Benzyl benzoate

• benzyl benzoate used to be a first line traditional treatment for scabies, and is licensed for use in adults, children and babies for the treatment of scabies
• first-line therapies now include topical permethrin and oral ivermectin, both of which demonstrate comparable efficacy and superior outcomes compared to alternative treatments. Permethrin is generally recommended as the initial therapy due to its safety profile, including use in children older than 2 months and pregnant women (1)
• there is minimal absorption of benzyl benzoate emulsion following application to the skin
• benzyl benzoate can be irritant, it requires up to 3 treatments, each one day apart, and the scabies mite may be resistant to it; it is considered as a third line treatment behind permethrin 5% cream and malathion 0.5% liquid
• benzyl benzoate can cause irritation to the skin, eyes and mucosal surfaces and should be avoided in infants and children where alternative treatments are available
• there is a lack of safety data concerning the use of benzyl benzoate in pregnancy; breast-feeding should be suspended after application of treatment, but may be restarted once the emulsion has been washed off the body

The summary of product characteristics should be consulted before prescribing this drug.

Reference

1. Dressler C, Rosumeck S, Sunderkötter C, Werner RN, Nast A. The Treatment of Scabies. Dtsch Arztebl Int. 2016 Nov 14;113(45):757-762