In the rest of Europe, a preparation is used to treat scabies, which is not available in Finland.
- In Finland, benzyl benzoate solution, which is commonly used in other parts of Europe, is not available for the treatment of scabies.
- With the help of the benzyl benzoate solution, almost 90 percent of the patients in the study got better.
- The effectiveness of the permethrin cream seems to have weakened considerably.
Finnish practice in the treatment of scabies is different from other European countries. We lack a product that has been found to be effective elsewhere in the treatment of scabies.
This missing preparation is benzyl benzoate solution.
Currently (March 5, 2024) in Finland, permethrin cream, sulfur vaseline cream and ivermectin tablets used in addition to these creams are used to treat scabies.
Permethrin used to work well for scabies, but the situation has changed. Permethrin cream, when used correctly, can cure some scabies, but not all.
– The clinical observation is that permethrin is no longer effective at all in some of the hypothyroid patients, stated the chief doctor of dermatology Katariina Hannula-Jouppi In the Swedish Institute of Health and Welfare’s (THL) cause information (March 4, 2024).
According to Hannula-Joup, permethrin cream is losing its status as a first-line treatment option for scabies. According to him, ivermectin tablets and sulfur vaseline are still effective for treating scabies.
If scabies does not improve with treatment, the reason may be a developed resistance to the treatment cream. The treatment can also fail because the cream has been applied incorrectly, only one treatment session has been performed, and there is insufficient scab cleaning or all close contacts have not been treated. ADOBE STOCK / AOP
Recommended in Europe
According to Hannula-Joup, benzyl benzoate solution is an effective and European-recommended first-line treatment for scabies.
In the study, a 25% benzyl benzoate solution cured 87% of the causative patients, and a 5% permethrin only 27%. 10-25% benzyl benzoate and ivermectin tablets were equally effective in curing scabies.
Hannula-Jouppi stated in her presentation at THL’s info that benzyl benzoate solution should also be included in the treatment selection of Finns.
Hannula-Joup’s presentation was made in collaboration with other dermatologists. At the end of the presentation, a specialist in dermatology and allergology was mentioned Janne Räsänen from Tays and the expert group of the Finnish Association of Dermatologists.
A number of dermatologists therefore require benzyl benzoate in the Finnish scabies treatment selection.
Dermatologist Katariina Hannula-Jouppi hopes that benzyl benzoate would be available in Finland as an over-the-counter medicine for the treatment of scabies. HELJÄ SALONEN
Not for animal drugs
Some Finns have used animal products containing benzyl benzoate to treat scabies.
Manager Maid Vuorela Fimeas reminded in syhyhyinfo that the use of products intended for animals is a health risk for humans.
– Good people, use preparations meant for humans, Vuorela appealed.
Preparations intended for the treatment of scabies have been purchased on our own from abroad in Finland.
According to Vuorela, legal online pharmacies in the European Economic Area (EEA) usually do not deliver medicines outside their country or language area.
Ordering medicinal products from outside EEA countries is prohibited.
Medicinal products may be brought into the country for your own personal use from EEA countries in a maximum amount corresponding to one year’s treatment and from outside the EEA countries in a maximum amount corresponding to three months’ treatment.
No sales license applied for
Then why is the benzyl benzoate product intended for human scabies not available in Finland?
A medicinal product can be placed on the Finnish market if a pharmaceutical company applies for a marketing authorization for its product. Marketing authorizations for medicinal products are evaluated and granted by Fimea.
– There are no pharmaceutical products containing benzyl benzoate on the market in Finland because no pharmaceutical company has applied for a sales license for such in Finland, says the chief physician Vesa Mustalami From Fime.
A Tenutex product containing benzyl benzoate and disulfiram has been used in Finland with a special permit granted by Fimea.
– The attending physician can initiate a special permit process to carry out medical treatment with a non-marketable product, if he deems the use of such a product necessary for special medical reasons, Mustalami says.
The pharmaceutical company also decides on the price of the product and whether it applies for KELA reimbursement for its drug.
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Medicines for scabies
1. Five percent permethrin cream
Permethrin cream is carefully applied to the entire skin. The scalp and ears are also lubricated without forgetting the navel. Children under the age of 3 should also take care of their face.
After applying the cream, put on cotton gloves. Disposable plastic gloves over cotton gloves when going to the toilet.
The cream is left on for 12-24 hours.
Treatment creams for a family of four cost approx 500 euros. SV compensation is not available for products.
Three importers bring permethrin cream to Finland.
2. Sulfur vaseline cream
Sulfur vaseline cream is a so-called ex tempore medicine, which is prepared in a pharmacy.
Sulfur vaseline cream is applied to the dry skin of the entire body on three consecutive evenings. The cream is left on for 12–24 hours.
Based on research, petroleum jelly seems to be more effective in the treatment of scabies than permethrin cream.
The price of a treatment session for a family of four is approx 130 euros.
The disadvantage of sulfur vaseline is its unpleasant smell. The cream also stains clothes and dries and irritates the skin.
3. Ivermectin tablets
Tablets are consumed according to the doctor’s instructions.
The price of the ivermectin tablets needed to treat a family of four is approx 180 euros.
Before corona, ivermectin was still a cheap medicine. In the early days of the corona pandemic, ivermectin was considered a miracle drug for a while, when the pharmaceutical industry raised its price. The price has remained high, even though ivermectin was not the solution for corona treatment as it was first thought.
Ivermectin is not SV-replaceable in the treatment of scabies.
Ivermectin tablets produced by three companies are on sale in Finland.
4. Benzyl benzoate solution or cream
This product is not available in Finland. In the rest of Europe, a 10–25% solution is used to treat scabies.
The solution is applied to the whole body two or three consecutive evenings. The solution is allowed to act for 24 hours.
In Finland, benzyl benzoate is only available as an ointment with a special permit. The preparation is not SV-substitutable.
In the treatment of scabies, it is never enough to simply treat the patient suffering from scabies. At the same time, all of his close circle with whom he has been in close physical contact must be taken care of.
All scabies treatments should be repeated for all of them about every week. In addition, after each treatment session, a careful scab cleaning should be done at home.
Source: Katariina Hannula-Joup’s presentation in THL’s syhyhyinfo 4 March 2024
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