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Treatment practices in the management of scabies in infants younger than two months
Cristina Thomas1, Wingfield Rehmus2, Aileen Y Chang3
1Harvard Medicine-Dermatology Combined Residency Training Program, Harvard Medical School, Boston, MA, USA.
Insights
Permethrin is commonly used to treat scabies in infants under two months old, despite not being FDA-approved. Dermatologists prefer permethrin, reporting few mild side effects in this young population.
Area of Science:
- Dermatology
- Pediatric Dermatology
- Infectious Disease
Background:
- Limited efficacy and safety data exist for scabies treatments in infants.
- Topical permethrin, a common adult scabies treatment, lacks approval for infants under two months globally.
- This study addresses the gap in knowledge regarding scabies management in this vulnerable infant population.
Purpose of the Study:
- To describe current treatment practices for scabies in infants younger than two months.
- To identify preferred scabies medications and reasons for their use or non-use in this age group.
- To gather data on perceived and experienced side effects of scabies treatments in young infants.
Main Methods:
- An international online survey was distributed to physicians via dermatology networks.
- Data collected included physician demographics, medication availability, and experience with scabies treatments.
- Survey questions focused on medication preferences, deterrents, administration, and side effects in infants under two months.
Main Results:
- Fifty-seven pediatric dermatologists from seven countries responded, primarily from the United States.
- Permethrin (82.5%) and precipitated sulfur (61.4%) were the most frequently used treatments.
- Permethrin was the preferred agent for 66.7% of respondents, with few reported side effects (4.3%).
Conclusions:
- Permethrin is widely used and preferred by dermatologists for treating scabies in infants under two months.
- Deterrents to permethrin use, such as potential side effects, were reported, but actual side effects were infrequent and mild.
- The findings support the common clinical practice of using permethrin in this population despite regulatory limitations.
Background/Objectives:
Efficacy and safety data of scabies treatments in infants are limited. Although topical permethrin is used in the treatment of scabies in adults, it is not approved for use in infants younger than 2 months of age in many parts of the world. This study aimed to describe treatment practices in the management of scabies in infants younger than 2 months.
Methods:
An online survey was developed and distributed to physicians worldwide through the Society of Pediatric Dermatology and the Pediatric Dermatology Research Alliance. Data collected included demographics, medication availability, experience using medications, deterrents to medication use, medication administration preferences, perceived and experienced medication side effects, and preferred treatment agent in this population.
Results:
In total, 57 physicians from seven countries responded. The majority of respondents were board-certified in pediatric dermatology (48/57, 84.2%) and resided in the United States (44/57, 77.2%). Respondents had experience using permethrin (47/57, 82.5%) and precipitated sulfur (35/57, 61.4%) most frequently. Most (38/57, 66.7%) preferred permethrin as their treatment of choice. Among those who did not use permethrin, potential side effects (8/10, 80%) were most frequently reported as a deterrent from its use. However, only 4.3% (22/47) of those who used permethrin reported side effects, including itching, erythema, and xerosis.
Conclusions:
Permethrin is frequently used in the treatment of infants younger than 2 months with scabies. Furthermore, our results demonstrate that permethrin is the preferred treatment agent among sampled dermatologists for infants younger than 2 months. Few side effects were reported, and none were serious.
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