Table 1. 2021 STI Treatment Guidelines: Ectoparasitic InfectionsTreatment of Scabies
Note: lindane was previously recommended as an alternative treatment for scabies, but lindane has been discontinued in the United States due to risk of neurotoxicity.
Recommended
for Treatment of Scabies
Permethrin 5% creamapplied to all areas of the body from the neck down and washed off after 8–14 hours
Permethrin 5% cream
Tradename:Acticin, Elimite, Nix
Recommended
for Treatment of Scabies
Ivermectin200 μg/kg body weight orally, repeated in 14 days*
Ivermectin
Tradename:StromectolNote: *Oral ivermectin has limited ovicidal activity; a second dose is required for eradication.
Recommended
for Treatment of Scabies
Ivermectin 1% creamapplied to all areas of the body from the neck down and washed off after 8–14 hours^
Ivermectin 1% cream
Tradename:SoolantraNote: ^Repeat treatment in 1 week if symptoms persist
Source: Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. Ectoparasitic infections. MMWR Recomm Rep. 2021;70(No. RR-4):1-187. [2021 STI Treatment Guidelines]
Table 2. 2015 STD Treatment Guidelines: Ectoparasitic InfectionsTreatment of Crusted Scabies
Substantial treatment failure might occur with a single-dose topical scabicide or with oral ivermectin treatment. Combination treatment is recommended.
Recommended
for Treatment of Crusted Scabies
Permethrin 5% creamtopical, full-body application to be repeated daily for 7 days then 2 times per week until cure
Permethrin 5% cream
Tradename:Acticin, Elimite, NixIvermectin200 ug/kg body weight on days 1, 2, 8, 9, and 15+
Ivermectin
Tradename:StromectolNote: Additional ivermectin treatment on days 22 and 29 might be required for severe cases
Recommended
for Treatment of Crusted Scabies
Tradename:
Ivermectin200 ug/kg body weight on days 1, 2, 8, 9, and 15+
Ivermectin
Tradename:StromectolNote: Additional ivermectin treatment on days 22 and 29 might be required for severe cases
Lindane should be avoided because of the risks for neurotoxicity with heavy applications or denuded skin