A female patient age 32, is being treated for a scabies infestation. Which of the following is true regarding treatment recommendations? Select one:

Scabies is a contagious skin infestation caused by the mite Sarcoptes scabiei, which burrows into the epidermis and causes intense itching and a papular rash. Transmission commonly occurs through prolonged skin-to-skin contact, making household spread very common. Effective management requires both pharmacologic treatment and prevention of reinfestation. Treating close contacts and addressing environmental contamination are essential parts of care. Rationale: A. All family members and close household contacts should be treated simultaneously, even if they do not yet have symptoms. Symptoms may take several weeks to appear after initial infestation, but transmission can still occur during this asymptomatic period. Simultaneous treatment prevents reinfestation cycles and is a standard recommendation in scabies management to ensure complete eradication. B. Treatment is not best with oral therapies because first-line management is usually with topical scabicides such as Permethrin 5% cream. Oral Ivermectin may be used in certain severe cases such as crusted scabies or outbreaks, but it is not the routine initial therapy for uncomplicated infestations. Topical treatment remains the preferred standard in most patients. C. Itching does not resolve immediately after treatment and may persist for several weeks despite successful eradication of the mites. This continued itching occurs because of an ongoing hypersensitivity reaction to dead mites and their products. Patients should be taught that persistent itching does not necessarily mean treatment failure, which helps reduce unnecessary retreatment. D. Lindane is not the medication of choice during pregnancy because of its potential neurotoxicity and risk of systemic absorption. It is generally avoided in pregnant patients, infants, and individuals with seizure disorders. Safer alternatives such as permethrin are preferred because they have a better safety profile and are more effective.