What is scabies?
Caused by human scabies mites (Sarcoptes scabiei), scabies is a fairly common skin condition that anyone can catch.
The symptoms are usually caused by just a dozen adult mites, which burrow into your skin, usually through your hands, and then spread through your body.
The scabies mites cannot jump or fly, so the infection can only be passed on by direct skin contact. That is why it is fairly common for several family members to have scabies at the same time. It is also commonly passed on when having sex.
There are two types, referred to as scabies and crusted scabies, which is also known as Norwegian scabies. We’ll talk about the difference later on. It is important to treat this condition quickly to stop it spreading.
Itching skin is the main symptom, which is usually worse at night. The itchiness tends to start off in just one area, often the hands, before spreading to other areas. It can affect any area, except the head, unless you’re elderly, very young or have a weakened immune system.
Scabies symptoms may only become evident two to six weeks from the point that you were exposed to the mites. The itch and rash are caused by an allergy to the mites and their saliva, faeces or eggs. If you have had scabies before, then you may notice symptoms sooner.
Scabies symptoms include:
- Itchy skin that gets worse at night/in bed.
- Mite tunnels, which look like fine, dark or silvery lines – they often appear on the loose skin between your fingers, the inner wrist or hands.
- A red, blotchy, bumpy rash.
- Hives, bites and pimple like bumps.
- Scratching, leading to skin damage and secondary skin infections.
- The worsening of other skin conditions, like eczema or psoriasis.
As we mentioned, the rash caused by scabies can cover much of your skin. However, the mites themselves are usually only found between your fingers, on the soles of the feet, and on the ankles and wrists. It is in these locations that the scabies mites burrow into the skin, where they then lay their eggs.
If you think you have scabies and notice small pus spots as an additional symptom, then this may be a sign of a secondary infection. It is important to avoid scratching the rash because this is one of the more common ways that your skin may become infected.
If your skin becomes infected, then a doctor may need to prescribe a course of antibiotics.
Our doctors can usually diagnose scabies during an online video consultation by looking at the affected area.
Scabies can look like eczema dermatitis and in some cases the doctor may need to refer you to a specialist for a skin scraping if they are unable to diagnose it just by looking at it. This can then be viewed under a microscope to see if the scabies mites or eggs are present.
Because scabies is passed on through close contact with others, it can quickly spread in certain environments, such as:
- Care facilities
- Nursing homes
- Sports or gym changing rooms
- Rehab facilities
- Shared houses
Occasionally, people with a weakened immune system, the elderly or the unwell, may get a variant of scabies that is called crusted scabies (Norwegian scabies). Crusted scabies involves thousands of scabies skin mites and in these cases the condition is highly contagious.
The crusted scabies rash resembles that of psoriasis and with crusted scabies, there may not be intense itching. You are more at risk of developing crusted scabies if:
- You have HIV or AIDS
- You are receiving chemotherapy
- You use steroids
- You take certain medicines, such as some of those that treat rheumatoid arthritis
- You are malnourished
If you have scabies, you do need to treat it. If you are confident that you have it, you can buy treatment over the counter at a pharmacy. If you’re not sure, you should see a GP for an accurate diagnosis.
Treating scabies is usually done with permethrin cream, which is an insecticide that kills the mites. The treatment usually clears up the condition completely and within a short amount of time. You will need to apply this directly onto your skin and over your whole body. An alternative is malathion liquid.
The best time to apply scabies ointments, creams or lotions is at night, when the scabies mites are most active (which is why you’ll be most itchy at this time). You may then wash off the medicine in the morning. The treatment may be repeated after seven days but a pharmacist or doctor will give you the required information on what to do.
If your symptoms are particularly bothersome or if you are not sure if it is scabies or another condition, you should see a doctor.
Symptoms may appear to get worse during the first week of treatment and this is quite normal. You should be aware that the itching may continue for a week or more, once the mites have been killed. If you’re still itchy two to three weeks after treatment, you may need to have a second course of treatment.
If you live or come in close contact with others, then the doctor may recommend that these people also complete a course of treatment. This is due to the contagious nature of scabies. These people may include your family members and sexual partners and you should all be treated at the same time, even if they don’t have the symptoms.
If scabies is left untreated, it will never go away.