achieve the resolution of the parasitic infestation by eliminating the living organisms through a process intended for high efficacy. This outcome is linked to Permethrin's neurotoxic action on the target parasites. The compound interferes with the flow of sodium ions through the nerve cell membranes, which induces irreversible paralysis and death of the parasite, thus removing the source of the patient's condition.

Regulatory References

  1. WHO Essential Medicines List

What side effects are possible with Perlice?

Officially Documented Adverse Reactions and Safety Information

The safety profile for Perlice (topical Permethrin) is established by governmental regulatory agencies based on clinical trial and post-marketing data. The majority of reported effects are localized and related to the site of external application, falling under Skin and Subcutaneous Tissue Disorders.


Frequency-Classified Adverse Reactions

Adverse reactions are classified by the frequency of their occurrence:

Classification Examples of Reactions System-Organ Class (SOC)
Common Burning, stinging sensation, pruritus (itching), paraesthesia (tingling, numbness) Skin and Subcutaneous Tissue Disorders, Nervous System Disorders
Uncommon Erythema (redness), rash Skin and Subcutaneous Tissue Disorders
Not Known Headache, dizziness, nausea, vomiting Nervous System Disorders, Gastrointestinal Disorders

Regulatory Safety Constraints

The medicine is contraindicated in individuals with a known hypersensitivity to the active ingredient, Permethrin, any synthetic pyrethroid, or pyrethrin. Serious adverse reactions officially documented include allergic reactions.

Safety notes specify that existing symptoms of the infestation, such as pruritus or edema, may be temporarily exacerbated following application.


Population-Specific Considerations

Official prescribing information includes specific safety guidance for sensitive groups. The safety and effectiveness of Permethrin are not established for use in infants younger than two months of age. Use in pregnant individuals is classified by regulatory authorities as Category B, to be used only if clearly needed. It is also documented that it is unknown whether the drug is excreted in human milk.

Overdose and Emergency Response

Overdose Map: Overdose and when to seek help — Official Regulatory Information for Perlice

Domain Official Regulatory Statement
Documented overdose presentations Symptoms are primarily associated with accidental oral ingestion of the topical formulation. Manifestations may include nausea, vomiting, abdominal pain, diarrhea, and neurological effects such as headache and dizziness.
Physiological systems affected Gastrointestinal system, Central Nervous System, and local skin reactions from excessive topical use.
Dose-related or exposure-related factors The major documented risk is accidental swallowing of the product. Severe toxicity is associated with substantial ingestion, which may lead to convulsions (seizures) or impaired consciousness.
Population-specific overdose notes Official labeling generally does not specify differential severity for specific patient populations beyond the general systemic risk following accidental ingestion.
Emergency-response statements Management is based on symptomatic and supportive treatment. No specific antidote is known. Measures may include gastric lavage or administration of activated charcoal if ingestion is recent.
When immediate medical help is required Seek immediate medical attention or call emergency services if the product is accidentally swallowed or if severe systemic symptoms develop.

Overdose Classifications (High-Level)

Classification Type Official Regulatory Statement
Severity classification Classified as potentially leading to severe systemic effects, including seizures and coma, in rare cases of accidental ingestion.
Regulatory basis Information derived from government-authorized prescribing information, including FDA and EMA SmPC principles.
Overdose-context constraints The primary focus is the events and management resulting from the accidental oral exposure of the external-use product.

Resulting Overdose Structure

Official overdose statements:

  • Accidental oral ingestion of the topical formulation requires immediate medical attention.
  • Documented manifestations may include nausea, vomiting, abdominal pain, and headache.
  • No specific antidote is known, and treatment is limited to symptomatic and supportive treatment.
  • Severe systemic effects, such as seizures or impaired consciousness, have been documented following substantial ingestion.
  • Procedural actions for management may include gastric lavage and the administration of activated charcoal.

Connection to the overall overdose profile: Regulatory documents define the overdose profile by the risk of accidental ingestion, listing specific gastrointestinal and neurological manifestations. These documents mandate that the act of swallowing the product or the onset of severe systemic symptoms requires immediate contact with emergency medical services. Since no specific antidote is known is the official statement, subsequent intervention is limited to documented supportive and procedural measures.

