Benzyl benzoate

How it works

It is toxic to the mite Sarcoptes scabiei and its eggs through actions on the parasite's nervous system, leading to its death.

Prescribing in practice

• It is irritant, can cause a burning sensation (especially on genitalia and broken skin) and is less suitable for children, in whom alternatives such as permethrin are generally preferred.
• Apply over the whole body and treat all close contacts simultaneously to prevent re-infestation.
• Avoid contact with the eyes and mucous membranes.

Monitoring

Review after treatment to confirm eradication, recognising that itch can persist for some weeks after successful treatment.

Counselling the patient

• Apply to the whole body, not just visibly affected areas, and reapply to the hands after washing.
• Treat all household and sexual contacts at the same time, and wash bedding and clothing.
• Itching may continue for a couple of weeks even after the mites are cleared.

Evidence & guidelines

Benzyl benzoate is an established scabicide, with topical permethrin generally recommended as first-line in current guidance.