The treatment is applied to cool, dry skin. The patient should not have a hot bath beforehand as this can make the treatment less effective.
Treatment for the affected person (s), the people who live with him or her, and other close physical or sexual contacts must occur at the same time.
If you are an adult, or treating a child over 2 years of age, then the treatment must be applied to the whole body from the neck down. Application can be with your hand, a small sponge or a new 3 inch paintbrush. Remember to apply to skin folds e.g. between buttocks, the soles of feet. Someone may need to help to apply treatment to awkward bits.
Children under 2 years old should be treated on the head, face and behind the ears, as well as the rest of the body. Caution must be taken not to get any in the eyes or around the mouth where it can be licked.
Treatment must be re-applied if you wash your hands or anywhere else within the 24 hour treatment period.
The treatment is left for 24 hours and then washed off with plain cool water. This is followed with a second wash with soap and water.
On the same day the patient first applies the medication, all the clothing and linen used should be washed (1). Bedding and clothing should be washed as you would normally. In order to decontaminate, the beddings and clothing can be either machine-washed, machine dried using the hot cycle, or dry cleaned, or they can be removed from body contact for at least 72 hours as the mites can't survive beyond this period (1).
The itch associated with scabies is an allergic reaction. It will probably continue for 2-3 weeks and may get worse over that period. The persistence of itch does not mean that the treatment has failed. The itch can be treatment with calamine lotion or skin treatments from your doctor. If the itch persists for more than 3 weeks then go back to your doctor. (2)
Reference:
1. Heukelbach J, Feldmeier H. Scabies. Lancet. 2006 May 27;367(9524):1767-74.
2. Gunning K, Kiraly B, Pippitt K. Lice and Scabies: Treatment Update. Am Fam Physician. 2019 May 15;99(10).
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