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For more than 50 years, lindane γ-benzene hexachloride) lotion reigned as the treatment of choice for scabies. Concerns about neurotoxicity, neurotransmitter inhibition, and seizures dampened enthusiasm for its use, and some scabies mites developed resistance. Other treatments include permethrin lotion, crotamiton lotion, benzyl benzoate lotion, and precipitated sulphur in ointment bases. Ivermectin is conveniently administered orally. It, too, is a neurotoxin and may not be ovicidal, but its off-label use for treatment of scabies is widespread.
In this single-blind, controlled study from Iran, 148 patients with scabies were randomized to receive oral ivermectin 200 µg/kg body weight or two applications of topical lindane lotion 1%, with a 1…