Published: 2017-06-23

Comparative study of once and twice application of topical 5% permethrin in patients of scabies

Rashmi Singh, Sujata Singh, Jitendra Pal Singh


Background: Scabies is an itchy skin condition caused by the Sarcoptes scabiei which is treated by various topical and oral drugs. Among the all topical drugs, permethrin has been the drug of choice for the treatment of scabies. Therefore the aim of this study was to compare the efficacy of once and twice (repeat after one week) application of topical 5% permethrin in patients of scabies.

Methods: This was an observational study in which a total number of 52, clinically diagnosed patients of scabies, receiving the topical 5% permethrin once (group A) and twice (repeat after one week-group B), were observed for treatment outcome. Treatment was evaluated at intervals of 1, 2, 3 and 4 weeks by improvement or decrease in number of lesions and severity of pruritus. The efficacy of both the methods was compared statistically within and between the two groups.

Results: A significant (p= <0.05) decrease in number of lesions as well as pruritus was observed at each follow up visit separately in both the groups. Between the groups comparison demonstrated a significant (p= <0.05) decrease in number of lesions as well as pruritus in group B, at follow up visit of 2 weeks while at the end of 4 weeks there was no difference in cure rate of both groups.

Conclusions: Both the treatment modalities revealed equal efficacy at the end of 4 weeks. However, twice application of topical 5% permethrin showed faster and significant improvement at 2 week follow up in reference to both the number of lesions and severity of pruritus.


Permethrin, Scabies, Topical

Full Text:



Mellanby K. The development of symptoms, parasitic infection and immunity in human scabies. Parasitol. 1944;35:197-206.

Fatimata Ly, Caumes E, Ndaw CAT, Ndiaye B, Mahé A. Ivermectin versus benzyl benzoate applied once or twice to treat human scabies in Dakar, Senegal: a randomized controlled trial. Bulletin of the World Health Organization. 2009;87:424-30.

Tripathi KD. Antiseptics, Disinfectants and Ectoparasiticides. In: Essential of medical pharmacology. 7th Ed. India, Jaypee Publisher; 2013;902-903.

Chosidow O. Scabies. New England Journal of Medicine. 2006 Apr 20;354(16):1718-27.

Hengge UR, Currie BJ, Jager G, Lupi O, Schwartz RA. Scabies: a ubiquitous neglected skin disease. Lancet Infect Dis. 2006;6:769-79.

Johnston G, Scabies SM. diagnosis and treatment. Br Med J. 2005;331:619-22.

Johnstone P, Scabies SM. Clin Evid. 2006;15:2284-90.

Heukelbach J, Feldmeier H. Scabies. Lancet 2006;367:1767-74.

McCarthy JS, Kemp DJ, Walton SF, Currie BJ. Scabies. More than just an irritation. Postgrad Med J. 2004;80:382-7.

Roberts LJ, Huffam SE, Walton SF, Currie BJ. Crusted scabies: clinical and immunological findings in seventy-eight patients and a review of the literature. J Infect. 2005;50:375-81.

Mumcuoglu KY, Gilead L. Treatment of scabies infestations. Parasite. 2008;15:248-51.

Karthikeyan K. Treatment of scabies: Newer perspectives. Postgrad Med J. 2005 Jan 1;81(951):7-11.

Orkin M, Maibach HI. Scabies therapy. In Seminars in dermatology. 1993 Mar;12(1):22-5.

Buffet M, Dupin N. Current treatments for scabies. Fundam Clin Pharmacol. 2003;17:217-25.

Green MS. Epidemiology of scabies. Epidemiol Rev. 1989;11:126-50.

Goldust M, Rezaee E, Raghifar R, Hemayat S. Treatment of scabies: topical ivermectin vs. permethrin 2.5% cream. Annals of Parasitology 2013;59(2):79-84.

Sharma R, Singal A. Topical permethrin and oral ivermectin in the management of scabies: a prospective, randomized, double blind, controlled study. Ind J of Der, Vener and Lepr. 2011;77:581-6.

Johnston G, Sladden M. Scabies: diagnosis and treatment. Br Med J. 2005;331:619-22.

Currie BJ, McCarthy JS. Permethrin and ivermectin for scabies. N Engl J Med. 2010;362:717-25.

Chhaiya SB, Patel VJ, Dave JN, Mehta DS, Shah HA. Comparative efficacy and safety of topical permethrin, topical ivermectin, and oral ivermectin in patients of uncomplicated scabies. Ind J of Der, Vener and Lepr. 2012;78:605-10.