What treatment options are available for scabies?

Topical permethrin cream and oral ivermectin are effective treatments for scabies because they specifically target the Sarcoptes scabiei mite, which is the causative agent of the condition. Permethrin is a topical insecticide that effectively kills the mites and their eggs upon application to the skin. It is usually applied from the neck down and left on for a prescribed period before washing off.

Oral ivermectin serves as an alternative, especially in cases where topical treatment may be difficult, such as in crusted scabies or in patients who are unable to apply topical medications properly. Ivermectin works systemically to eliminate the mites and is particularly useful in outbreaks or when multiple individuals are affected.

The other treatment options listed do not directly address the scabies mites. Topical hydrocortisone and oral antibiotics could be used to manage inflammation and secondary bacterial infections resulting from scratching, but they do not eliminate the cause of scabies. Hydration therapy and antihistamines help alleviate itching and discomfort associated with scabies but also do not address the infestation itself. Cool compresses and topical anesthetics may provide symptomatic relief but again do not treat the underlying infestation.