Scabies : Management for Nurses , pharmacists and paramedics

Scabies is a contagious skin infestation caused by the Sarcoptes scabiei mite. It presents with intense itching, especially at night, and a rash consisting of small, red bumps. Transmission occurs through close physical contact, making outbreaks common in households and institutions such as care homes.

Primary care professionals like nurses, pharmacists, and paramedics play a critical role in the management of scabies. Effective management involves timely diagnosis, appropriate treatment, and preventive measures to limit the spread of infestation.

Key Principles of Management:

1. Diagnosis:

   • Early identification of scabies is crucial to avoid widespread outbreaks. Diagnosis is based on clinical symptoms, such as itching, burrows, and rash, often affecting the hands, wrists, and genital areas.

2. First-Line Treatment:

   • Permethrin 5% cream is the most commonly recommended treatment, applied over the entire body and left on for 8-12 hours before washing off. A second application is recommended after 7 days to ensure eradication of the mites .
   • Malathion 0.5% aqueous liquid is used for pregnant or breastfeeding women due to its minimal systemic absorption .

3. Simultaneous Treatment:

   • All household members and close contacts should be treated simultaneously, even if asymptomatic, to prevent reinfestation. This includes sexual partners from the...