Scabies

Scabies is a skin condition caused by tiny mites called Sarcoptes scabiei.

Scabies can affect anyone. It is not caused by poor hygiene and does not mean that a person or home is unclean.

Symptoms

Common symptoms include:

• intense itching, especially at night
• a rash of small red bumps or spots
• scratch marks or crusting from scratching
• fine thread-like lines (burrows) on the skin

The rash usually affects your:

• fingers and between your fingers
• wrists
• hands
• elbows
• armpits
• waist
• buttocks
• genital area
• feet

Children, older adults and some people with weakened immune systems may also develop a rash on their:

• scalp
• face
• palms
• soles

Symptoms usually develop 2 to 6 weeks after becoming infected. They may develop more quickly if you've had scabies before.

Stopping the spread of scabies

Scabies spreads through skin-to-skin contact with an infected person.

Early diagnosis and treatment can help to prevent the spread.

Scabies often spreads among:

• sexual partners
• people living or working closely together
• people providing close personal care for others

Scabies is not usually spread through brief or casual contact, such as shaking hands, hugging or sitting beside someone.

It is also not spread through contact with animals.

Treating close contacts

To prevent scabies spreading or coming back, all close contacts need to be treated at the same time.

This usually includes:

• current sexual partners
• everyone living in the same household
• people in close physical contact during the previous 6 weeks

How scabies is treated

You can usually treat scabies with a medicated cream or lotion that you apply to your skin.

Some people may be prescribed an oral medicine instead.

Talk to a GP, pharmacist or other healthcare professional for advice on which type of treatment to use.

Treatment works best when:

• everyone needing treatment is treated at the same time
• you follow the treatment instructions carefully
• you wash any clothing, bedding and towels that may have come in contact with scabies mites on the day treatment begins

Applying cream or lotion correctly

The instructions on this page are based on the most up-to-date clinical evidence for treating scabies. They may be different from the instructions in the product leaflet.

Current clinical guidance advises treating all areas, including the face, neck and scalp, to make sure no mites are missed. Following these instructions improves the chance of successful treatment. It reduces the risk of scabies returning.

The best time to apply the cream or lotion is before bedtime. Do not apply it immediately after a hot bath or shower.

When applying the cream or lotion:

• make sure your skin is clean, dry and cool
• apply the cream or lotion to your whole body, including your neck, face and scalp - even if the product leaflet suggests not to
• avoid your eyes, or a child's mouth area (they may lick it off)
• remove all clothes and jewellery first - if you cannot remove a ring, move it so you can reach the skin underneath
• keep your nails short and brush some of the product under your nails with a soft nail brush - mites can easily escape treatment there
• apply it to the soles of your feet after your body has dried - you can do this with your feet dangling over the side of a bed or chair
• reapply the cream or lotion to your hands if you wash them during treatment
• let the cream or lotion dry (usually for 10 to 15 minutes) before getting dressed, or it may rub off
• follow the instructions on the packet about how long to leave the treatment on your skin before washing it off (usually overnight)

Pay particular attention to:

• the gaps between your fingers and toes
• under fingernails and toenails
• wrists
• armpits
• groin area
• buttocks
• skin folds

Treating all areas of your body helps to ensure no mites are missed. This improves the chance of successful treatment and reduces the risk of mites returning.

You may need help applying the treatment to areas that are hard to reach.

You need to repeat the treatment 7 days later.

How to wash off the cream or lotion

When the product has been on for the correct time, wash it off with cool water. Do not use soap.

When the cream or lotion is washed off, you can take a shower or bath using soap.

Use clean towels to dry your skin. Wash towels after using them.

Washing clothes, bedding and towels

On the day treatment begins, wash the clothing, bedding and towels you were using at 50 degrees Celsius or higher. You can also tumble dry them using a hot cycle.

Seal items that cannot be washed in a plastic bag for at least 4 days. This kills the scabies mites.

Normal household cleaning and vacuuming is fine. You do not need to use chemical sprays or fumigate your home.

Tell your close contacts

If you have scabies, it is important to tell people who may also need treatment.

This may include:

• everyone living in your home
• current sexual partners
• people you had close physical contact with during the previous 6 weeks

Early diagnosis and treatment can:

• help prevent scabies spreading to others
• reduce the chance of it returning

Going to work, school or childcare

You can usually return to work, school, childcare or normal activities 24 hours after completing your first treatment.

Most people are no longer infectious 24 hours after completing their first treatment.

But having scabies does not mean you cannot get it again. You can become infected again following contact with someone who has scabies.

Itching after treatment

Itching can continue for up to 6 weeks after treatment.

This does not necessarily mean the treatment has failed.

The skin may continue to react as the dead mites clear.

When to get medical help

Pregnancy and breastfeeding

Talk to a GP, pharmacist or midwife before starting treatment if you are pregnant, breastfeeding or think you may be pregnant.

There are different treatment options available if you're pregnant or breastfeeding.

Scabies in care facilities and shared accommodation

Scabies can spread more easily in places where people live closely together, such as:

• nursing homes
• residential care facilities
• disability services
• homeless accommodation
• prisons and places of detention
• other shared accommodation

Residents, staff and close contacts may need treatment at the same time to control the spread in these settings.