Scabies treatment involves which regimen?

• A. Ivermectin alone
• B. Permethrin 5% cream applied from the neck to the feet, washed off after 8-14 hours; repeat in 7 days
• C. Oral antibiotics
• D. Antifungal cream for 14 days

Answer: (B)

Treating scabies hinges on eradicating the mites and their eggs with a potent scabicide applied to the skin, followed by a second dose to cover mites that hatch after the first treatment. The best regimen uses permethrin 5% cream applied to the entire body from the neck down to the feet, left on for about 8–14 hours, then washed off. A second application is given about a week later to ensure those that hatch after the first treatment are killed. This approach ensures full skin contact where mites burrow and accounts for the life cycle, so reinfestation is minimized. Alternatives exist, like oral ivermectin, but the described topical regimen is the standard when using permethrin. Antifungal or antibiotic creams don’t address the mites and aren’t appropriate for treating the infestation.