What are the instructions for using permethrin to treat body lice?

Permethrin Instructions for Body Lice

Body lice are treated with permethrin 1% cream rinse applied to affected areas and washed off after 10 minutes, though the primary treatment is addressing clothing and bedding hygiene rather than topical therapy alone. 1

Key Distinction: Body Lice vs. Other Lice

Body lice differ fundamentally from head and pubic lice because they live in clothing seams rather than on the body itself. 2 This means topical treatment is secondary to environmental measures. 2

Treatment Protocol

Topical Permethrin Application

• Apply permethrin 1% cream rinse to affected skin areas 1
• Leave on for 10 minutes, then wash off thoroughly 1
• Use warm (not hot) water to limit absorption through vasodilation 1

Essential Environmental Measures (Critical for Success)

• Machine wash all clothing and bedding in hot water, then machine dry using the heat cycle 1, 3
• Alternatively, dry-clean contaminated items 1
• Items that cannot be washed should be removed from body contact for at least 72 hours 1
• Personal hygiene measures are essential for successful treatment - regular bathing and changing of clothes 2

Special Populations

Pregnant and Lactating Women

• Permethrin is the preferred and safe treatment option 1, 3
• Avoid lindane in this population due to neurotoxicity risk 1

Children

• Permethrin 1% is safe for use 1
• Lindane should not be used in children under 2 years old 1

Follow-Up and Treatment Failure

• Evaluate after 1 week if symptoms persist 1
• Re-treatment may be necessary if live lice are found 1
• If permethrin fails, consider oral ivermectin (200 mcg/kg, repeated in 2 weeks) as an alternative 4, 5

Common Pitfalls to Avoid

• Treating only the body without addressing clothing and bedding - this is the most common cause of treatment failure with body lice 2
• Applying permethrin to eyes - if eyelash involvement occurs, use occlusive ophthalmic ointment to eyelid margins twice daily for 10 days instead 1, 3
• Unnecessary fumigation of living areas - this is not required 1, 4
• Expecting immediate symptom resolution - pruritus may persist for up to 2 weeks after successful treatment due to hypersensitivity reaction 1

Contact Management

• Treat all close personal or household contacts within the preceding month 4, 3
• For body lice specifically, focus on persons sharing clothing or bedding 2