flashcards_scabies
What is the first line treatment for scabies?
Prescribe a topical insecticide/scabicide (permethrin 5% cream).
How should permethrin 5% cream be applied for scabies treatment?
Apply to the whole body from the chin and ears downwards, with particular attention to areas in between the fingers and under the nails. Apply to cool, dry skin and allow to dry before dressing.
How long should permethrin be left on before washing off?
Permethrin should be washed off after 8-12 hours.
When is a second application of permethrin required?
A second application is required 10-14 days after the first application.
What is the second line treatment for scabies if permethrin is contraindicated or not tolerated?
Ivermectin 0.5% 200 mcg/kg.
What advice should be given to patients regarding household members and close contacts?
Household members and other close contacts should be treated.
How should the bedding, clothing, and towels of the patient be decontaminated?
Decontaminate by washing at a high temperature and drying in a hot dryer.
What should be done if symptoms persist 2-4 weeks after the last treatment application?
Advise to retreat.
How can post-scabietic itch be treated?
Treat with crotamiton 10% cream or topical hydrocortisone.
What can help reduce itching and improve sleep at night for scabies patients?
A night-time sedative antihistamine (e.g. chlorphenamine) may help.
How should scabies be treated in babies?
Include the face and scalp, but avoid the eyes.
What is an alternative treatment to permethrin and what are its drawbacks?
Benzyl benzoate emulsion can be applied below the neck and left on for 12 hours, but it smells bad and has irritant action.
When should specialist advice be sought for scabies?
Seek specialist advice if crusted scabies or if the patient is under 2 months old.
