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Research summary: Scabies resistance to permethrin

In the latest year, we have experienced a proven inefficacy of permethrin in the treatment of scabies, both in children and in adults.

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Permethrin is considered worldwide the first-line therapy for patients with scabies, but it seems not to work anymore. According to the guidelines, one or two applications of permethrin would be enough to treat the disease, but unfortunately we have witnessed a failure in treatments, even after long courses of therapy.

In a recent paper we established this presumptive resistance, then confirmed also by other authors.

What are the possible reasons? Actually, we think that a true resistance of the mite does exist maybe due to a selection of mechanisms of protections against the molecule.

Other reasons may be the high cost of treatments, the low compliance for a topical medication, the low sociocultural level of patients affected by scabies or the inappropriate application.

An unmet need of novel treatments is felt among clinicians and it was partly covered by the approval in some countries of oral ivermectin for the treatment of scabies.

Further observation and novel therapeutic strategies are desirable in the near future. Stay updated!


vincenzo piccolo

– Dr Vincenzo Piccolo

Full paper:

Mazzatenta C, Piccolo V, Argenziano G, Bassi A. Is Scabies becoming less sensitive to permethrin therapy? J Eur Acad Dermatol Venereol. 2021 Sep;35(9):e607-e609.

Read more recent research from Dr Vincenzo Piccolo: Unilateral periflexural exanthema and COVID

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