Ivermectin vs Permethrin for Scabies
Investigators evaluate household-level cure rates in dermoscopy-confirmed cases at day 28.
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By
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Kathryn Wighton
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March 3, 2026
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Clinical Scorecard: Ivermectin vs Permethrin for Scabies
At a Glance
| Category | Detail |
|---|
| Condition | Scabies |
| Key Mechanisms | Topical 5% permethrin cream vs oral ivermectin |
| Target Population | Adults and children weighing more than 15 kg with classic scabies |
| Care Setting | Multicenter hospitals |
Key Highlights
- Permethrin demonstrated higher clinical cure rates than ivermectin at day 28.
- Cure rates: 88.5% for permethrin vs 71.8% for ivermectin.
- Study involved 1,092 participants across 28 hospitals in France.
- Children under 15 kg received permethrin regardless of group assignment.
- Adverse events were reported in 9.9% of ivermectin and 13.6% of permethrin cases.
Guideline-Based Recommendations
Diagnosis
- Dermoscopy-confirmed classic scabies.
Management
- Topical 5% permethrin is preferred over oral ivermectin.
Monitoring & Follow-up
- Assess for resolution of pruritus, burrows, and papules or vesicles.
Risks
- Potential for cutaneous adverse events with both treatments.
Patient & Prescribing Data
Adults and children with classic scabies, excluding those with diffuse eczematization or extensive impetiginization.
Consider compliance, adherence, ease of use, and skin condition when prescribing.
Clinical Best Practices
- Use topical permethrin for higher cure rates.
- Monitor for adverse events post-treatment.
- Consider patient-specific factors in treatment decisions.
References
