Scabies (sarcoptes scabeii)

Doses are oral and for adults unless otherwise stated. Visit the Health Products Regulatory Board website or the printed Irish Medicines Formulary for drug SPCs, dosage, contraindications, interactions, or IMF/BNF/BNFC/MIMS. See guidance on dosing in children for quick reference dosage/weight guide.

Letters indicate strength of evidence range from A+ (systematic review) to D (informal opinion). Statins can interact with some antibiotics and increase the risk of rhabdomyolysis. Amiodarone and drugs which prolong the QT interval can interact with many antibiotics. Many antibiotics increase the risk of bleeding with anticoagulants. Please refer to our Drug Interactions Table for further information.


Comments

  • In adults and children over 2 years of age permethrin dermal cream should be applied to the whole body excluding the head and paying particular attention to the areas between the fingers and toes, wrists, axillae, external genitalia, buttocks and under finger and toe nails.
  • In children between 2 months and 2 years permethrin dermal cream should be applied over the whole body as directed for adults and children over 2 years, but should include the face, neck, scalp and ears.
  • All members of the affected household should be treated simultaneously
  • For difficult to treat scabies, cases in assisted care facilities or immunocompromised hosts, seek dermatological advice.

Pregnancy

Permethrin 5% or Malathion 0.5% lotion may be used, in lactating mothers, care must be taken that the breastfeeding infant does not suckle on treated skin thereby avoiding oral ingestion of the scabicide.

Outbreaks

For outbreaks particularly in assisted care facilities, the local Public health office should be contacted.


Treatment

Treatment Dose TX Duration
permethrinA+ (Lyclear) 5% cream 2 applications one week apart
malathion (Derbac) 0.5% aqueous liquid 2 applications one week apart (Note: availability can be limited)
Comment

Ivermectin 200mcg/kg in adults 2 weeks apart has been shown to be effective in treating scabies, it is used in Europe and more recently in the U.K. But is not generally considered as a first line treatment. It is unsuitable for children in pregnancy or lactating mothers.

Patient Information

We recommend patients use the website developed by HSE/ICGP/IPU partnership www.undertheweather.ie for tips on how to get better from common infections without using antibiotics, what you can do for yourself or a loved one and when to seek help.

The HSE Health A-Z website provides patient information on many hundreds of conditions and treatments.


Reviewed June 2017