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Scabies - OBSOLETE

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Checked: 23-08-2020 by Vicky Ryan Next Review: 23-08-2021

Principles of Management

Local clinicians recommend the:

Primary Care Dermatology Society (PCDS): Scabies clinical guidance

National Institute for Health and Care Excellence (NICE): cks.nice.org.uk/scabies#!scenario

Please always refer to the BNSSG Formulary for the latest prescribing guidance.

Persistent symptoms:

The itch of scabies may not clear for at least a month after successful eradication of the mite. Treatment with Eurax HC ® cream (available over the counter from a Pharmacist for one week use for over 10 years of age, please note this item is non-formulary for prescribing) helps reduce itch and it also acts as a mild scabicide. Nodules, which are not contagious, can occasionally persist for several months and should be treated with a moderately potent topical steroid

Re-infection is common if patients and contacts are not compliant: re-treat and check contacts

Red Flags

Crusted Scabies- (Uncommon form of scabies) For more information see principles of management above.

Public Health to be notified if an institution such as a Nursing or Residential Home has a case(s) of Crusted Scabies.

Untreated scabies - is often associated with secondary bacterial skin infections.

Infants Under 2 Months old with scabies - Specialist advice from a Paediatric Dermatologist will need to be sought.

Referral

Scabies can normally be diagnosed and managed in primary care.

If advice or confirmation of diagnosis is required then consider using Dermatology Advice and Guidance initially.

Referrals can also be made to the Community Dermatology Service who can offer individual patient management plans and advice.

Resources

Patient information leaflet important to highlight steps for Patients and for other family members if they also require treatment. See link below:

British Association of Dermatology (BAD): bad.org.uk/patient-information-leaflets/scabies

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.