Benzyl Benzoate for Scabies Treatment
Introduction to Benzyl Benzoate
- The American Academy of Pediatrics and other guideline societies recommend benzyl benzoate as a treatment option for scabies, particularly in cases of resistance to permethrin 1
Treatment Recommendations
- The Centers for Disease Control and Prevention (CDC) recommend permethrin 5% as the first-line treatment for scabies, but benzyl benzoate is a valid alternative, especially in cases of suspected resistance to permethrin 2, 3, 1
- Apply benzyl benzoate at 20-25% concentration daily for three consecutive days to the entire body from the neck down, leaving it on for 8-14 hours before washing 3
Special Populations
- For infants and neonates, the CDC does not recommend benzyl benzoate for those under 2 months old 2
- For pregnant and breastfeeding women, the CDC recommends permethrin as the preferred treatment due to limited safety data with other options 2, 3
Contact and Environmental Management
- Treat all close contacts, sexual partners, and family members from the previous month simultaneously, even if asymptomatic 2, 3
- Decontaminate bedding and clothing by washing in hot water, dry cleaning, or removing from body contact for at least 72 hours 3, 1
Treatment Failure Management
- Pruritus may persist for up to 2 weeks after effective treatment and does not indicate failure 3, 1
- Consider re-treatment after 2 weeks only if symptoms persist or live mites are observed 3