Table 37.2Evidence of the Efficacy of Treatments for Scabies

Treatment and average wholesale priceStrongest evidenceNumber of people in studyResultsComments
Ivermectin oral US$5.20 (3 mg), given at 200 μg/kg, one or two dosesRandomized clinical trial (versus placebo) (Hegazy and others 1999)5579.3 percent cure with single dose of ivermectin 200 μg/kg versus 16.0 percent cure with placebo (p < 0.001)
  • Will treat concomitant strongy-loidiasis and onchocerciasis
  • Not approved for scabies by the U.S. Food and Drug Administration
  • Safety not established for children under five and pregnant women
Randomized clinical trial (versus permethrin) (Taplin and others 1991)85Single dose: 70.0 percent cure with ivermectin 200 μg/kg versus 97.8 percent cure with permethrin 5 percent
Second dose (two-week interval): 95.0 percent cure with ivermectin 200 μg/kg (statistically equivalent cure rates with ivermectin and permethrin used as single dose/application)
  • A single application of permethrin is superior to a single dose of ivermectin, which suggests that ivermectin may not be effective at all stages in the life cycle of the parasite
Ivermectin (topical)Open-label, prospective, single group (Macotela-Ruiz and Ramos 1996)32100 percent cure rate with two doses of ivermectin 1 percent solution at six weeks (no statistics reported)
  • Subjects treated with 1 percent ivermectin in a solution of propylene glycol at 400 μg/kg repeated once after one week
  • Well tolerated
Sulfur compounds (topical)
Ointment (480 grams) US$2.32
Open-label, nonrandomized, prospective cohort (Usha and Gopalakrishnan Nair 2000)10271 percent cure at four weeks using sulfur, 5 percent in children younger than 12 months, and 10 percent in children older than 12 months
  • Typically used as 5 percent to 10 percent in petrolatum
  • Messy and smelly
  • Must be applied repetitively for three nights
  • Mild local irritation may occur

Source: Authors.

μg = microgram; kg = kilogram; mg = milligram; p = probability.

From: Chapter 37, Skin Diseases

Cover of Disease Control Priorities in Developing Countries
Disease Control Priorities in Developing Countries. 2nd edition.
Jamison DT, Breman JG, Measham AR, et al., editors.
Copyright © 2006, The International Bank for Reconstruction and Development/The World Bank Group.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.