The scabies situation in Finland is catastrophic – Dermatology professor was appalled by THL’s scabies line – 2024-03-02 00:47:37

Syphilis diagnoses are on the rise in Finland. According to the statistics of the Institute of Health and Welfare (THL), 21,355 cases were recorded in the whole country in 2022, and already 37,190 cases the following year.

Chief physician of the Institute of Health and Welfare (THL). Leif Feast still commented in Iltalehti’s story on Sunday that, based on research data, it is not possible to say whether the number of scabies cases in Finland has really increased explosively or not at all.

Specialist in dermatology, professor of dermatology, emerita Erna Snellman finds the claim outrageous.

– The syphilis statistics clearly show an increase in cases, which is only the crest of a wave. The situation is probably worse. Belittling the scabies problem and resistance is naive and even arrogant when you look at the situation from the patient’s side.

According to Snellman, the last year has been a disaster, because people who have already been treated come to receptions again and again despite the precise instructions.

– The worst of all are the large medical costs and trouble caused by the treatment for the family. For a large family, medications can easily cost a ton, especially if there is no insurance.

Dermatology specialist Erna Snellman thinks that the conditions of the corona epidemic could have exposed the spread of scabies when people spent more time indoors. – It’s not about any uncleanliness. Adobe stock/AOP

Already years ago

Today, Snellman, who runs a private practice, says that the increase in scabies began to be seen already 3–4 years ago. At that time, Snellman worked at the Satasairala in the Satakunta welfare area.

– There started to be a lot of scabies, whole families repeatedly came to be treated, whose scabies did not get better despite the treatment. Those who came to the hospital were, of course, only the peak of the ice age from the total number of people with scabies.

Even then, in Snellman’s opinion, scabies should have been treated as an infectious disease.

– That includes the fact that the treatment should be paid for by society. At the time, my idea was that there should also be a cause polyclinic, where people could apply directly. There, they would check whether it was scabies or not, and if necessary, medicine would be given. Unfortunately, nothing like this has happened.

Ineffective drugs

The ineffectiveness of medicines available in Finland has become a problem in the treatment of scabies infections.

In Finland, two different medicines are mainly used to treat scabies, permethrin cream and ivermectin tablets.

In the Helsinki and Uusimaa Hospital District (Hus), more and more patients have been seen for whom previous scabies treatments have not been effective.

Doctors and patients have reported that permethrin no longer works as reliably.

THL’s Lakoma previously commented to Iltalehti that there is no scientific evidence of the ineffectiveness of the medicines. According to him, the fact that the cause would develop resistance to two different drugs would be “very, very rare”.

Almost no one gets better with permethrin alone, says Snellman.

– The resistance to it is quite obvious, although it is difficult to show it. Many dermatologists therefore usually use a combination of permethrin and ivermectin. The improvement is probably due to the ivermectin then.

Scabies infection has also been treated locally with sulfur vaseline. However, it is a strong substance that can cause skin problems for people with atopy, for example.

At the beginning of the year, illegal medicinal products purchased especially for the treatment of scabies have remained in the customs’ wounds. People also try to obtain preparations for the treatment of scabies by getting them from abroad. For example, the cream sold in Sweden contains benzyl benzoate, which has been found to help effectively with scabies.

– In Finland, benzyl benzoate has been available with a special permit from the end of summer 2023. It should be available as a self-medication product as soon as possible.

Snellman finds the situation incomprehensible.

– The authorities should take initiative in this matter. The situation in Finland is worse than at any time during my long career as a doctor, and catastrophic for families, so societal intervention is needed, he states.