Medication for Treatment of Scabies

Scabies are mites (a type of small insect that can be seen with a microscope) that burrow under the skin, causing severe itching and red bumpy rashes. They rarely affect the skin above the neck, except in infants and young children. Usually more than one person in a family has scabies as it easily transmitted by close physical contact.

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​Treatment for Scabies

Permethrin 5% Lotion, Malathion 0.5% (Licecare®) Lotion

Scabies are mites (a type of small insect that can be seen with a microscope) that burrow under the skin, causing severe itching and red bumpy rashes. They rarely affect the skin above the neck, except in infants and young children. Usually more than one person in a family has scabies as it easily transmitted by close physical contact.​ 

Symptoms may take up to 2 months to develop after exposure.  Therefore, all infected people and close contacts (eg. baby sitter, everyone living in the house or have skin contact) have to be treated at the same time even if they have not developed a rash.

Your child will be given one of the following medications depending on age:

AGEMEDICATIONINSTRUCTIONS
Less than 6 monthsPermethrin 5% LotionApply once for 8-14 hours and may repeat 7 days after initial treatment.
6 months or moreMalathion 0.5% Lotion
(​Lice Care​)
Apply once for 24 hours and repeat application 7 days after initial treatment.

​Preparing for Application

  • Application is done preferably in the evening
  • Take a warm bath and dry well
  • Trim the child's fingernails if they are long

 

Instructions for Application

  • Apply the lotion onto the entire body surface from the neck down
  • If the child is less than 2 years old, you will also need to apply the cream to the scalp, face, neck and ears carefully, avoiding the area around the eyes and mouth.
  • You may use your hands, a small soft sponge or brush to apply the cream.
  • Do not forget the navel, between the toes and fingers, wrists, armpit region, genital area, buttocks, or any other body creases and folds.
  • Reapply if the hands/other parts if the drug is washed away or to diaper area of babies during changes within 8 hours (Permethrin) or 24 hours ( Malathion) of application.
  • Leave some of the medication under the finger and toe nails.
  • Areas that do not seem infected should still be covered with the medication.
  • You may wish to wear gloves if you are applying the medication for other individuals.
  • Put on fresh clothing after application.

 

Washing off

  • Leave the medication for 8 to 14 hours (Permethrin) / 24 hours (Malathion).
  • Use soap and water to wash off the medication after 8 to 14 hours (Permethrin) / 24 hours (Malathion).

 ​​

Question​s

What if the medication c​​omes into contact with my child's eyes?

Immediately wash the child's eyes under a running tap for at least 15 minutes. If irritation, pain, swelling or tearing of the eyes persists, consult a doctor. 

What if my child like​​s to put his hands into the mouth? 

Cover the hands with cotton mitts or socks to prevent the child from ingesting the medication.  You can also use them to prevent the child from rubbing his eyes. 

Do I need to clean the h​​ouse? 

To prevent getting infected again, it is very important to wash in hot water all bedsheets, pillowcases, underwear, pyjamas and recently worn clothing (in the past few weeks) after completing the treatment and dry under direct sunlight or in a hot cycle dryer.  Items that cannot be washed, e.g. large blankets, stuffed animals or dolls, should be put away in sealed plastic bags (away from contact) for at least 1 week. 

Why is it still itching after t​reatment? 

Itching may occasionally worsen 1 to 2 days after treatment.  It may also persist for 2 to 3 weeks after successful treatment which is normal and possibly due to the allergic reaction to the dead scabies mites.  Your doctor may give you some medication to relieve the itch in the meantime. You may also visit a pharmacist for some calamine lotion or antihistamines for the itch.  If the skin appears to be dry, consult your pharmacist for a moisturiser and milder soap. If the itch does not go away by the fourth week after treatment or new bumpy red rashes appear 1 week after treatment, consult your doctor.

​​


 

 

Version 1
Last Review: June 2017
Produced by Department of Pharmacy
KK Women's and Children's Hospital

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Medication for Treatment of Scabies

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