Scabies infestation: everything you need to know

Just what is scabies – and how can you rid yourself of the dreaded itch?

What to do about scabies
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You might feel embarrassed if you’ve been diagnosed with scabies, but try not to worry – it’s not hygiene related. In fact, anyone can catch scabies if they come into close contact with an infected person.

Dr Adam Friedmann, consultant dermatologist at Stratum Clinics offers his expert advice on how to spot and treat the symptoms of scabies:

What is scabies?

Scabies is a common condition, the main symptom of which is an itchy rash. It’s caused by a parasitic mite, called Sarcoptes scabiei, which eats through the outer (epidermal) layer of the skin. While the mites cannot be seen with the naked eye, their tiny burrows might be visible, leaving silvery lines underneath the skin.

How is scabies spread?

People normally become infected with scabies mites via direct skin contact with a person who is already infected.

Less commonly, you might also becoming infected by using infested bath towels, wearing infested clothing or sleeping on infested bedding. Due to the close contact, if you share a bed with a person who has scabies you are highly likely to become infected.

🐶 Animals do not carry the sabies mites that infect humans, which means that you cannot catch scabies from a pet or other animal.



Scabies signs

Scabies mites typically prefer warm, moist areas of the body. These include:

  • External genitalia
  • Beneath the breasts
  • Between the buttock folds
  • In the webs of the fingers or toes
  • Underneath the fingernails

    However, scabies can set up home almost anywhere on the body, including the palms of the hands and soles of the feet. Scabies does not normally appear on the face and neck.

    Identifying the scabies rash

    The superficial burrows created by the mites appear as small curves or lines, but they can be hard to see. Often there are small weepy spots and areas of swelling and redness. Due to the excessive itchiness, scaly inflamed scratch marks may also become visible, and scabies infestation often resembles severe eczema. Sometimes the condition is very hard to diagnose.



    Scabies symptoms

    The only real symptom of scabies is intense itching. The itch can become particularly bad at night or in a warm, humid environments.

    While there are generally no serious health complications associated with scabies, it’s vital to seek treatment as soon as possible, to prevent symptoms persisting for months or even years – scabies is unlikely to clear up by itself. Treatment is also important, to stop you infecting family, friends, partners and colleagues.

    The only real symptom of scabies is intense itching, which can be particularly bad at night or in humid environments.

    Bear in mind that once you have become infected, it can take up to eight weeks for the itching to start, because it can take a while for your body to develop the allergic reaction that causes the itching.

    A rare but highly contagious form of the disease, which is referred to as crusted or Norwegian scabies, can occur when large areas of the body become infested with a considerable number of mites. This mostly affects people whose natural defence mechanisms are weak, for example, people with cancer or AIDS.



    Scabies treatment

    Scabies can be treated in a number of ways:

    • Scabies medicated cream

    The most common treatment for scabies is the application of a medicated cream containing permethrin. Permethrin is highly effective at killing the mites. If this does not work for you, your doctor may prescribe a different lotion containing malathion. While these medications will kill the mites themselves, the itching is caused by an allergic reaction, so it can take some time before your symptoms completely disappear.

    • Scabies topical steroid cream

    If your scabies is accompanied by eczema (which can sometimes happen), a topical steroid cream can be prescribed, for example, betamethasone.

    • Scabies tablet medication

    If you have the more severe, crusted form of scabies, you will require a tablet medication, called Ivermectin.

    ⚠️ Please note, you may still think you feel itchy long after the physical symptoms of scabies have cleared up. These psychosomatic effects can linger on for many months after the disease has been treated.



    Scabies prevention tips

    Once you have been treated for scabies, there are several measures you can take to help prevent re-infection. These include the following:

    ✔️Avoid close bodily contact with others who are also undergoing treatment.

    ✔️ Do not share items that have been used by others during treatment, for example towels.

    ✔️ Ensure everyone in the household undergoes treatment for scabies (as well as sexual partners) even if they have no symptoms.



    Last updated: 07-11-19

    Consultant Dermatologist and Clinical Lead Dr Adam Friedmann is a UK-trained Dermatologist who trained at King's College School of Medicine, London.
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