Among them 5% permethrin is the most effective scabicide
with fewer side effects.
Permethrin 5% is an effective topical scabicide used commonly.5,11 Limiting factors are its high treatment cost along with emerging drug resistance.8
Ivermectin is the only available oral scabicide.2,5,6 It is a synthetic, macrolide antihelminthic being used in various parasitic disorders like onchocerciasis and filariasis.1,7
Exclusion criteria included: pregnant or lactating patients, hypersensitivity to permethrin or ivermectin, prior use of topical or systemic scabicide in last 4 weeks, patients on radiotherapy, steroids or other immunosuppressive drugs for any systemic or cutaneous indication.
Neurotoxicity associated with appropriate use of the scabicide is rare and appears to involve those patients--infants, children, the malnourished, and the elderly--in whom concomitant factors increase cutaneous absorption.[6-8] We report a case of lindane poisoning in a 38-year-old prisoner with the human immunodeficiency virus (HIV).
Repeated treatment with a scabicide and use of sequential agents may be necessary.
(Trade Names-US) Pregnancy Category * 5% permethrin cream B (Actin [R], Nix [R], Elimite [R]) 1% lindane lotion or B cream 10% crotamiton cream C or lotion (Eurax [R]) 2%-10% sulfur in C petrolatum ointments 10%-25% benzoyl None benzoate lotion 0.5% malathion lotion B (Ovide [R]) (1% shampoo is unavailable in US) Ivermectin C (Stromectol [R]) (0.8% lotion is unavailable in US) Scabicides
(Trade Names-US) Dosing Schedules 5% permethrin cream Apply from neck (Actin [R], Nix [R], down; wash off after Elimite [R]) 8-14 hours.
Drug resistance to topical scabicides is occurring.
* Apply scabicides from the neck down over the entire body, especially unaffected intertriginous areas of the skin.
(3) When symptoms or signs persist, evaluation should ensue for faulty application of topical scabicides
and for treatment failure.