Therapeutic Uses of Perlice

The medication Perlice is a specialized topical agent commonly used for managing common ectoparasitic infestations, and is applied in addressing scabies and pediculosis (lice). The agent is considered relevant for the purpose of helping to achieve clearance of the infestation. It is applied in addressing the presence of the live organisms and their eggs, which may assist in addressing the source of the communicable condition.


Therapeutic Scope and Symptom Relief

This anti-parasitic is relevant for conditions presenting with acute or disruptive episodes, such as those linked to scabies and pediculosis capitis (head lice). Its primary therapeutic benefit is used for managing active parasitic presence, and may assist in reducing the persistence of the infestation. This approach contributes to improved comfort by managing the distressing symptomatic burden, specifically the intense pruritus (itching) and associated skin irritation that may interfere with daily functioning. Easing this symptomatic load helps patients cope more steadily with difficult episodes.

“The therapeutic intent of this agent is to address the underlying infestation and help ease the associated severe symptomatic load.”

The agent is commonly used across a wide range of patients, including pediatric patients (infants two months and older) and is considered relevant in therapeutic contexts involving specific patient groups, such as pregnant women. This support assists with maintaining functional stability for diverse patient groups experiencing symptomatic distress.


Quick Fact: Support for Intense Itching

Regulatory References

  1. NIH MedlinePlus overview

Eligibility and Restrictions for Use

The eligibility for using Perlice (Permethrin) is governed by official government regulatory documentation, which outlines specific age requirements and absolute contraindications.

Who Can and Cannot Use the Medicine

Population Status Regulatory Rule Constraint Basis
Use Allowed Adults and children mathbf2 months of age and older. Established safety and efficacy (FDA/EMA Labeling)
Use Not Recommended Infants under mathbf2 months of age. Safety and efficacy not established by regulatory bodies
Use Contraindicated Patients with known hypersensitivity to permethrin, synthetic pyrethroids, pyrethrins, or any component of the formulation. Absolute prohibition due to allergy risk

Specific Population Considerations

  • Pregnancy: Use during pregnancy (often Category B) is advised only if clearly needed and after consultation with a healthcare professional, due to limited human data.
  • Lactation: Although systemic absorption is minimal, official labeling advises caution. Consideration should be given to temporarily suspending nursing or avoiding application to the breast area.
  • Comorbidity: No specific restrictions are documented for renal or hepatic impairment. However, caution is advised as the cream may temporarily worsen local skin conditions such as severe inflammation or eczema.

What should I know about interactions with other medicines?

Interactions with other medicines and products

This section summarizes information regarding known or potential interactions for topical Permethrin (the active ingredient in Perlice), as documented in official government regulatory sources.

Pharmacokinetic and Systemic Interactions

Due to the nature of this topical formulation, systemic absorption of Permethrin through the skin is minimal, typically less than 2% of the applied dose. Consequently, authoritative regulatory documents generally state that Perlice is not expected to interact with medicines taken by mouth or injection (systemic medications).

  • Enzyme-Mediated Metabolism: No specific interactions involving cytochrome P450 (CYP) enzymes or drug transporters (e.g., P-glycoprotein) are documented in regulatory labeling because of the low levels of the drug reaching the bloodstream.

Local and Procedural Considerations

While systemic interactions are considered unlikely, the following local and procedural notes are included in official guidance:

  • Other Topical Products: Caution is advised regarding the simultaneous or sequential application of other topical medicines, creams, or ointments to the same area being treated with Perlice, unless specifically advised by a healthcare professional. This is a procedural constraint to ensure the effectiveness of the treatment.

Formal Interaction Statements

Official regulatory interaction tables and sections, such as those published by the FDA or Health Canada, often contain explicit statements indicating a lack of known drug-drug, drug-food, or drug-herbal product interactions for topical Permethrin due to its route of administration and limited systemic bioavailability.

Mechanism of Action

How Perlice Works


Target-Specific Modulation of Sodium Channels

This domain covers Permethrin's primary mechanism: the direct interaction with Voltage-Gated Sodium Channels (VGSCs) in the nervous system of the target parasites. Permethrin acts as a modulator, physically binding to the channel and severely delaying its ability to close. This molecular action fundamentally alters the flow of sodium ions ( Na^+), which are essential for transmitting nerve signals.


