Scabies

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

Scabies mainly causes two things: intense itching, and a rash in the parts of your body where the mites have burrowed. The itching tends to get worse at night, when your skin is warmer.

A scabies rash is made up of tiny red spots. If you scratch the rash, crusty sores may develop.

You can find burrow marks anywhere on the body. They are short lines, 1cm or less, wavy and silver-coloured. At one end there's a black dot, which you can see with a magnifying glass.

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

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

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

Scabies isn't usually a serious condition, but it does need to be treated.

A pharmacist will recommend a cream or lotion that you put on over your whole body. Read the instructions carefully. If you're pregnant or breastfeeding, tell the pharmacist.

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 have no symptoms. The same goes for anyone you've had sexual contact with in the past 8 weeks.

Don't use pharmacy treatments on children under 2 years old. They need to see a doctor.

Contact a sexual health clinic if:

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

At the clinic, you'll be asked for some personal details and your sexual history. Then you'll be examined and, if you need it, given treatment.

Avoid having sex and close bodily contact until you and your partner have both finished a full course of treatment.

You may also be offered tests for STIs.

• your child is under 2 years old and has symptoms of scabies, or someone else in your household has scabies
• you have scabies and think your skin may be infected, or you have another skin condition like eczema
• you have a crusted, flaky rash on your elbows, knees, hands or feet
• you've used pharmacy treatment for scabies and your skin is still itching 2 to 4 weeks after the treatment has finished

There are 2 common treatments for scabies: permethrin cream and malathion lotion. Both medicines contain insecticides that kill the scabies mite.

Doctors usually recommend permethrin cream first. If permethrin isn't effective, malathion lotion is used instead.

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

• steroid cream
• menthol cream or gel
• antihistamines

You may still feel itchy for a couple of weeks after your treatment has finished. This happens because your immune system is still reacting to the dead mites and their droppings.

Contact your doctor if you're still itchy 6 weeks after completing your treatment.

You can go back to school or work once the first treatment has been completed.

Scabies spreads through direct skin contact, and that includes sexual contact. A quick bit of touching, like shaking hands or a hug, is unlikely to pass it on.

The infection can spread fast. Most people don't know they have scabies until 2 to 3 weeks after they first catch it, so they can pass it on without realising.

People who work closely together in confined places are more at risk. Think of those working in schools, nurseries, nursing homes or university halls.

Scabies mites can live outside the human body for 24 to 36 hours. So it's possible to catch scabies from contaminated clothes, towels or bed linen. But this is rare.

If you or someone in your family has scabies, there are some things you can do to lower the chance of it spreading to others.

• 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

• don't have any close physical contact with anyone until you've finished your treatment
• don't share bedding, clothing or towels with someone who has scabies

Scabies can sometimes lead to a secondary skin infection. It happens when all the itching leaves your skin irritated and inflamed.

Crusted scabies is a rare but more severe form of the condition, with a large number of mites living in the skin. It can develop in older people and in those with a lowered immunity. It's highly infectious.

Normal scabies itches, but the rash of crusted scabies doesn't usually itch. The extra mites cause thick, warty crusts to form on the skin.