Topical permethrin better than oral ivermectin

A randomized trial compared oral ivermectin with 5% permethrin for treating scabies in index cases and household clusters of up to eight people¹.

Ivermectin 200 µg/kg was taken with food on days 0 and 10, while permethrin was applied head-to-toe, including hair, genitalia, and children’s faces, left on overnight, and washed off after at least eight hours. Emollients and textile decontamination were advised. Children under 15 kg received permethrin only. 

Cluster-level cure rates were 71.8% with ivermectin versus 88.5% with permethrin, favouring permethrin.

The adults did not get facial permethrin. Remember to apply permethrin after handwashing.

Reference:

Oral ivermectin versus 5% permethrin cream to treat children and adults with classic scabies: multicentre, assessor blinded, cluster randomised clinical trial BMJ (2026)

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