The treatment for scabies involves several options, including first-line therapies, alternative treatments, and specific management for crusted scabies.
First-line therapy
- Permethrin 5% cream: Applied from head to toe and washed off after 8–12 hours, with a repeat application after 7–14 days
- Ivermectin: Administered orally at a dose of 200 mcg/kg with food, with a repeat dose after 7 days
- Benzyl benzoate 10–25% lotion: Applied once daily at night on two consecutive days, with a repeat application after 7 days
Alternative treatment options
- Malathion 0.5% aqueous lotion: Considered as an alternative treatment option
- Ivermectin 1% lotion: Another alternative treatment
- Sulfur 6–33% cream, ointment, or lotion: Applied on three successive days
- Synergized pyrethrins foam: Also considered as an alternative treatment
Management of crusted scabies
- Combination therapy: For patients with crusted scabies, a combination of topical permethrin (5% cream) or benzyl benzoate (25% lotion), repeated daily for 7 days then twice weekly until cure, and oral ivermectin 200 mcg/kg on days 1, 2, and 8 is recommended
Specific circumstances
- Pregnant patients: Benzyl benzoate and sulfur are recommended for use in pregnant patients due to their safety in this population
In conclusion, the treatment for scabies involves a variety of options, with permethrin 5% cream, oral ivermectin, and benzyl benzoate 10–25% lotion being the first-line therapies. Alternative treatments and specific management strategies are available for crusted scabies and pregnant patients.