Scabies is a common ectoparasitic infestation that remains highly endemic in low- and middle-income countries due to overpopulation and limited access to health care. Its prevalence is also increasing in developed countries, including Europe. Climate change associated with rising temperatures, migration, and overpopulation is likely to increase the clinical and public health impacts of scabies. Historically, topical therapies and more recently oral ivermectin have been used. There is uncertainty about the most appropriate first-line treatment due to the lack of high-quality studies. Boralevi and colleagues conducted the clustered and rigorous SCRATCH (Scabies Randomized Trial in Children and Adults) study to fill this gap.