From the Guidelines
Topical ivermectin is an effective treatment for parasitic skin conditions like scabies and head lice, and its use is recommended as a topical application for these conditions. For scabies, apply a thin layer of 1% ivermectin cream to clean, dry skin from the neck down, leaving it on for 8-14 hours before washing off, as recommended by the guidelines 1. A single application is often sufficient, but a second treatment may be needed 7-14 days later to kill newly hatched mites. For head lice, apply ivermectin 0.5% lotion to dry hair, covering the scalp and hair completely, leave on for 10 minutes, then rinse thoroughly. One treatment is typically sufficient for lice.
Some key points to consider when using topical ivermectin include:
- Common side effects include skin irritation, burning, or stinging at the application site
- Topical ivermectin works by paralyzing and killing parasites by disrupting their nervous system through binding to glutamate-gated chloride channels
- It's essential to treat all household members simultaneously to prevent reinfestation and to wash all bedding, clothing, and towels in hot water to eliminate any remaining parasites
- Ivermectin has limited ovicidal activity and may not prevent recurrences of eggs at the time of treatment; therefore, a second dose of ivermectin should be administered 14 days after the first dose, as noted in the guidelines 1
The guidelines also recommend permethrin 5% cream as an alternative treatment for scabies, applied to all areas of the body from the neck down and washed off after 8–14 hours 1. However, topical ivermectin is a viable option for treating scabies and head lice, especially in cases where other treatments have failed or are not tolerated. It's crucial to follow the recommended treatment guidelines and to consult with a healthcare professional before initiating treatment with topical ivermectin.
From the Research
Guidelines for Using Ivermectin Topical
- Ivermectin is an antiparasitic medication used to treat conditions like scabies and lice.
- The efficacy of ivermectin compared to other treatments such as permethrin and malathion has been studied in several trials 2, 3, 4, 5, 6.
- For scabies treatment, oral ivermectin may lead to slightly lower rates of complete clearance after one week compared to permethrin 5% cream, but by week two there may be little or no difference 5.
- Topical ivermectin 1% lotion may lead to little or no difference in rates of complete clearance when compared to permethrin cream after four weeks of treatment 5.
- For head lice treatment, oral ivermectin had superior efficacy compared to topical 0.5% malathion lotion, with 95.2% of patients receiving ivermectin being lice-free on day 15, as compared with 85.0% of those receiving malathion 6.
Efficacy and Safety
- The efficacy of ivermectin for scabies treatment is comparable to permethrin, with some studies showing similar complete clearance rates after two weeks of treatment 2, 4.
- The safety of ivermectin has been evaluated in several studies, with few and mild adverse events reported 5, 6.
- Topical ivermectin may lead to a slightly larger proportion of participants with at least one adverse event compared to permethrin cream, but the difference is not significant 5.