Patterns of Scabies Treatment Among Syrian Dermatologists: A Cross-Sectional Study

Area of Science:

• Dermatology
• Public Health
• Infectious Diseases

Background:

• Scabies, caused by *Sarcoptes scabiei var. hominis*, is a persistent public health issue in Syria, exacerbated by socioeconomic factors and overcrowding.
• Current scabies treatment practices in Syria require examination to assess alignment with international guidelines.

Purpose of the Study:

• To investigate the scabies treatment strategies employed by Syrian dermatologists.
• To evaluate adherence to internationally recommended scabies management protocols among Syrian dermatologists.

Main Methods:

• A structured online questionnaire was distributed to 159 dermatologists across Syria.
• The survey collected data on permethrin regimens, reasons for protocol deviation, management of contacts, adherence rates, perceived resistance, and adverse effects.
• International guideline adherence was defined as weekly 5% permethrin application for 8-12 hours, repeated after one week.

Main Results:

• Only 34.0% of dermatologists used the classical weekly permethrin regimen; 54.7% used modified regimens, and 11.3% used sulfur first-line.
• Primary reasons for non-adherence to classical protocols included poor patient/household contact adherence (57.1%) and concerns about drug effectiveness (37.1%).
• An estimated 87.4% of respondents reported contact adherence below 80%.

Conclusions:

• Syrian dermatologists utilize diverse scabies treatment approaches influenced by patient adherence, perceived resistance, and conflict-related challenges.
• There is a critical need for enhanced patient and household education, improved physician training, and renewed adherence to guideline-based scabies management.