A comparison of efficacy of single topical permethrin and oral ivermectin in the treatment of scabies


  • Munazza Saqib
  • Lamees Mehmood Malik
  • Muhammad Jahangir


Scabies, permethrin, ivermectin


Background Scabies is a common health problem worldwide. Among available topical treatment modalities, 5% permethrin is the most effective scabicide with few side effects. Ivermectin is the only oral scabicide available. It is effective, inexpensive and easy to administer with no known drug interactions and limited side effects. Objective To compare the efficacy of topical permethrin and oral ivermectin in treatment of scabies. Patients and methods In this quasi-experimental study, a total of 120 patients of scabies were enrolled and randomly divided in 2 groups of 60 each. Topical 5% permethrin whole body application for 10-12 hours and oral ivermectin as 200µg/kg were used in groups A and B, respectively. In both groups, history, examination and microscopy were carried out at day 0, 7 and day 14. Response to treatment was judged on following parameters: decrease in severity of pruritus, nonappearance of new lesions and absence of burrows. Each parameter was scored and sum total of individual scores was used to determine the efficacy. Results Mean age in group A (permethrin) was 29.45+9.72 years and in group B (ivermectin) was 31.45+12.78 years. In both groups, 66.7% patients showed complete cure. Conclusion There is no significant difference regarding efficacy of topical permethrin and oral ivermectin when used in treatment of scabies. 


Karthikeyan K. Treatment of scabies: newer perspectives. Postgrad Med J 2005;81:7-11.

Burns DA. Diseases caused by arthropods and other noxious animals. In: Burns T, Breathnach S, Griffiths C, editors. Rook’s Textbook of Dermatology. 7th ed. London: Blackwell Science; 2004. P. 33.37-41.

Ribeiro FA, Taciro E, Guerra MR, Ecklley CA. Oral ivermectin for the treatment and prophylaxis of scabies in a prison. J Dermatol Treat 2005;16:138-41.

Scheinfeld N. Controlling scabies in institutional settings; a review of medications, treatment models and implementation. Am J Clin Dermatol 2004;5:31-7.

Usha V, Nair TV. A Comparative study of oral ivermectin and topical permethrin cream in the treatment of scabies. J Am Acad Dermatol 2000;42:236-40.

Arndt KA, Bowrs KE, editors. Manual of Dermatologic Therapeutics with Essentials of Diagnosis. 6th ed. Philadelphia: Lippincott Williams and Wilkins; 2002.

Bukhari SA, Mann MA, Iqbal J. A randomized controlled trial to compare the efficiency of 1% lindane (scabene) cream and 5% permethrin (lotrix) cream for the treatment of scabies. J Pak Assoc Dermatol 2000;10;2-4.

Santoro AF, Rezae MA, Lee JB. Current trend in ivermectin usage for scabies. J Drugs Dermatol 2003;2:397-401.

Dourmishev AL, Dourmishev LA, Schwartz RA. Ivermectin: pharmacology and application in dermatology. Indian J Dermatol 2005;44:981-8.

Fawcett RS. Ivermectin use in scabies. Am Fam Physician 2003;68:1089-92.

Chouela E, Abeldaño A, Pellerano G, Forgia M. Equivalent therapeutic efficacy and safety of ivermectin and lindane in the treatment of human scabies. Arch Dermatol 1999;135:651-5.

Walton SF, Currie BJ. Problems in diagnosing scabies, a global disease in human and animal populations. Clin Microbiol Rev 2007;20:268-79.

Vorou R, Remoudaki HD, Maltezou HC. Nosocomial scabies. J Hosp Infect 2007;65:9-14.

Strong M, Johnstone PW. Update of: interventions for treating scabies. Cochrane Database Syst Rev 2007 Jul 18; (3):CD000320.

Madan V, Jaskiran K, Gupta U, Gupta DK. Oral ivermectin in scabies patients: a comparison with 1% topical lindane lotion. J Dermatol 2001;28:481-4.

Elgart ML, Cost benefit analysis of ivermectin, permethrin and benzyl benzoate in the management of infantile and childhood scabies. Expert Opin Pharmacother 2003;4:1521-4.

Meinking TL, Taplin D, Hermida JL et al. The treatment of scabies with ivermectin. N Engl J Med 1995;333:26-30.

Abedin S, Narang M, Gandhi V, Narang S. Efficacy of permethrin cream and oral ivermectin in treatment of scabies. Indian J Pediatr 2007;74:915-6.

Akhtar SJ, Maan MA, Iqbal J, Kapadia N. Treatment of scabies simplified. J Pak Assoc Dermatol 2007;17:240-9.

Aubin F, Humbert P. Ivermectin for crusted (Norwegian) scabies [letter]. N Engl J Med 1995;332:612.

Khan I, Yasmin R. Ivermectin in the treatment of scabies. J Pak Assoc Dermatol 2007;17:78-83.

Mounsey KE, Holt DC, McCarthy J, Walton SF. Identification of ABC transporters in Sarcoptes scabiei. J Med Entomol 2007;44:1054-63.




How to Cite

Saqib M, Malik LM, Jahangir M. A comparison of efficacy of single topical permethrin and oral ivermectin in the treatment of scabies. J Pak Assoc Dermatol [Internet]. 2017Jan.4 [cited 2024Feb.26];22(1):45-9. Available from: https://www.jpad.com.pk/index.php/jpad/article/view/900



Original Articles

Similar Articles

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)

1 2 3 > >>