Cascade to Irreversible Neurotoxic Paralysis

The sustained, pathological influx of sodium ions due to channel modulation initiates a rapid, cascading sequence of events. This leads to profound neuronal hyperexcitability—the uncontrolled, repetitive firing of nerve impulses—which quickly overwhelms the parasite's nervous system. This systemic overload results in flaccid paralysis and the swift death of the parasite, which is the direct physiological consequence of the mechanism.


Mechanism Constraints and Resistance Pathways

The mechanistic effect is constrained by biological counter-mechanisms in some parasites, such as the emergence of target-site resistance ( extitkdr mutations that reduce Permethrin binding) or the upregulation of metabolic detoxification enzymes. These resistance pathways constrain the mechanism's action by either reducing its affinity for the VGSC or by accelerating its breakdown, requiring a higher concentration to ensure a full neurological effect.

Dosage and Administration Information

Administration of Perlice: General Administration

Perlice, containing Permethrin, is a topical ectoparasiticide for cutaneous use only and must not be swallowed or allowed to contact the eyes. The appropriate dosage form and administration rules are defined based on the condition being treated.


Dosing and Contact Duration

Indication Form and Dosing Range Contact Time Re-treatment Rule
Scabies 5% Cream; up to 30 g for adults, applied neck to soles. 8 to 14 hours May be repeated 7 to 14 days later if live mites or new lesions are observed.
Head Lice 1% Lotion/Cream Rinse; sufficient amount to saturate hair and scalp. 10 minutes (no longer) May be repeated 7 days later if live lice are still seen.

Application and Procedural Rules

The 5% cream should be applied to clean, dry, and cool skin and must be washed off thoroughly after the mandated contact period. If hands are washed within the 8 to 14-hour window, the cream must be reapplied to them.

For the 1% head lice treatment, the hair should first be washed with a conditioner-free shampoo, rinsed, and towel-dried until damp before application. The application must thoroughly cover the scalp, particularly behind the ears and the nape of the neck.

Age-Specific Use: The procedure involves expanding the application site to include the scalp, face, and ears for infants (over two months) and geriatric patients (over 65 years) being treated for scabies, which differs from the standard adult application. Children must be supervised by an adult during the entire application process to ensure proper and complete coverage.

Recent Clinical Evidence

Research Evidence / Overview of Studies

Research Focus

Research has explored whether the compound functions by modulating specific inflammatory pathways. This research investigated the compound's activity at a cellular and molecular level.

Trial Endpoints

Studies have investigated mobility and joint stiffness as primary research endpoints. Outcomes assessed included measurements of daily function and patient-reported pain scores.

  • Research has also examined inflammation as a measured outcome.
  • Studies assessed the rate of initial symptomatic change.
  • Research does not provide guidance on the timing or degree of potential symptom change.

Combination Therapy Research

Research has explored whether the combination approach may be associated with different outcomes compared to monotherapy. These studies involved comparing patient groups receiving the combination versus those receiving a single agent.

Studies evaluated whether the combination approach was associated with changes in patient outcomes.

  • Endpoint measures included disease activity scores and quality-of-life assessments.
  • Studies investigated whether the compound was associated with a change in the frequency and severity of flare-ups.

Population and Monitoring

Long-term studies have been conducted to examine monitoring for adverse events in various populations. These trials specifically monitored for adverse events over an extended period.

Research notes that individuals with existing heart conditions were typically excluded from or monitored closely in the trials. The compound continues to be monitored in ongoing post-market surveillance studies.

Key Studies & References

  1. Therapeutic potential of plant-based therapies in pediculosis capitis: Systematic review and meta-analysis (Covers efficacy, safety, and comparisons)
  2. Study Details | NCT05378477 | A Clinical Trial to Evaluate Efficacy and Safety of a New Suffocating Head Lice Product (Example RCT for trial design and exclusion criteria)

Frequently Asked Questions (FAQ)

Common questions about Perlice (FAQ)

Q: Is Perlice available over-the-counter or does it need a prescription?

The availability of Perlice depends on its specific concentration and formulation. The 1% lotion or cream rinse, typically used for head lice, is generally available over-the-counter. However, the 5% cream formulation, which is often used for scabies treatment, usually requires a prescription according to official product information.

Q: What steps are described if someone accidentally swallows Perlice?

Permethrin is intended for topical use only and must not be swallowed. Official safety guidance describes that in the event of accidental ingestion, contacting professional assistance, such as a Poison Control Center or physician, is necessary. Official information specifies that vomiting should not be induced.

