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Scabies - Management
How should I advise someone to apply an insecticide?
- Apply the treatment to the whole body from the chin and ears downwards paying special attention to the areas between the fingers and toes and under the nails. The exceptions to this are people who are immunosuppressed, the very young and elderly people where the insecticide should be applied to the whole body including the face and scalp.
- Apply the treatment to cool dry skin (i.e. not after a hot bath).
- Allow the lotion or cream to dry before dressing.
- Wash the treatment off after prolonged contact with the skin:
- Permethrin — 8 to 12 hours.
- Malathion — 24 hours.
- Reapply treatment if it is washed off during this treatment period (e.g. after washing the hands or nappy area).
Clarification / Additional information
- To prevent small children and babies sucking the treatment from their hands, mittens can be worn.
- Help may be required to apply the treatment properly and special attention should be paid to the axillae, the flexor aspect of the wrists and elbows, and beneath the breasts and around the nipples in women.
Basis for recommendation
- These recommendations are based on expert advice from the published medical literature and from the British Association of Dermatologists [HPA, 2005; BAD, Personal Communication, 2007].
- Treatment should not be applied after a hot bath, as this increases systemic absorption and removes the drug from its treatment site.
[Figueroa, 1998; Roberts, 2000; Scott, 2001]
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