Which statement accurately describes scabies treatment and containment measures?

Which statement accurately describes scabies treatment and containment measures?

• A. Permethrin topical is first-line; Lindane is cheaper but should not be used after bath/shower; clothing should be bagged for 72 hours; treat family
• B. Lindane is first-line
• C. Treat only the patient
• D. Do not treat family members

Answer: (A)

Treating scabies effectively requires killing the mites on the person and preventing re-infestation from close contacts or contaminated items. The preferred first-line option is a topical cream containing permethrin 5%, applied to the entire body and left on for several hours before washing off. It has a strong balance of high efficacy and safety. Lindane is an option some clinicians consider because it’s cheaper, but it carries notable safety concerns, especially neurotoxicity. Because of these risks, it is not used as the first choice and is avoided after bathing or showering, since water exposure increases skin absorption and the potential for toxicity. Containment is essential to stop transmission. Items that can harbor mites—clothing, bedding, and towels—should be decontaminated. Laundering on hot cycles and drying on hot settings is ideal; if items can’t be washed, they should be sealed in an airtight bag for about 72 hours so the mites off the body die off. In addition, all household members and close contacts should be treated at the same time, even if they aren’t showing symptoms, to prevent reinfestation. This combined approach—effective, safe treatment of the patient with a well-chosen agent, simultaneous treatment of contacts, and proper off-host decontamination—best containment and cure.

Treating scabies effectively requires killing the mites on the person and preventing re-infestation from close contacts or contaminated items. The preferred first-line option is a topical cream containing permethrin 5%, applied to the entire body and left on for several hours before washing off. It has a strong balance of high efficacy and safety.

Lindane is an option some clinicians consider because it’s cheaper, but it carries notable safety concerns, especially neurotoxicity. Because of these risks, it is not used as the first choice and is avoided after bathing or showering, since water exposure increases skin absorption and the potential for toxicity.

Containment is essential to stop transmission. Items that can harbor mites—clothing, bedding, and towels—should be decontaminated. Laundering on hot cycles and drying on hot settings is ideal; if items can’t be washed, they should be sealed in an airtight bag for about 72 hours so the mites off the body die off. In addition, all household members and close contacts should be treated at the same time, even if they aren’t showing symptoms, to prevent reinfestation.

This combined approach—effective, safe treatment of the patient with a well-chosen agent, simultaneous treatment of contacts, and proper off-host decontamination—best containment and cure.