Scabies and head lice
IACS diagnostic criteria, permethrin and ivermectin regimens and PBS rules, crusted scabies and its associations (HTLV-1), outbreaks in residential aged care, scabies-driven streptococcal disease in remote communities, and head, body and pubic lice.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Scabies is an infestation with Sarcoptes scabiei, spread by prolonged skin-to-skin contact. Severe night itch, burrows in the web spaces and itchy contacts make the diagnosis.
- Treat the patient and every close contact at once, with two applications of permethrin 5% a week apart, or oral ivermectin twice.
- Crusted scabies carries thousands to millions of mites, is highly contagious, and marks immunosuppression (HTLV-1, HIV, corticosteroids). It needs repeated ivermectin plus topical treatment in hospital.
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Sources
- Therapeutic Guidelines: Dermatology and Antibiotic (scabies and lice)AU/NZTherapeutic Guidelines Limited (eTG complete), current eTG edition, accessed November 2026 (topic version not verified)
- National Healthy Skin Guideline: for the diagnosis, treatment and prevention of skin infections for Aboriginal and Torres Strait Islander children and communities in Australia (2nd edition)AU/NZThe Kids Research Institute Australia and Australian Healthy Skin Consortium, 2nd edition, 2023
- PBS Schedule: ivermectin 3 mg tablet, item 2868Y (scabies, crusted scabies, strongyloidiasis)AU/NZAustralian Government Department of Health, Disability and Ageing (PBS), Streamlined Authority; schedule checked November 2026
- Head lice: guidance for schools, parents and health professionalsAU/NZVictorian Department of Health, Updated 31 March 2025
- Engelman D et al. The 2020 International Alliance for the Control of Scabies consensus criteria for the diagnosis of scabies. Br J Dermatol 2020;183:808-20International Alliance for the Control of Scabies (British Journal of Dermatology), 2020
- Romani L et al. Mass drug administration for scabies control in a population with endemic disease (SHIFT). N Engl J Med 2015;373:2305-13New England Journal of Medicine, 2015
- Chosidow O et al. Oral ivermectin versus malathion lotion for difficult-to-treat head lice. N Engl J Med 2010;362:896-905New England Journal of Medicine, 2010
- Last updated
- 14 November 2026
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