First-Line Treatment of Scabies: Structured Evidence-Based Approach
Scabies is an infestation that requires prompt, structured treatment to achieve full eradication. This protocol defines the first-line management approach and the criteria used to confirm clearance.
Clearance Goal
Treatment success is defined as no active lesions and no nocturnal pruritus at one week after the end of the treatment course.
Treatment Approach
The first-line protocol covers both topical and oral antiparasitic options, each delivered according to a structured schedule that includes a repeat or re-application step to ensure complete eradication.
Full regimen details — specific agents, timing, and re-treatment steps — are in the complete protocol ↓
References
DOI: 10.1111/jdv.14351
- Permethrin 5% cream applied head to toe and washed off after 8–12 h. The treatment must be repeated after 7–14 days.
- Oral ivermectin (taken with food) 200 micrograms/kg as two doses 1 week apart.
- Benzyl benzoate lotion 10–25% applied once daily at night on 2 consecutive days with re-application at 7 days.
- The infestation is considered cleared if 1 week after the end of treatment there are no manifestations of active scabies (no active lesions, no nocturnal pruritus).
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