Scabies

What is scabies?

Scabies is caused by an infestation of tiny burrowing mites which penetrate the skin by digging tunnels. A pregnant female mite hatches eggs and the baby mites (larvae) emerge 2-3 days later. These larvae dig new burrows and the cycle repeats itself fortnightly. Children are most likely to be infested but this can occur at any age.

How is it spread?

Scabies can be spread via body-to-body contact. It is extremely contagious, often spread between two people through skin contact – it is rare for scabies to be transmitted through clothing and bedsheets unless these have been contaminated by people already infested.

Diagnosing scabies

Correct diagnosis involves a high level of suspicion and physical examination of the skin. Several family members that have suddenly developed a severe itch over a short timeframe are a key giveaway for scabies. However, itching is not always present in scabies and in practice, it can be challenging to get your family members to admit there is a history of scabies. Common places for scabies to develop are your:

• Hands
• Arms
• Skin that is covered by jewellery or accessories.

Untreated scabies can persist for months. Even if you have tried treatments for scabies, you cannot rule it out entirely because you may have used the treatment incorrectly or your family members may still be untreated leading to re-infestation.

Signs and Symptoms

The most common symptoms include:

• Intense itching (pruritus) - The itching often worsens at night to the point where sleep is affected.
• Rashes – tiny, inflamed, red spots that often form lines due to excessive itching. Constantly scratching the rashes can lead to sores which may get infected (as the skin barrier is repeatedly broken and exposed to foreign objects).
• Less commonly, severe scabies can be identified when thick crusts appear on the skin.

Which treatments are available?

Scabies is not usually a serious condition but do require treatment. There are two main treatments available over the counter from pharmacies. Treatment involves creams or lotions applied onto the skin (topical). The first line treatments are Lyclear dermal cream or permethrin 5% cream, both of which are available on our website. These drugs work as insecticides to prevent the growth of mites and kill them, including the eggs.

The exact directions for each are found on their patient information leaflets but there is some general advice to take note of for both. The treatments should be used on the entire body excluding the eyes – including the face, neck, behind the ears and nails. This is to ensure all the mites and any eggs are being exposed to the medicine. The treatment should be left on for 8-12 hours and then removed by showering. A second application is needed after a week’s time to ensure all the mites are killed. Note that successful treatment will rapidly kill the mites but the itching can still continue for a few weeks.

All family members should be treated at the same time whether they have symptoms or not to reduce the risk of reinfection. If you have had sexual contact with anyone within the past 2 months, they should also receive treatment.

You should see your GP if you have applied the medicine twice but the scabies infestation still has not resolved.

How to prevent scabies

Wash all clothes, bed sheets and towels in the washing machine at 60C or more to stop spreading and re-infestation. Any clothes which cannot be washed immediately should be separated in a sealed bag for 3 days which causes the mites to die. If your family members have scabies, do not share any clothing or personal items with them. Avoid physical or sexual contact until the full treatment has been completed.

Authored By

Melissa Keen

Medical Content Writer

Melissa is a medical content writer specialising in health and wellness, distinguished by her work with leading UK health brands.

Published on: 31/10/2023

Reviewed By

Dr Giuseppe Aragona

Doctor

This content has been checked for quality and accuracy by Dr. Giuseppe utilises his extensive experience in general practice to ensure the accuracy and safety of the website's content.

Reviewed on: 31/10/2023