It important to treat all members of the family at the same time. Even members with no symptoms of scabies must be treated as they may still carry mites. Scabies can be treated with a local application of 12.5% benzyl benzoate (Ascabiol) lotion (half strength), which is applied from the neck down to the whole body. Only dress once the lotion has dried. In children over 2 years and adults, wash the lotion off after 24 hours. In children from 2 months to 2 years, use a 6.25% lotion (quarter strength) and wash off after 12 hours. After treatment, bath and dress in clean clothes. Wash all used clothes and change the bed linen. Remember that this lotion can be very irritating and may cause discomfort. A 1% hydrocortisone cream can be used after treatment to help control the itching.
Infants under 2 months should rather be treated with 5% sulphur ointment nightly for 3 days. Antiscabies soap alone is not effective treatment. Keeps nails short. Wash clothes and bedding in hot water.
The whole family must be treated for scabies at the same time.
If there is additional bacterial infection (impetigo), treat locally with 2% vioform in zinc ointment. Oral penicillin may be needed if the infection is severe, especially if the local lymph nodes are enlarged or the child is pyrexial. Treat the bacterial infection first before treating the scabies.
Secondary bacterial infection of scabies (impetigo) is a very important cause of acute glomerulonephritis.
Lindane, also known as gamma benzene hexachloride (Gambex), and pyrethrines (Lyclear and Nitagon), are less irritating but more expensive.