Comparison of efficacy of oral ivermectin and topical permethrin 5% in the treatment of scabies


  • Maimona Ilyas Department of Dermatology, Fatima Jinnah Medical University, Lahore
  • Atif Shahzad Department of Dermatology, Allama Iqbal Medical College, Lahore
  • Saadiya Siddiqui Department of Dermatology, Services Hospital, Lahore
  • Mohsina Awais Department of Dermatology, Fatima Jinnah Medical University, Lahore
  • Maryam Qayyum Department of Dermatology, Fatima Jinnah Medical University, Lahore
  • Nadia Ali Azafar Department of Dermatology, Gujranwala Medical College, Gujranwala


Scabies, oral ivermectin, permethrin, efficacy, safety, side effects


Background Scabies an ectoparasitic infection caused in humans by the sarcoptes scabiei var.hominis.Ivermectin, an antiparasitic agent effective against a variety of ectoparasites and endoparasites . Permethrin an insecticide, applied topically kills the mite and its eggs, although patients may still experience some itching for several weeks. Objective: To compare the efficacy of oral ivermectin and topical permethrin 5% in treatment of scabies. Methadology : It was a randomized controlled trial conducted at Dermatology Department; Sir Gangaram Hospital Lahore / Fatima Jinnah Medical University Lahore. Sixty enrolled patients  after informed consent were divided in 2 groups i.e. group-A and group-B. In group-A ,cases were treated with Tab ivermectin orally in dose of 200mcg/kg at day 0 and in group-B all cases were treated with topical permethrin 5% at day 0.The lesions were examined and compared with baseline clinical grading and itch grading scores .The cured patients were provided antihistamines for further 1 week if itching is  moderate to severe.Efficacy  was determined after one week of tretment. Results: Mean age in patients who recieved Permethrin 5 % was 41.67 ± 10.35 years and those received Ivermectine mean age was 39.67 ± 12.38 years. In Permethrin 5% group, 22(73.3%) cases showed efficacy and Ivermectine group  8(26.7%) cases showed efficacy (p-value < 0.05). Permethrin (5%) remained more efficacious. Conclusion:   Scabies can be treated with permethrin 5% to achieve higher cure, by doing so we can improve patient’s quality of life. Keywords: Scabies, oral ivermectin, permethrin, efficacy, safety, side effects     


Sunderkötter C, Wohlrab J, Hamm H. Scabies: Epidemiology, Diagnosis, and Treatment. Dtsch Arztebl Int. 2021;118(41):695-704. doi:10.3238/arztebl.m2021.0296

Zhang W, Zhang Y, Luo L, et al. Trends in prevalence and incidence of scabies from 1990 to 2017: findings from the global Burden of disease study 2017. Emerg Microbes Infect. 2020;9(1):813-6. doi:10.1080/22221751.2020.1754136

Ahmad HM, Abdel-Azim ES, Abdel-Aziz RT. Clinical efficacy and safety of topical versus oral ivermectin in treatment of uncomplicated scabies. Dermatol Ther. 2016;29(1):58-63.

Seetan K, Rashdan Y, Alsharei A, et al. Impact of socio-demographic factors on knowledge, attitude and practices toward scabies among syrian refugees in Jordan: A prospective cross sectional study. Ann Med Surg (Lond). 2021;69:102738.

Thompson R, Westbury S, Slape D. Paediatrics: how to manage scabies. Drugs Context. 2021;10:2020-12-3.


Engelman, D., Yoshizumi, J., Hay, RJ et al. The 2020 international alliance for the control of scabies consensus criteria for the diagnosis of scabies. Br J Dermatol. 2020 183(5):808-20.

Welch E, Romani L, Whitfeld MJ. Recent advances in understanding and treating scabies. Fac Rev. 2021;10:28.


Rosumeck S, Nast A, Dressler C. Ivermectin and permethrin for treating scabies. Cochrane Database Syst Rev. 2018;4(4):CD012994. doi:10.1002/14651858.CD012994

Sharma R, Singal A. Topical permethrin and oral ivermectin in the management of scabies: a prospective, randomized, double blind, controlled study. Indian J Dermatol Venereolog Leprolog. 2011;77(5):581-6.

Ranjkesh MR, Naghili B, Goldust M, Rezaee E. The efficacy of permethrin 5% vs. oral ivermectin for the treatment of scabies. Ann Parasitol. 2013;59(4):189-94.

Goldust M, Rezaee E, Hemayat S. Treatment of scabies: Comparison of permethrin 5% versus ivermectin. J Dermatol. 2012;39(6):545-7.

Chhaiya SB, Patel VJ, Dave JN, Mehta DS, Shah HA. Comparative efficacy and safety of topical permethrin, topical ivermectin, and oral ivermectin in patients of uncomplicated scabies. Indian J Dermatol Venereol Leprol. 2012;78(5):605.

Mushtaq A, Khurshid K, Pal SS. Comparison of efficacy and safety of oral ivermectin with topical permethrin in treatment of scabies. J Pak Med Assoc. 2010;20(4):227-31.

Scheinfeld N. Controlling scabies in institutional settings. Am J Clin Dermatol. 2004;5(1):31-7.

Albakri L, Goldman RD. Permethrin for scabies in children. Can Fam Physician. 2010;56(10):1005-6.

Chouela E, Abeldaño A, Pellerano G, Hernández MI. Diagnosis and treatment of scabies. Am J Clin Dermatol. 2002;3(1):9-18.




How to Cite

Maimona Ilyas, Atif Shahzad, Saadiya Siddiqui, Mohsina Awais, Maryam Qayyum, Ali Azafar N. Comparison of efficacy of oral ivermectin and topical permethrin 5% in the treatment of scabies. J Pak Assoc Dermatol [Internet]. 2023Mar.5 [cited 2024May20];33(1):132-6. Available from:



Original Articles

Most read articles by the same author(s)