What is scabies?
Scabies is caused by a mite, or parasite, which burrows into the skin, causing the commonly experienced itchy rash.
What are the symptoms of scabies?
An itchy rash, often worse at night. The rash appears as small, pimple-like bumps on the skin, often in a line known as ‘burrows or ‘tracks’. The pimples can be silver or skin coloured, and can become red or blistered due to irritation and broken skin caused by itching. The rash can be anywhere on the body, but usually does not affect the head or neck. More common areas affected are between the finger spaces, the wrists, elbows, waist, genital area and armpits. There may be larger, red ‘nodules’ in areas such as the scrotum and penis in men, buttocks, groin and armpits.
Although scabies can be distressing, people with scabies do not report feeling otherwise unwell. If you are feeling unwell with fever or flu-like symptoms it is important to mention this when being seen by a healthcare professional.
How is scabies diagnosed?
Scabies is diagnosed by a healthcare professional following careful review of the symptoms, how long they have been present, and examination of the rash. It is not necessary to send off any samples of skin to diagnose scabies. Occasionally skin scrapings may be taken if there is any uncertainty about the diagnosis.
How is scabies treated?
Scabies is treated with a cream called permethrin. The cream should be applied to the whole body, including the face, neck, ears and scalp, and kept on for 8-12 hours. Before applying the cream, ensure the skin is clean and avoid hot baths prior to application. Be careful to ensure cream is re-applied if hand washing. Some people find it useful to apply the cream before bed. After 8-12 hours, the cream should be washed off. You will need to repeat the treatment 7 days later.
All clothing, bedding and towels should be washed at a high heat (60oC), and if possible in a hot drier, and floors should be thoroughly vacuumed. Clothing that cannot be washed can be put in a sealed bag for at least 3 days until the mites die.
It is very important that all household contacts are also treated. This will help to prevent cross-infection and re-infection.
If permethrin treatment is unsuccessful, there are other treatments available and this can be discussed with your healthcare professional.
For the itch symptom an antihistamine medication is recommended. Antihistamines are available over the counter from most local pharmacies. Eurax (crotamiton) anti-itch cream can also be helpful.
Although the treatment kills the scabies mites quickly, the itching can carry on for a few weeks.
Are there any side effects of the treatment?
Permethrin cream is a safe treatment for scabies, including during pregnancy and breastfeeding. Some people may notice a burning or stinging sensation when first applying the cream, but this normally resolves within a few hours and the advice is to continue with the treatment.