Scabies and pregnancy

Considering treatment options for scabies: (1) (2)

• permethrin 5% cream - anecdotal evidence suggests that permethrin 5% cream can be used safely in pregnancy and breast-feeding women (however there is a lack of data to confirm this). According to the company, "any risk to the foetus following treatment of the mother with permethrin 5% cream is minimal"
• malathion 0.5% liquid - this is not contraindicated in pregnancy or breast-feeding women
• topical benzyl benzoate is considered safe to use in pregnancy and in children (3)
• ivermectin - this drug is contraindicated in pregnancy and breast-feeding women
• the use of lindane 1% is contraindicated in children younger than 10, pregnant or breastfeeding women, and those with extensive dermatitis (4)

Prior to breastfeeding liquid or cream should be removed from the nipple area and reapply after feeding.

Reference:

1. UK Teratology Information Service. Treatment of scabies in pregnancy: August 2023, Version: 4
2. Patel V. et al. Safety of Topical Medications for Scabies and Lice in Pregnancy. Indian J Dermatology. 2016 Nov-Dec; 61(6): 583–587.
3. Thomas C, Castillo Valladares H, Berger TG, Chang AY. Scabies, Bedbug, and Body Lice Infestations: A Review. JAMA. 2024 Sep 09
4. Workowski KA et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187.