“…The main reason could be treatment failure, which has generally been attributed to various causes, such as incorrect application of the cream by patients, failure to simultaneously treat cohabitants, or insufficient disinfection of the environment [ 26 , 27 , 28 ]. However, an increasing number of dermatologists are suggesting a real resistance to permethrin after ruling out the previously described errors and achieving a cure with other active principles for topical use, including magistral preparations, such as sulfur in an ointment base (petrolatum) or benzyl benzoate [ 29 ]. For example, Sunderkötter et al warned in 2018 of a surprising increase in the incidence of scabies in Germany and described, among the possible causes, the development of resistance to permethrin [ 30 ].…”