Acticin: Targeted Relief for Scabies Infestations
Acticin (permethrin) 5% cream is a topical scabicidal medication prescribed for the eradication of Sarcoptes scabiei mites and their eggs. Formulated with precision, this neurotoxic agent selectively targets arthropod parasites while maintaining a favorable safety profile for human use. Its mechanism involves disrupting sodium channel kinetics in the neuronal membranes of mites, leading to paralysis and death. Clinically validated and widely recommended in dermatological guidelines, Acticin represents a first-line therapeutic option for confirmed scabies infestations across diverse patient populations, including pediatric and geriatric cohorts when appropriately indicated.
Features
- Contains 5% permethrin as the active scabicidal agent
- Topical cream formulation for direct cutaneous application
- Rapidly absorbed through the exoskeleton of arthropods
- Demonstrates ovicidal activity against scabies eggs
- Minimal systemic absorption in humans when applied correctly
- Single-use typically sufficient for most infestations
- Available by prescription following clinical diagnosis
Benefits
- Provides clinically demonstrated eradication of scabies mites within 24 hours of application
- Breaks the transmission cycle of scabies infestations in household and community settings
- Alleviates intense pruritus associated with mite infestation typically within days
- Minimizes risk of secondary bacterial infections from excoriation
- Reduces environmental contamination and spread to contacts
- Offers convenient single-application protocol for most patients
Common use
Acticin is primarily indicated for the treatment of scabies infestations caused by the mite Sarcoptes scabiei var. hominis. The medication is appropriate for both classic scabies presentations and more challenging cases including crusted (Norwegian) scabies, though the latter may require repeated applications under medical supervision. Healthcare providers may also consider Acticin for off-label applications such as pediculosis pubis (pubic lice) when standard treatments are contraindicated or ineffective. Diagnosis should be confirmed through microscopic identification of mites, eggs, or fecal pellets whenever possible, though empirical treatment may be initiated based on characteristic burrows, papules, and nocturnal pruritus in endemic settings.
Dosage and direction
For scabies treatment: Thoroughly massage Acticin cream into the skin from the chin down to the soles of the feet, paying particular attention to areas between fingers and toes, wrists, axillae, external genitalia, and beneath nail plates (which should be trimmed short). Apply a thin layer to all skin surfaces, not merely visible lesions. In infants and elderly patients, application may include the face and scalp if these areas are involved, avoiding direct contact with eyes and mucous membranes.
Leave the cream on for 8-14 hours before washing off thoroughly with soap and water. A single application is usually sufficient, but a second treatment after 7-14 days may be recommended if new burrows or mites appear. For crusted scabies: Typically requires 2-3 applications at weekly intervals combined with keratolytic therapy. Nail involvement necessitates application beneath nail edges.
Precautions
- Perform patch testing in patients with known sensitivity to chrysanthemums or other pyrethroids
- Use caution in patients with pre-existing seizure disorders due to theoretical neurotoxicity risk
- Avoid application to acutely inflamed or broken skin as absorption may increase
- Do not apply immediately after hot baths as increased blood flow may enhance absorption
- Wear gloves when applying to another person to prevent accidental exposure
- Launder all clothing, bedding, and towels used within 48 hours before treatment in hot water
- Sexual partners and household members within the previous month typically require simultaneous treatment
- Monitor for treatment failure which may indicate resistance, reinfestation, or incorrect diagnosis
Contraindications
- Documented hypersensitivity to permethrin, other pyrethroids, or pyrethrins
- History of severe allergic reaction to any component of the formulation
- Concurrent use with other topical scabicidal agents without medical supervision
- Application to neonates under 2 months of age (safety not established)
- Active cutaneous tuberculosis, varicella, or vaccinia infections at application sites
Possible side effect
Most common reactions are mild and transient, including:
- Temporary burning, stinging, or tingling at application site (15-30% of patients)
- Pruritus, erythema, or mild edema (typically resolves within days)
- Transient numbness or increased itching paradoxically after treatment
Less frequently reported:
- Contact dermatitis or allergic reactions in sensitive individuals
- Headache, dizziness, or mild respiratory irritation from vapor inhalation
- Rash extending beyond original application sites
- Paresthesia that may persist for several weeks
Rare but serious:
- Seizures (case reports, typically with misuse or overapplication)
- Severe allergic reactions including angioedema or bronchospasm
Drug interaction
No clinically significant pharmacokinetic drug interactions have been documented with topical permethrin. Theoretical considerations include:
- Potential additive neurotoxicity with other neurotoxic agents
- Possible enhanced absorption when used concurrently with occlusive dressings
- Reduced efficacy when applied immediately after bathing with oil-based products
- No known interactions with systemic medications due to minimal absorption
Missed dose
As Acticin is typically administered as a single application, the concept of “missed dose” does not apply in the conventional sense. If the application is washed off prematurely (before 8 hours), reapplication may be considered if consulted with a healthcare provider. For prescribed multiple applications in crusted scabies: If a scheduled follow-up application is missed, apply as soon as remembered unless it is nearly time for the next scheduled application. Do not double apply.
Overdose
Topical overdose may occur through excessive application or accidental ingestion. Symptoms may include:
- Increased skin reactions: severe erythema, burning, or blistering
- CNS effects: dizziness, headache, fatigue, muscle twitching
- Gastrointestinal distress if ingested: nausea, vomiting, abdominal pain
- In severe cases: seizures, respiratory difficulty
Management: Remove cream by thorough washing with soap and water. Provide supportive care. For ingestion, gastric lavage may be considered if presented early. There is no specific antidote; manage symptoms appropriately. Seek immediate medical attention for significant ingestion or severe reactions.
Storage
- Store at controlled room temperature (15-30°C or 59-86°F)
- Keep tube tightly closed when not in use
- Protect from excessive heat and direct sunlight
- Do not freeze
- Keep out of reach of children and pets
- Discard any unused product after treatment completion
- Do not transfer to other containers
Disclaimer
This information provides a comprehensive overview of Acticin but does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for personalized recommendations based on your specific medical situation. Never disregard professional medical advice or delay seeking it because of information contained herein. The manufacturer and distributors accept no liability for any outcomes resulting from the use of this product contrary to prescribing information or without proper medical supervision.
Reviews
Clinical studies demonstrate efficacy rates of 85-95% with single application of permethrin 5% cream. In a randomized controlled trial of 467 patients, permethrin showed significantly higher cure rates at 28 days (91.2%) compared to crotamiton (63.3%) and lindane (86.6%). Dermatological guidelines consistently rank permethrin as first-line therapy due to its favorable efficacy-to-safety profile. Patient-reported outcomes indicate high satisfaction with rapid symptom relief, though some note the temporary burning sensation upon application. Treatment failures are typically associated with improper application, reinfestation from untreated contacts, or rare resistance patterns.