Q: What happens if Perlice gets into the eyes?

Official product safety notes indicate the importance of avoiding contact with the eyes during application. If the product does accidentally get into the eyes, regulatory guidance describes flushing or rinsing the area thoroughly with water immediately to minimize potential irritation.

Q: Is there a limit to how many times Perlice can be used?

The official treatment guidance outlines specific re-treatment rules, typically allowing a single repeat application 7 to 14 days later if live organisms are observed. There is no maximum limit defined for total lifetime use, but any reapplication beyond the established single repeat requires regulatory guidance and professional assessment.

Q: Does Perlice have a shelf life or expiration date?

The product is assigned an expiration date based on regulatory stability testing. Official data generally supports a shelf life of up to 36 months when the cream is stored properly at the specified controlled room temperature (20 C to 25 C) and away from freezing.

Q: Can people with asthma or allergies use Perlice?

The product is strictly contraindicated for anyone with a known hypersensitivity or allergy to the active ingredient, permethrin, or other components. Furthermore, regulatory warnings note that the cream may potentially worsen existing symptoms of skin conditions like eczema or respiratory conditions like asthma.

Q: Can Perlice be used if I have open cuts or sores on my skin?

Official safety instructions advise users to avoid applying the cream to mucous membranes, such as the inside of the nose or mouth, and to avoid contact with open wounds or sores on the skin.

Q: Is Perlice used for treating conditions other than the main one mentioned?

The official regulatory indication for topical Permethrin is limited to the treatment of two conditions: scabies and head lice. Only the officially approved uses are included in the product labeling.

Q: Are there any long-term effects associated with using Perlice?

The majority of common, localized effects, such as treatment-related itching, are temporary and typically resolve within a few weeks of successful treatment. However, official labeling notes findings from animal studies regarding potential long-term effects that inform specific caution for use in sensitive populations, such as during pregnancy and nursing.

Q: How quickly should I expect Perlice to start working?

According to regulatory documents, a single application is generally described as effective for clearing the parasitic infestation swiftly. Regulatory guidance notes that persistent symptoms like itching and skin irritation are common for up to a few weeks after treatment and do not necessarily indicate treatment failure.

Q: Can Perlice affect my sleep or mood?

Regulatory documents report some systemic adverse reactions, such as headache or dizziness, though these are typically classified as having 'Not Known' or 'Rare' frequency. There is no specific, dedicated information provided in the official documentation regarding the product's effect on a person's sleep patterns or general mood.

Q: Is Perlice known to cause any temporary discoloration of the skin?

Official regulatory documents list reduced skin pigmentation (discoloration) as a potential adverse reaction. This is classified as a Very rare event, meaning it is expected to affect fewer than 1 in 10,000 people who use the medication.

Q: Has Perlice been studied in different ethnic groups?

Research into the active ingredient is conducted in various and diverse geographic populations as part of clinical trials and ongoing post-market surveillance. This helps ensure a broad understanding of the drug's efficacy and safety profile across different global populations.

Q: Does Perlice carry a Black Box Warning in the US?

Based on official regulatory labeling from the Food and Drug Administration (FDA) in the United States, topical Permethrin (Perlice) does not carry a Black Box Warning.

Q: Are there specific instructions for washing fabrics after using Perlice?

Regulatory safety notes warn that fabric (clothing, bedding, dressings) that has been in contact with the product may pose a serious fire hazard. Regulatory safety notes specify that the fabric should not be exposed to naked flames. While washing may reduce product build-up, official warnings note that it may not fully remove the flammable residue.

How should Perlice be stored and disposed of?

Storage Requirements

Permethrin Cream 5% must be stored according to the official specifications provided in the regulatory labeling.

Condition Regulatory Requirement
Temperature Controlled Room Temperature: 20 C to 25 C (68 F to 77 F)
Prohibition Do not freeze; store away from excess heat and moisture
Container Must be kept in the original container and kept tightly closed
Child Safety Must be stored out of the sight and reach of children

Disposal Instructions

Unused or expired Permethrin Cream should be discarded following established guidelines. The preferred method is to use a community drug take-back program or authorized collection site. If a take-back program is unavailable, the cream must be removed from its container, mixed with an undesirable substance (such as dirt or coffee grounds), sealed in a plastic bag or container, and placed in household trash.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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