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
• benzyl benzoate - there is a lack of safety data but according to the company, the preparation has been widely used by pregnant women "for many years without apparent ill consequence". After application of treatment breast-feeding should be suspended, but may be restarted once the emulsion has been washed off the body
• ivermectin - this drug is contraindicated in pregnancy and breast-feeding women

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.