Year: 2026 | Month: September | Volume: 13 | Issue: 9 | Pages: 568-574
DOI: https://doi.org/10.52403/ijrr.20260952
Comparison of the Effectiveness of Topical Permethrin and Oral Ivermectin as Treatments for Scabies: A Systematic Review
I Gusti Ayu Devina Putri Aryana1, Ni Nyoman Indra Lesthari2
1General Practitioner, Prima Medika Hospital, Denpasar, Bali, Indonesia.
2Sano Clinic Bali, Indonesia.
Corresponding Author: I Gusti Ayu Devina Putri Aryana
ABSTRACT
Background: Scabies is a common parasitic skin disease. Topical 5% permethrin and oral ivermectin are widely used, but their speed of action and dosing schedules differ.
Objective: To compare the effectiveness and safety of topical permethrin and oral ivermectin for scabies.
Methods: PubMed and ScienceDirect were searched for English-language human studies published from January 2000 to December 2024. Reference lists and Google Scholar were used to find additional reports. Studies had to compare oral ivermectin with topical permethrin and report clinical outcomes. Study selection followed PRISMA 2020.
Results: The search found 260 records. After duplicate removal and screening, 14 studies with 1,931 participants in the relevant treatment groups were included. Permethrin usually produced faster improvement during the first one to two weeks. By week four, the difference was smaller when ivermectin was given again after 7–14 days. Both treatments were generally well tolerated. Combination treatment showed a possible benefit in severe or difficult cases, but the evidence was limited.
Conclusion: Topical 5% permethrin remains the preferred option for classic scabies when it can be applied correctly. Two-dose oral ivermectin is a useful alternative when topical treatment is difficult or many people need treatment at the same time.
Keywords: Scabies, ivermectin, permethrin, treatment, systematic review
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