Severe crusted scabies warrants the combined use of Crusted scabies requires aggressive ivermectin (2-4 doses), 5% permethrin (to entire body treatment to successfully treat due to once a week and daily to crusted plaques) and 6% the large number of mites and mite salicylic acid debridement of crusts (daily). protection offered by the crusted skin. This degree of treatment needs This should be done under the direction of a specialist review and advice dermatologist either directly or via the GP All residents should have a complete head to toe skin To detect unsuccessful treatment assessment one week after the second treatment. If early and avoid facility re-infestation scabies does not appear to be improving the patient(s) should be reassessed by the GP or dermatologist. ACTION RATIONALE On the morning after everyone has been treated, all Bedding of affected individual is the bedding and towels must be stripped and hot washed most highly contaminated area, heat (500C or 1200F for at least 10 minutes) and hot dried kills the mite (hottest tumble dryer setting for 20 minutes). For bedding that cannot be hot washed/dried, see options below In the laboratory mites have survived Contaminated clothing (clothing worn immediately prior off host for 14 days in warm moist to treatment and stored clothing that has been regularly environments. In normal handled by contaminated person) must also be circumstances mites live up to a few decontaminated using one of the following methods days off host hot wash and dry as above or dry clean or seal in plastic bag for one week (7 days) at room temperature or seal in plastic bag and freeze to below -200C for at least 12 hours
Severe crusted scabies warrants the combined use of ivermectin (2-4 doses), 5% permethrin (to entire body once a week and daily to crusted plaques) and 6% salicylic acid debridement of crusts (daily). This should be done under the direction of a dermatologist either directly or via the GP Crusted scabies requires aggressive treatment to successfully treat due to the large number of mites and mite protection offered by the crusted skin. This degree of treatment needs specialist review and advice All residents should have a complete head to toe skin assessment one week after the second treatment. If scabies does not appear to be improving the patient(s) should be reassessed by the GP or dermatologist. To detect unsuccessful treatment early and avoid facility re-infestation ACTION RATIONALE On the morning after everyone has been treated, all bedding and towels must be stripped and hot washed (500C or 1200F for at least 10 minutes) and hot dried (hottest tumble dryer setting for 20 minutes). For bedding that cannot be hot washed/dried, see options below Contaminated clothing (clothing worn immediately prior to treatment and stored clothing that has been regularly handled by contaminated person) must also be decontaminated using one of the following methods hot wash and dry as above or dry clean or seal in plastic bag for one week (7 days) at room temperature or seal in plastic bag and freeze to below -200C for at least 12 hours Bedding of affected individual is the most highly contaminated area, heat kills the mite In the laboratory mites have survived off host for 14 days in warm moist environments. In normal circumstances mites live up to a few days off host
5783-Managing-Scabies-in-Age-related-Residential-Care-2.docx