An oral drug for the treatment of Scabies is now available. ‘Ivermectin is indicated for treatment of scabies, a parasitic infestation of the skin caused by the scabies mite, which causes itch, inflammation and discomfort, and in some populations is associated with the development of serious secondary infection.
In Australia the two groups most at risk for scabies infestation are Aboriginal and Torres Strait Islander communities and people in residential aged-care facilities. In both settings ivermectin has advantages over topical treatments.
Ivermectin is the only acaricide indicated for scabies treatment that can be taken orally, making it convenient for use where application of topical therapy is logistically difficult, and for crusted scabies, when topical application may not completely penetrate the thick crusts. Ivermectin is a treatment option for people with typical scabies when:
- treatment with sequential topical permethrin and benzyl benzoate at least 4 weeks prior has been completed and has failed, or
- topical treatment is contraindicated when the patient has:
- an allergy to pyrethrins or pyrethroids and cannot use permethrin, and/or
- acutely inflamed, raw or weeping skin and cannot use benzyl benzoate.
Ivermectin is also used for treatment of crusted scabies in conjunction with topical scabicides and keratolytics’.
There is a great article on Crusted Scabies available to read in the Rural and Remote Update section.