Scabies

Scabies is a contagious skin condition caused by tiny mites that burrow into the skin.

Symptoms of scabies

The main symptoms of scabies are intense itching and a rash in areas of the body where the mites have burrowed.

The itching  is often worse at night when your skin is warmer.

What does a scabies rash look like?

A scabies rash is made up of tiny red spots. Scratching the rash may cause crusty sores to develop.

Burrow marks can be found anywhere on the body. These are short (1cm or less), wavy and silver-coloured lines on the skin. There’s a black dot at one end that can be seen with a magnifying glass.

Scabies usually affects the whole body, apart from the head. Some areas are more likely to be affected, including the:

• folds of skin between fingers and toes
• wrists
• underarm area
• waist
• groin
• bottom

Some people may also develop a rash on their head, neck, palms and soles of the feet. This includes older people and young children.

Get help from a pharmacist

Scabies is not usually a serious condition, but it does need to be treated.

A pharmacist will recommend a cream or lotion that you apply over your whole body. It’s important to read the instructions carefully.

Let the pharmacist know if you’re breastfeeding or pregnant.

You’ll need to repeat the treatment 1 week later.

Everyone in your home needs to be treated at the same time, even if they do not have symptoms.

Do not use pharmacy treatments on children under 2 years old. They will need to see a GP.

Anyone you’ve had sexual contact with in the past 8 weeks should also be treated.

Get help from a sexual health clinic

You should contact your local sexual health clinic if:

• you think you have genital scabies
• your partner has been diagnosed with genital scabies

When you get to the clinic, you’ll be asked for some personal details and your sexual history. You’ll then get an examination and, if necessary, treatment.

You should avoid having sex and close bodily contact until you and your partner have completed a full course of treatment.

Treatment for scabies

The 2 most common treatments for scabies are permethrin cream and malathion lotion. Both medications contain insecticides that kill the scabies mite.

Permethrin cream is usually recommended as the first treatment. Malathion lotion is used if permethrin isn’t effective.

To help reduce the itchiness, you may also be given:

• steroid cream
• menthol cream or gel
• antihistamines

You may have itchiness for a couple of weeks after your treatment has finished. This is because the immune system will still be reacting to dead mites and their droppings.

Contact your GP if you’re still experiencing itchiness 6 weeks after completing your treatment.

You can return to school or work after the first treatment has been completed.

How is scabies passed on

Scabies is spread through direct skin contact, including sexual contact.

It’s unlikely that scabies will spread through brief physical contact. For example, shaking hands or hugging.

Scabies infections can spread quickly. This is because people are usually unaware they have it until 2 to 3 weeks after the initial infection.

People who work closely together in confined environments are more at risk. For example, people working in schools, nurseries, nursing homes or university halls.

Scabies mites can survive outside the human body for 24 to 36 hours. This makes it possible to be infected by contaminated clothes, towels or bed linen. But, it’s rare for someone to be infected this way.

How to help prevent scabies

If you or someone in your family has scabies there are things you can do to reduce the risk of it spreading.

• wash all bedding and clothing at 60C or higher and, if possible, in a hot dryer on the first day of treatment
• put clothing that can’t be washed in a sealed bag for 3 days until the mites die
• clean your floors
• hoover your carpets and furniture, including the armchairs and sofa

Complications of scabies

Scabies can sometimes lead to a secondary skin infection. This is when your skin becomes irritated and inflamed through lots of itching.

Crusted scabies is a rare but more severe form of scabies. This is where a large number of mites are in the skin. This can develop in older people and those with a lowered immunity. It’s highly infectious.

Unlike normal scabies, a crusted scabies rash doesn’t usually itch. In crusted scabies, the increase in the number of mites causes thick, warty crusts to develop on the skin.