Which treatment is considered the first-line option for scabies?

Permethrin cream is considered the first-line treatment for scabies due to its efficacy and safety profile. It is a topical insecticide that works by disrupting the nervous system of the scabies mite, leading to its death. The cream is applied to the entire body from the neck down, left on for several hours or overnight, and then washed off. This method effectively kills mites and their eggs, making it a highly effective option for treating scabies infestations.

While oral ivermectin is an alternative treatment, especially in cases of widespread infestation or when topical treatments are not feasible, it is generally not the first-line therapy. Lindane is also effective but has fallen out of favor due to potential neurotoxicity and environmental concerns. Sulfur ointment can be used for scabies, particularly in young children and during pregnancy, but it is not the preferred first-line treatment compared to permethrin cream. Thus, the established guidelines and clinical practice emphasize permethrin as the best option for the initial treatment of scabies.