Scabies
Canadian Guidelines on Sexually Transmitted Infections - Ectoparasitic Infestations
- Lindane has been discontinued from the Canadian market (Feb 2012) as it is a persistent organic pollutant.
- Wash clothes and bedding in hot water/hot dryer or place in plastic bags for 3-7 days. Vacuum mattresses.
- Treat all household contacts and sexual partners within last month.
- Pruritus may persist for several weeks. Retreat after 1 week if no clinical improvement.
Usual Pathogens
Sarcoptes scabiei
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Permethrin 5% cream (Nix®) | Apply from neck down, wash off after 8-14 hours | May be repeated in 7 days |
Alternative
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Sulphur 5% in petroleum | Apply hs for 3 nights, wash off 24 hours after last application | 3 doses |
Resistant/failure of above
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Ivermectin | 200mcg/kg PO | 1 dose. Repeat in 2 weeks. |
| or | ||
| Ivermectin 1% cream | Apply to all areas of the body from the neck down, wash off after 8–14 hours | 1 dose. Repeat treatment in 1 week if symptoms persist. |