Topical scabicide Pregnancy: Do not use in pregnancy or breastfeeding (per SPC of the sourced product); inadequate evidence of safety in human pregnancy, with a possible very small risk of cleft palate and intrauterine growth retardation and neonatal HPA axis suppression.

Benzyl benzoate

Brand names: Ascabiol (specialist)

Benzyl benzoate is a topical agent used in the treatment of scabies and sometimes pediculosis, applied to the skin as an emulsion.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Apply ointment to the affected area (anal application) up to a maximum of 4 applications a day

Route: Topical / anorectal (external and internal via rectal nozzle)

Frequency: At night, in the morning and after each evacuation (max 4 applications/day)

SOURCE MISMATCH: the fetched SPC is Anusol HC Ointment (a hydrocortisone-containing anorectal product in which benzyl benzoate is an excipient, not the labelled active); it does not describe benzyl benzoate as an antiscabietic. Faithful to source: thoroughly cleanse the affected area, dry, and apply on a gauze dressing; for internal conditions use the rectal nozzle provided. Use for a maximum period of one week. Not to be taken orally. Elderly (over 65): as for adults. Children: not recommended. Clinician to source a benzyl-benzoate-specific product (e.g. topical antiparasitic application) for the intended indication.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Tubercular, fungal and most viral lesions including herpes simplex, vaccinia and varicella
Hypersensitivity to the active substance(s) or any excipient
Pregnancy or breast-feeding

Side effects

Application site reactions (burn, erythema, exfoliation, irritation, pain, pruritus, rash, urticaria)
Hypersensitivity (rare)
Blurred vision (not known)
Skin sensitisation reactions and systemic contact dermatitis

Interactions

Concurrent use with other corticosteroid preparations (topical or oral) may increase likelihood of systemic effects
Co-treatment with CYP3A inhibitors, including cobicistat-containing products, may increase risk of systemic effects

Clinical monograph

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.

Reference: NICE CKS Scabies; UKHSA; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Pathways