Pharmacists and doctors notice uptick in scabies cases
Pharmacies have seen a rise in scabies medication sales since fall and a family doctor says cases have increased in recent years. Proper treatment is essential.
Pharmacists in Tallinn and Tartu have observed a noticeable uptick in purchases of scabies treatments since the fall.
Südameapteek marketing and communications director Enel Kolk confirmed the same trend, telling ERR that December in particular saw an unusually high demand for scabies medications — whether custom-mixed on site, prescribed or available over the counter.
"It's eased off a bit now, but this isn't something we typically see every December or January. It feels like there's a wave going on," Kolk said.
According to Triinu-Mari Ots, head of the Laagri Family Health Center, scabies cases have already been more common over the past year or two. She noted that pharmacies tend to have a broader picture of outbreaks, since doctors usually see more severe cases when initial treatments fail or when patients need a prescription.
"As a doctor, I'm seeing some resistance," said Ots. "There's increased resistance to permethrin, the standard over-the-counter treatment, though we don't know why."
Ots emphasized that scabies is not caused by poor hygiene. It spreads as a contagious infection and can affect both children and adults.
"Adults may simply be more aware, notice the symptoms sooner and seek help earlier," she suggested. In her view, the disease does not appear to follow a seasonal pattern.
Both pharmacists and doctors agree that the most important factor is for the infected person to carefully follow the treatment instructions.
"It's absolutely essential to treat all close contacts and to apply the treatment to the entire body," Ots stressed. "The rash often shows only on the hands, so people might assume they just need to treat that area. But the scabies mite lives all over the body. And anyone you've had skin-to-skin contact with — typically, your whole household — needs to be treated as well."
She added that while pharmacists are well-equipped to advise on treatment, it's also important to wash bedding and clothing in 60-degree Celsius water. Items that can't withstand hot water should be placed in the freezer, which also kills the mites.
"It's crucial, or we'll never stop treating them," the doctor warned.
Important to follow through even after itching ends
According to a Südameapteek representative, it is crucial to complete the full course of treatment, but people often assume that once the itching stops, further treatment is unnecessary.
There are several medications available for treating scabies, but Kolk noted that doctors tend to favor prescribing sulfur ointment, which is mixed on-site at the pharmacy.
Benu Pharmacy emphasized that all scabies treatments are effective if used according to instructions and hygiene guidelines. For over-the-counter products like ointments containing benzyl benzoate and gels with permethrin, it's important to note that one tube is typically needed per person per treatment.
Scabies spreads through close skin-to-skin contact and, according to the doctor at Laagri Family Health Center, it generally does not transmit via buses or other public surfaces.
Ilona Leok, a school nurse with the Tallinn School Health Foundation (SA Tallinna Koolitervishoid), said that a first-time scabies infection is often mistaken for an allergic reaction. However, allergy medications do not kill scabies mites or relieve the itching they cause.
Scabies can be recognized by red spots and blisters that typically appear on the inner thighs, buttocks, abdomen, wrists and between the fingers. The itching caused by scabies is most intense in the evening before bed and during the night.
If an outbreak occurs in a school, care facility or similar setting, staff can receive guidance from the Health Board on how to proceed. However, the agency does not keep separate statistics on scabies cases.
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Editor: Marcus Turovski
