Canadian Guidelines on Sexually Transmitted Infections - Ectoparasitic Infestations


- Lindane has been discontinued from the Canadian market (Feb 2012) as it is a persistent organic pollutant.

- Wash clothes and bedding in hot water/hot dryer or place in plastic bags for 3-7 days. Vacuum mattresses.

- Treat all household contacts and sexual partners within last month.

- Pruritus may persist for several weeks. Retreat after 1 week if no clinical improvement.

Usual Pathogens

Sarcoptes scabiei


Empiric Therapy Dose Duration
Permethrin 5% cream (Nix®) Apply from neck down, wash off after 8-14 hours May be repeated in 7 days


Empiric Therapy Dose Duration
Sulphur 5% in petroleum Apply hs for 3 nights, wash off 24 hours after last application 3 doses

Resistant/failure of above

Empiric Therapy Dose Duration
Ivermectin 200mcg/kg PO 1 dose. Repeat in 2 weeks.
Ivermectin 1% cream Apply to all areas of the body from the neck down, wash off after 8–14 hours 1 dose. Repeat treatment in 1 week if symptoms persist.