13.10.4 Parasiticidal preparations

Scabies

Prescribing Notes

• Scabies can be treated in community pharmacy under the Pharmacy First Service
• Refer to BAD website for Patient Information Leaflet on scabies
• All members of the household and close contacts should be treated simultaneously
• Aqueous preparations are preferable. Alcoholic solutions are not recommended due to irritation of excoriated skin and the genitalia
• Treatment should be applied as per product instructions. Particular attention should be paid to the webs of fingers and toes and lotion brushed under the ends of nails.
• Clothes, towels and bed linen should be washed at high temperatures at time of treatment
• It is important to warn users to reapply treatment to the hands if they are washed
• The itch, and eczema, of scabies can persist for 4-6 weeks after the infestation has been eliminated and treatment for pruritus and eczema may be required. Crotamiton, a topical corticosteroid, or a sedating antihistamine at night may be of benefit

Head Lice

• Head lice can be managed and treated in community pharmacy under the Pharmacy First Service. A variety of products are also available to purchase over-the-counter.

Pubic Lice

Prescribing Notes

• Refer to NICE CKS Public Lice
• Consider referral to Genito Urinary Medicine (GUM) clinic
• Alcoholic lotions are not recommended due to irritation of excoriated skin and genitalia
• Refer to NICE CKS for treatment of pubic lice affecting the eye lashes
• A different insecticide should be used if a treatment course fails