Scabies is a common problem which particularly affects people living in crowded circumstances where personal hygiene is poor. It often causes considerable discomfort and intense itching. Several, mostly topical, treatments are available for treating scabies; few trials of their relative effectiveness have been carried out, however. Thirteen trials were identified, all of which were relatively small. Permethrin appeared to be more effective than crotamiton for clinical (relief of itching) and parasitic (demonstrated clearance of the scabies parasite) cure rates. Permethrin appeared to be better than hexachlorocyclohexane (also known as lindane or gamma benzene hexachloride - in this review lindane is used to cover all three terms) for clinical cure rates in two small trials but had no advantage in the largest trial. Permethrin also appeared more effective in reducing itch persistence than lindane. There appeared to be no difference in clinical cure rates between crotamiton and lindane or benzyl benzoate and sulphur. Two trials assessed the effectiveness of oral versus topical treatment (ivermectin versus benzyl benzoate and ivermectin versus lindane) but were too small to demonstrate an effect. No randomised trials of malathion were identified. Serious but rare adverse drug reactions (including death and convulsions), most notably to lindane, permethrin, and ivermectin, have been reported elsewhere.
The Cochrane Database of Systematic Reviews 2000, Issue 3. Art. No.: CD000320. DOI: 10.1002/14651858.CD000320.