Scabies (sarcoptes scabiei)

Doses are oral and for adults unless otherwise stated. Visit the Health Products Regulatory Authority (HPRA) website for detailed drug information (summary of product characteristics and patient information leaflets). Dosing details, contraindications and drug interactions can also be found in the Irish Medicines Formulary (IMF) or other reference sources such as British National Formulary (BNF) / BNF for children (BNFC). See guidance on dosing in children for quick reference dosage/weight guide. Refer to drug interactions table for detailed drug interactions for all antimicrobials. Note extensive drug interactions for clarithromycin, fluoroquinolones, azole antifungals and rifampicin. Many antibiotics increase the risk of bleeding with anticoagulants.

Note additional warnings for clarithromycin and fluoroquinolones


Comments from Expert Advisory Committee

  • 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 advice from microbiology, public health. 
  • Oral Ivermectin has been shown to be effective in treating resistant scabies .Seek advice from public health or microbiology if you suspect resistance scabies.

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)

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 October 2019