Scabies, a common and treatable condition

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Scabies is a contagious skin condition caused by a parasitic mite called Sarcoptes scabiei that burrows into your skin. It is highly contagious and can easily be passed from one person to another through direct skin contact or infested clothing or bedding. Outbreaks often occur in confined environments such as schools, sports locker rooms, prisons or nursing homes, where people are in close proximity to each other.

Scabies mites cannot fly or jump and can only be transmitted from one person to another by prolonged, direct physical contact such as prolonged holding hands, or having sexual intercourse with an infected person. Transmission through brief and limited physical contact, such as shaking hands or hugging someone is unlikely but it can sometimes occur by sharing clothes, towels or bedding with an infected person.

Symptoms

After the initial exposure to scabies, it can take up to twelve weeks for symptoms to appear. The symptoms usually develop more quickly in people who’ve had scabies before. The most common symptoms are severe itchiness and a pimple-like rash. Occasionally, tiny burrows may be seen in the skin.

  • Intense Itching

The itch is caused by the body’s reaction to the mites droppings. It may take four to six weeks for the itch to develop initially, however if you have been infected before, you can have symptoms in 1-2 days. The itch is generally worse at night or after a hot bath/shower when your skin is warmer.

  • Rash

The rash usually appears shortly after the itching starts. It is typically a blotchy, lumpy, red rash. The rash can usually affect any part of the body, apart from the head. It is usually most obvious on the inside of the thighs, around the waist, buttocks, armpits and groin area.

 

  • Infection

Continuous scratching of the infected area can create sores that become infected. If this occurs, additional treatment with antibiotics for the skin infection may be recommended. Our Haven pharmacists will be able to advise you about whether you will need to consult your GP once they see the rash.

 

Common Sites for Scabies:

  • Wrist
  • Elbow
  • Armpit
  • Nipple
  • Penis
  • Waist
  • Buttocks
  • Area between the fingers
  • Knees
  • Ankles
  • Area between toes

 

Diagnosis
It’s a good idea to visit your Haven pharmacist first, as they can often diagnose scabies by the appearance of the rash and advise on whether or not to visit your GP.

Treatment
The most common treatment is Permethrin Cream (Lyclear).

 

  • Permethrin Cream (Lyclear) is considered safe, easy to apply and tends not to irritate the skin. It should be left on the skin for at least eight hours and may not be used on the head and necks of children under two years. This is available over-the-counter and on prescription from your Haven pharmacy and can be used on babies from 2 months. An adult will need 30g (one tube of cream) to cover the body. Particular attention should be paid to difficult-to-reach areas, such as your back, the soles of your feet, in between your fingers and toes, under fingernails, and on your genitals.  The cream is applied when your skin is cool and dry, not after a hot shower or bath. It is left on for 8-12 hours before washing it off thoroughly. It is important to reapply the cream to any area that is washed during the treatment period e.g. hands. This treatment should be repeated after 7 days.
  • A lotion containing an insecticide called malathion is also available but mainly used only if permethrin cream has not worked. Unlike permethrin cream it needs to be left on the body for 24 hours before washing off.

Creams should be applied to the whole body except the head and neck of all household members, close contacts and sexual partners of the infected person. This precaution should be taken at the same time by all those possibly affected, even if these people don’t have symptoms of scabies, to avoid reinfection.

Prevention

If someone you know has been infected with scabies, it’s important that you take the following steps as well as using the treatment mentioned above

  • Wash all clothes, towels and bed linen at a temperature above 50 degrees Celsius on the day you first apply the cream to kill the scabies mites.
  • Clothing that cannot be washed should be kept in a sealed plastic bag for 72 hours to contain the mites until they die.
  • Other alternatives to kill mites are ironing with a hot iron, dry cleaning or putting the items in a dryer on a hot cycle for 10-30 min.

Haven Pharmacist Advice

  • Wash hands before and after use of the cream
  • Patients should see your doctor or Haven pharmacist if you think you might have scabies, especially if they are elderly or have a lowered immunity. These patients are more at risk of developing crusted or Norwegian scabies, a rare form of scabies where there are a large number of mites on the skin.
  • Repeated scratching of the skin may break the skins surface, increasing the chance of secondary bacterial infections. These will often require antibiotic treatment from your doctor.
  • If you find that symptoms persist after four weeks of treatment, we would recommend contacting your Doctor right away.
  • It is important to ask your Haven pharmacist for advice on which treatment to use and to make them aware of any drugs you may be taking or if you have any allergies