Scabies

What is this?

Scabies is an infestation of the skin by a tiny mite. If left untreated, these mites can live on your skin for months.

They reproduce on the surface of your skin and then burrow into the skin to lay eggs. This causes an itchy, red rash on the skin.

How do you get it?

Scabies can be passed on by skin-to-skin contact. This can be sexual or other close contact, such as sleeping in the same bed as a person who has scabies or simply skin contact between children when playing.

Scabies mites can survive away from the body for about 24 - 36 hours, so it is possible to get scabies from sources such as bed linen and clothing, although this is much less common.

Scabies usually stops being infectious 24 hours after treatment.

What are the symptoms?

The main symptom of scabies is itching. This is usually intense, typically worse at night and after a hot shower or bath. It can involve large areas of the body.

There is often a rash, but it is usually minor compared with the itch.

Scabies mites burrow into the skin, and the burrows may be visible particularly between the fingers, on the wrists, inner elbows, abdomen and genitals. These are often difficult to see. In the genital area, you may see or feel itchy bumps.

Symptoms typically develop 3 - 4 weeks after infection. However, in people who have previously been exposed, symptoms may occur within 24 - 48 hours, because the immune system takes less time to respond.

How do you test for it?

Scabies is most often diagnosed by its typical signs and symptoms. In some cases, a skin scraping may be taken to confirm the diagnosis.

How is it treated?

Scabies is usually treated by applying a topical cream to the skin.

For effective treatment, you should:

• have a shower and dry the skin
• apply the cream to the whole body from the chin down, paying special attention to the spaces between the fingers, under the nails, the soles of the feet, the genitals and between the buttocks. Do not wash your hands after applying cream
• leave the cream on the skin for 12 - 24 hours (or overnight). You can wash it off afterwards. If washed off sooner, it should be reapplied.
• wash bedding, recently worn clothing and towels in hot water at the same time as your treatment. Mites die if they are not in contact with the human body for some time, so storing clothes and shoes in a plastic bag for a week is also effective.
• tell your close contacts - family members and sexual partners - so they can be treated at the same time

Are there any complications if not treated?

If untreated, the infection can lead to a persistent itch. Excess scratching can cause skin sores that may become infected with other common skin bacteria.

Is it likely to come back after treatment?

The treatment may need to be repeated in one week to kill any recently hatched mites.

Symptoms can persist for around 2 - 3 weeks, even if the scabies has been effectively treated. The itch is caused by your body’s immune system responding to the mites, and this can take time to settle down. There are treatments available to help with the itch, such as antihistamines and cortisone creams, so talk to your doctor or pharmacist if this is a problem.

If symptoms persist for longer than 2 - 3 weeks you should see your doctor. 

How can I protect myself?

The best way to avoid being re-infected is to follow the treatment instructions carefully, and make sure all close contacts are treated at the same time.

Scabies can infect anyone, regardless of how often you wash. It is not a sign of poor personal hygiene.

Where can I get help?

• Visit a sexual health service near you
• Visit your local doctor
• Visit your local community health centre