Topical antiparasitic drugs in dermatology: Current insights, future directions

Parasitic skin infestations, including scabies, pediculosis, and demodicosis, remain important clinical problems, particularly in vulnerable populations such as the pediatric population and immunocompromised individuals. Topical antiparasitic drugs, when applied directly to the skin, exert their effect by disrupting the nervous system of these parasites, causing paralysis and death. Because of their targeted action, convenience of use, and favorable safety profile, topical therapies are often considered first-line treatment for many ectoparasitic infestations. Topical antiparasitic drugs such as ivermectin, permethrin, benzyl benzoate, crotamiton, spinosad, and abametapir have an established role in treating ectoparasitic infestations such as scabies and pediculosis. This review explores the clinical evidence, safety data, therapeutic strategies, and growing challenge of drug resistance of commonly used topical antiparasitic drugs.