5% permethrin lotion or cream is applied to the whole These are areas of particular body including the scalp, neck, face and ears. Take infestation. New Zealand Formulary particular care to ensure permethrin is applied to the states: webs of the fingers and toes and under finger and toe application “manufacturer nails (use a nail brush as necessary), in the umbilicus, recommends excluding head, to the genitals and other skin folds. however application should include scalp, neck and face NOTE: For bed bound frail residents pay particular attention to the scalp, face and neck. Frail older adults experience infestation in the scalp/head. Wash off the lotion or cream after at least 8 hours (up Permethrin is an insecticide and to 14 hours). needs prolonged contact to be effective. If areas (eg hands or bottom) are washed during this time, re-apply the lotion or cream. After this time remove via usual personal care methods. Repeat this treatment in one to two weeks Permethrin is effective against mites, but not eggs. Treatment is repeated to kill any hatchlings and to cover any areas of skin inadvertently missed during application one. ACTION RATIONALE If treating with ivermectin (StromectolTM) the dose is Repeated doses 1 week apart have a calculated by resident weight (200 micrograms per 98% cure rate. The cure rate of a kilogram) and rounded up to available tablet size (it is single dose is as low as 70% in supplied as 3 mg tablets) dependent on resident weight immuno-compromised patients. Ivermectin is effective against mites not eggs. Treatment is repeated to kill hatchlings. The shear volume of mites in crusted This dose is repeated in one to two weeks. It may be scabies can reduce the effectiveness necessary to repeat the dose up to four times for of ivermectin crusted scabies under the direction of a dermatologist.
5% permethrin lotion or cream is applied to the whole body including the scalp, neck, face and ears. Take particular care to ensure permethrin is applied to the webs of the fingers and toes and under finger and toe nails (use a nail brush as necessary), in the umbilicus, to the genitals and other skin folds. NOTE: For bed bound frail residents pay particular attention to the scalp, face and neck. Wash off the lotion or cream after at least 8 hours (up to 14 hours). If areas (eg hands or bottom) are washed during this time, re-apply the lotion or cream. After this time remove via usual personal care methods. Repeat this treatment in one to two weeks These are areas of particular infestation. New Zealand Formulary states: “manufacturer application recommends excluding head, however application should include scalp, neck and face Frail older adults experience infestation in the scalp/head. Permethrin is an insecticide and needs prolonged contact to be effective. Permethrin is effective against mites, but not eggs. Treatment is repeated to kill any hatchlings and to cover any areas of skin inadvertently missed during application one. ACTION RATIONALE If treating with ivermectin (StromectolTM) the dose is calculated by resident weight (200 micrograms per kilogram) and rounded up to available tablet size (it is supplied as 3 mg tablets) dependent on resident weight This dose is repeated in one to two weeks. It may be necessary to repeat the dose up to four times for crusted scabies under the direction of a dermatologist. Repeated doses 1 week apart have a 98% cure rate. The cure rate of a single dose is as low as 70% in immuno-compromised patients. Ivermectin is effective against mites not eggs. Treatment is repeated to kill hatchlings. The shear volume of mites in crusted scabies can reduce the effectiveness of ivermectin