Scabies

Reviewed by Dr John Pillinger, GP

What is scabies?

Scabies is a contagious skin disease caused by a mite (Sarcoptes scabiei), which is becoming increasingly common for reasons that are unknown.

Scabies spreads from person to person usually by close skin-to-skin contact or shared clothing or bed linen.

It is now accepted that mites can spread when a non-infected person stands too close to an infected person. Mites are 0.1mm in diameter.

How can you be infected with scabies?

Scabies is transferred when fertilised female mites gnaw their way through the skin and create little passageways in the process.

In these passageways, they lay their eggs and die. Approximately three weeks later the eggs hatch and a new generation of itch mites are ready to reproduce.

It will also take about three weeks from the time of infection before the itch starts. It will make the victim scratch the skin day and night and can cause bleeding.

Itch mites have their favourite areas of the body - the web spaces of the fingers and toes; palms and soles; the wrists; the armpits; the skin around the navel; and women's nipples.

How does the doctor make the diagnosis?

It is difficult for a doctor to diagnose scabies with 100 per cent certainty unless a mite can be found and examined under a microscope.

What are the prospects for the future?

Scabies will not disappear by itself; it requires treatment. There is a risk of developing eczema or other kinds of chronic skin diseases.

How is scabies treated and what medicaton is used?

The treatment for scabies is simple and efficient. The medicines used are malathion liquid (eg Derbac-M, Prioderm or Quellada-M) or 5 per cent permethrin dermal cream (Lyclear dermal cream), all of which can be bought from pharmacies without a prescription.

Medical advice should be sought before using malathion on children under six months of age, and before using permethrin on children under two years.

Malathion is applied to the whole body and washed off after 24 hours. Permethrin is applied to the whole body and washed off after 8 to 12 hours. Make sure you carefully follow the directions for use supplied with the medicine.

When there is an outbreak of scabies, it is important that the whole family is treated at the same time. Otherwise, the itch mites may return after two to three weeks because they have survived on the skin of some of the family and infected the others again.

Let people who have visited in the previous three weeks know that they may be infected. It would be a shame if family and friends later found they had scabies.

Also inform the children's schools. They need to take precautions.

The itch of scabies may persist for some weeks after the infection has been eradicated. This can be relieved by applying crotamiton (Eurax cream or lotion), providing the skin has not been damaged by scratching.

Sedating antihistamines may also be useful to relieve itching at night. Your pharmacist will be able to give you advice on the most appropriate treatments for you and your family.

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