This product has been more thoroughly tested than any pediculicide ever introduced. The 1% permethrin cream rinse for head lice is available over the counter under the brand name NIX. Even the most pronounced skin effects were not disabling or a risk to the person's general health. In general, the reported skin effects of permethrin were uncommon and of a mild degree. Skin problems, ranging from mild itching to paresthesia and occasional erythematous or eczematous conditions, were reported in most of these trials rates varied from none to 7% to an isolated rate of 70% among a group of 10 subjects treated intensively for scabies with 5% permethrin cream. Selected Clinical Trials of Permethrin with Detailed Possible Side Effects. However, several subjects described a transient burning, stinging, or itching sensation. None of the 184 test subjects showed evidence of allergic contact dermatitis. Two weeks after the induction period, a challenge application was made on a previously untreated site and removed 72 hr later. The patches were kept dry and left on between applications. A dose of 0.2 mL was applied to the upper arm or back of each subject and placed beneath an occluded patch 3 times per week for 3 weeks. A 40% permethrin solution (technical-grade permethrin, 92.5%, and ethanol, 95%) was used. Snodgrass (1986) performed a Draize repeat insult patch test with 184 subjects who represented both sexes, ranged in age from 18 to 80, and were from all races. The changes caused by permethrin were substantially less than those caused by pyrethroids that contained an α-cyano group. Paresthesia typically developed within 30-60 min of application, was maximal within 8 hr, and slowly disappeared within 24 hr. Evaluation at 48 hr showed that all pyrethroids, including permethrin, produced altered skin sensation. Permethrin (0.13 mg/cm 2) was applied on five occasions to 4 cm 2 of an ear lobe the other lobe had distilled water applied. The production of skin paresthesia by various pyrethroids, including permethrin, has been examined in human volunteers (Flannigan and Tucker, 1985 Flannigan et al., 1985a,b). Their average exposure to permethrin was 3.8 mg/day, and none complained of skin irritation or other health problems. They were evaluated after 48 hr for their levels of permethrin exposure and for symptoms of toxicity. Although substantial exposures and absorption occurred, as shown by urinary excretion studies, no adverse health effect could be attributed to permethrin exposures in this group.Īmong 17 civilian volunteers exposed to 1% permethrin (cis/trans ratio, 25:75) via skin patches for up to 9 days, two complained of mild erythema and skin irritation (Pegum and Doughty, 1978).Ī group of 10 male volunteer soldiers wore uniforms impregnated with an aqueous solution of 0.2% permethrin (cis/trans ratio, 25:75) (Farquhar et al., 1981). Staff involved with bagging, mixing, or spraying a 5% preparation of permethrin (cis/trans ratio, 25:75) in Nigeria were evaluated with a questionnaire and urinalysis (Rishikesh et al., 1978). In addition, increased nasal secretions were noted among 13% of those exposed to the 25:75 mixture. Symptoms were twice as prevalent among workers exposed to a permethrin mixture of cis/trans isomers in a ratio of 25:75 than to a mixture of 40:60 skin and respiratory irritation was reported by 63% of those exposed to a cis/trans ratio of 25:75 and by 33% of those exposed to a ratio of 40:60. In another study of 87 Swedish nursery workers who were studied 1-2 months after the planting season, symptoms of itching and burning skin and respiratory and eye irritation were reported. In a study of six Swedish forestry workers who handled seedlings immersed in a 2% aqueous solution of permethrin (Kolmodin-Hedman et al., 1982), airborne permethrin concentrations ranged from 0.01 to 0.09 mg/m 3 No adverse effects of those exposures were noted. Little information exists on workers who manufacture permethrin.
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