Which topical treatment is used for scabies from the neck down?

• A. Hydrocortisone cream
• B. Premethrin cream from neck down
• C. Oral ivermectin
• D. Cetirizine cream

Answer: (B)

Treating scabies with a topical agent requires one that effectively kills mites on the skin across the areas most likely to harbor them. The standard first-line choice is permethrin 5% cream applied to the entire body from the neck down and left on for about 8–14 hours before washing off. This full-body coverage ensures mites and eggs in folds, interdigital spaces, and other hidden areas are reached. Hydrocortisone or cetirizine creams don’t eradicate the infestation; they just address itching or inflammation. Oral ivermectin can be used as an alternative or in cases where topical treatment isn’t feasible or in crusted scabies, but it isn’t a topical treatment applied from the neck down.