A 7-year-old girl has itchy scalp and white flakes in her hair. What is the best treatment for her likely diagnosis?

The scenario describes a 7-year-old girl with an itchy scalp and white flakes in her hair, which suggests the presence of either dandruff or head lice. In cases of suspected head lice, treatment options typically include topical insecticides.

Permethrin cream is a common first-line treatment for head lice. It works by disrupting the nervous system of the lice, effectively killing them. This non-systemic treatment is safe and generally well-tolerated in children, making it highly appropriate for a pediatric patient.

While other treatments like ketoconazole shampoo can be effective for fungal infections such as seborrheic dermatitis or dandruff, they may not address the specific issue of head lice. Additionally, oral ivermectin is usually reserved for more severe infestations or cases where topical treatments have failed. Selenium sulfide shampoo, while it may help with superficial fungal infections, doesn't specifically target lice.

Given the clinical presentation, permethrin cream is the most suitable and effective option for treating head lice in this child.