A scarcity of therapy for the pores and skin situation scabies “is likely to become a major public health issue”, the British Association of Dermatologists has warned.

A medicine supply notification, issued by the Department of Health and Social Care (DHSC) on 8 September 2023, mentioned that permethrin 5% w/w cream (Sandoz) can be “in limited supply until further notice due to an increase in demand”.

The notification additionally warned that malathion liquid, a substitute for permethrin for therapy of scabies, was presently unavailable, including that crotamiton 10% cream (Eurex; Thornton & Ross), which is licensed for the therapy of scabies, stays obtainable “but can only meet its current demand for other conditions”.

According to the notification, ivermectin 3mg tablets are licensed for therapy of scabies, however usually are not marketed within the UK. Unlicensed provides of the product can be found, as is benzyl benzoate 25% topical emulsion, which can also be unlicensed however could be sourced from special-order producers.

Scabies is a parasitic infestation brought on by mites. The contagious pores and skin situation can result in sores and severe problems, together with septicaemia, coronary heart illness and kidney issues.

Commenting on the scarcity, Mabs Chowdhury, president of the British Association of Dermatologists, mentioned: “We are aware of an increasing number of scabies cases being reported in the UK. Given this situation, if supplies of standard topical treatments, such as 5% permethrin cream, are unavailable for treating this debilitating and intensely itchy skin condition, then this is likely to become a major public health issue.

He added that scabies commonly affects young children and adolescents and it is often associated with vulnerable adults, with outbreaks common in care homes and similar facilities.

“We urge manufacturers of permethrin and other widely used topical treatments for scabies, such as malathion, to urgently increase production to avert potential shortages in the UK.

“Unfortunately, alternatives are either unavailable or are unlicensed and very expensive,” Chowdhury mentioned.

Suraj Shah, drug tariff and reimbursement supervisor at Community Pharmacy England, mentioned provide of permethrin cream has been topic to provide disruption for a number of months, exacerbated by a number of localised scabies outbreaks.

“Whilst the DHSC issuing a medicine supply notification is a positive step, it comes much later than we would have hoped,” he mentioned.

“Unfortunately, we expect that fulfilling prescriptions will remain a challenge as alternative products may struggle to meet demand or require prescribers to amend prescriptions, and local discussions may be required to ensure patients can access treatment in a timely manner.”

Shah added that ongoing medication provide points had been inflicting pharmacy groups to spend further time sourcing medicines, contacting prescribers to subject alternative prescription for different obtainable alternate options, and explaining causes for delays in provide to involved sufferers and carers.

“We have been pressing the DHSC to think broadly about what measures could help to manage the mounting medicine supply problems and consider the introduction of greater flexibilities, such as allowing pharmacists more professional discretion to give alternative formulations such as unlicensed preparations.

“We have also been clear that more communications are needed to reassure patients and to protect pharmacy staff from the abuse that they are reporting,” he mentioned.