Scabies Drug Summary

Last updated: 05 March 2026
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Other Dermatologicals

Drug Dosage Remarks
Ivermectin Classical Scabies
Children ≥15 kg and adults:
200 mcg/kg PO single dose
Repeat dose after 1-2 weeks
Crusted Scabies
In combination with topical scabicide
Children ≥15 kg and adults:
200 mcg/kg PO given in sequence below depending on severity:
3 doses: Days 1, 2 and 8
5 doses: Days 1, 2, 8, 9 and 15
7 doses: Days 1, 2, 8, 9, 15, 22 and 29		 Adverse Reactions
  • GI effects (diarrhea, nausea/vomiting, increased liver enzymes); Respiratory effects (sore throat, cough); CNS effects (headache, somnolence); Musculoskeletal effects (arthralgia, myalgia); Other effects (fever, pruritus, lymphadenopathy, postural hypotension, edema, tachycardia)
Special Instructions
  • No food should be taken 2 hours before or after the dose

Topical Antifungals & Antiparasites

Drug Available Strength Dosage Remarks
Benzyl benzoate 25% emulsion Apply and leave on for 24 hours then wash off
May repeat within 5 days or apply 3x at 12-hour intervals followed by bathing 12 hours after last application		 Adverse Reactions
  • Irritant to the eyes and mucous membranes, burning sensation especially on genitalia and excoriations, irritant dermatitis may occur
  • Systemic symptoms (stimulation of the CNS and convulsions) following excessive topical use or oral ingestion
Special Instructions
  • Apply to the whole body from the neck down immediately after bathing and drying
  • Not generally recommended for use in children
    • 10% solution has been used for children in some countries
  • Avoid contact with eyes and mucous membranes
  • Do not use on broken or secondarily infected skin
Crotamiton 10% cream, lotion Apply 12-24 hourly x 3-5 days
Antipruritic:
Apply 8-12 hourly		 Adverse Reactions
  • Occasional irritation
Special Instructions
  • Apply to the whole body from the neck down especially on folds and creases after bathing and drying
    • Patient should bathe prior to the first application and 24 hours after the last application
  • Should not be applied near the eyes, mouth, mucous membranes or on excoriated skin
Malathion 0.5% topical emulsion Apply and leave on for 8-12 hours then wash off
May repeat after 7 days		 Adverse Reactions
  • Irritation, stinging sensation, mild conjunctivitis
Special Instructions
  • Apply to the whole body including the scalp, neck, face and ears
  • Should not be applied near the eyes, mouth, mucous membranes or on excoriated skin
Lindane
(Benzene hexachloride)		 1% lotion Children ≥10 years old and adults:
Apply a thin layer and leave on for 8-12 hours then wash off		 Adverse Reactions
  • Burning or stinging, contact dermatitis, seizures have occurred
  • Signs of toxicity: nausea/vomiting, weakness, tremors, irritability, disorientation, giddiness, seizures, respiratory compromise, etc
Special Instructions
  • Apply to the whole body from the neck down
    • Consider applying to the scalp, if necessary
  • No bathing/showering before application unless the skin needs to be clean; if bathing is necessary, apply 1 hour after bathing or showering to allow skin to dry
  • Avoid contact with face, eyes, mucous membrane and urethral meatus
  • Use with caution in young children and in patients with a history of seizures
Permethrin 5% cream, lotion Classical scabies:
Apply and leave on for 8-14 hours then wash off
Repeat after 7 days
Crusted scabies:
Apply and leave on for 8-14 hours then wash off x 7 days		 Adverse Reactions
  • Mild burning or stinging, temporary redness, swelling, itching
Special Instructions
  • Apply to the whole body from the neck down
    • May need to extend application to scalp, face and ears in young children
  • Do not use on broken or secondarily infected skin
  • Avoid contact with the eyes
  • Use with caution in children <2 months
Sulfur 2% bar soap
5-10% cream, ointment		 Apply and leave on for 24 hours then wash off x 3-5 days Adverse Reactions
  • Skin irritation and dermatitis
  • Malodorous, may discolor certain metals (eg silver) and can stain clothing
Special Instructions
  • Apply to the whole body from the neck down after bathing and preferably at night
    • If necessary may treat the head and scalp
  • Avoid contact with the eyes, mouth and another mucous membranes

Disclaimer

All dosage recommendations are for non-pregnant and non-breastfeeding women, and non-elderly adults with normal renal and hepatic function unless otherwise stated.  
Not all products are available or approved for above use in all countries.  
Products listed in the Drug Summary are based on indications stated in the locally approved product monographs.   
Please refer to local product monographs in Related MIMS Drugs for country-specific prescribing information.

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