SKIN - Scabies (Sarcoptes scabiei) General statement: Itching may continue for several weeks following successful therapy and should not be viewed as failure. Oral antihistamines or topical corticosteroids may provide symptomatic relief. Clothing and bedding should be washed in hot water and dried in hot dryer. Treat close contacts if needed.
Permethrin 5% Preferred to lindane. (Elimite^®) Generics available Pregnancy: B; Lactation: Topical Okay Cream 5%	Children ≥2 months and Adult: Massage into all areas of skin from chin line to toe (head to toe in infants), leave on for 8-14 hours, then wash off thoroughly. May repeat in 1 week if live mites are seen.	Important side effects: Mild temporary itching, burning, or erythema. Caution: Avoid contact with eye(s) and mucous membranes. Contraindicated if allergic to chrysanthemum flower.
Lindane 1% (G-well^®, Kwell^®) Generics available Pregnancy: B; Lactation: Unk Lotion 1%	Children > 10 yo and Adult: Apply a thin layer and massage well into skin from chin line to toes (head to toe in infants). Wash off after 6 hours (infant), 6-8 hours (child), or 8-12 hours (adult). Do not repeat sooner than 1 week and only if live mites are seen.	Important side effects: Nausea, vomiting, headache, seizure may be signs of excessive absorption. Contact healthcare provider immediately.
Ivermectin (off-Label) (Stromectol) Oral Tab: 3 mg Non-Ovicidal. For extensive Crusted Scabies, use combination Permethrin and oral tx.	Children: Limited data Head lice: Children ≥15 kg and Adolescents: Oral: 400 mcg/kg/dose on days 1 and 8 (Chosidow 2010) or 200 mcg/kg/dose repeated once after 10 days (Jones 2003) have been shown to be effective (AAP [Devore 2015]; Red Book [AAP 2015]) Pubic lice: Children ≥15 kg and Adolescents: Oral: 250 mcg/kg/dose for 2 doses administered 14 days apart (CDC [Workowski 2015]) Adult: Pediculus humanus capitis: Oral: 200-400 mcg/kg/dose every 7 days for 2 doses (Chosidow 2010) Pediculus humanus corporis: Oral: 200 mcg/kg/dose every 7 days for 3 doses (Foucault 2006) Pediculosis pubis (due to Phthirus pubis; pubic lice): Oral: 250 mcg/kg/dose every 7 days for 2 doses (Burkhart 2004) or 250 mcg/kg/dose every 14 days for 2 doses (CDC [Workowski 2015])	Food: Empty Stomach with water. No adjustment for hepatic impairment noted by manufacturer. Common Side effect >10%: Prutitis, Arthralgia, Lymphadenitis, fever.