TABLE 1.
Scabies management in Canada
| Treatment | Application period | Repeat | Age restrictions | Caution(s) | Other comments |
|---|---|---|---|---|---|
| 5% permethrin cream (Nix Dermal Cream*, Kwellada-P Lotion†) | Leave on for 12–14 h, followed by bathing | 7 days | >3 months of age | Consider as first-line treatment | |
| 10% crotamiton lotion/cream (Eurax Cream) | 24 h | May be repeated in 24 h; wash off 48 h after last application | Skin irritation and contact dermatitis | Consider as second-line treatment | |
| Sulphur (8%–10%) precipitated in petroleum jelly (compounded) | Daily for 3 consecutive days | No | Safe in pregnancy and for infants | Effective but not commonly used due to messy application and odour | |
| Benzyl benzoate 28% in adults, 10%–12.5% in children | 24 h | May be repeated 1 day apart | Caution in pregnancy | Not available in North America but widely available elsewhere | |
| 1% Lindane cream | Apply 8–12 h for adults, 6–8 h for children, followed by bathing | Only if new mites or papules after 7 days of treatment | Use with caution in small children | Associated with neurotoxicity, ataxia, tremors and bone marrow suppression | Consider as second-line treatment only |
| Ivermectin (oral) for outbreak (Stromectol, Mectizan‡) | Single dose oral 200 mcg/kg | May need to be repeated in 2 weeks | Safety not established in infants <15 kg, pregnant or lactating women | Not licensed in Canada§ | |
| Ivermectin (oral) for crusted scabies (Stromectol, Mectizan‡) | Single dose oral 200 mcg/kg | Multiple repeat doses with keratolytics¶ and consider combination with 5% permethrin | Safety not established in infants <15 kg, pregnant or lactating women | Not licensed in Canada§ |
Read the product monographs before prescribing or applying any of these products. For information on coverage under Non-Insured Health Benefits Program, see <http://www.drugcoverage.ca/en-ca/Federal-Plans/non-insured-health-benefits>.
*
GlaxoSmithKline, USA.
†
MedTech Products, USA.
‡
Merck and Co, USA.
§
Need to request through Health Canada’s Special Access Programme <www.hc-sc.gc.ca/dhp-mps/acces/drugs-drogues/index-eng.php>.
¶
Keratolytics help remove keratin to allow better penetration of topical medications