Scabies

What is scabies?

Scabies is a skin infestation caused by very small mites called sarcoptes scabiei. The mites burrow into the skin to lay their eggs. New insects hatch from the eggs and can spread to other parts of the skin when you scratch.

Scabies is spread by direct, prolonged physical contact including sexual activity.

Scabies mites can survive away from humans for about 24 to 36 hours. It’s possible to get scabies from infected belongings (such as bed linen and clothing), although this is much less common.

Scabies is common around the world. They can affect anyone regardless of how often they wash. Scabies are not a sign of poor personal hygiene.

Pets do not cause human scabies infections.

Image of scabies, courtesy DermNet

Scabies symptoms

The main symptoms of scabies are:

• intense itching of the skin – typically worse at night and after a hot bath or shower
• it can be difficult to see the areas where scabies burrow into the skin between the fingers and in skin folds (such as armpits and genitals)
• a mild rash, which can occur on large areas of the body
• itchy bumps in the genital area.

Scabies rash

Usually, the rash may not show because scabies mites bury into the skin.

In elderly people, the rash may appear more widespread.

In children, areas such as the face, scalp, palms and soles of the feet are often affected.

Scabies itch may last 2 to 3 weeks

Itching may continue for 2 to 3 weeks, after treatment. The itch is caused by an immune system response to scabies mites and may take time to settle down.

If you experience symptoms longer than 2 to 3 weeks, see your doctor for a review.

Duration of scabies infection

Symptoms usually develop 3 to 4 weeks after infection. However, people who have previously been exposed may develop symptoms within 24 to 48 hours, because the immune system takes less time to respond.

Generally, a person is no longer infectious 24 hours after treatment.

Diagnosing scabies

Scabies can be diagnosed by observing signs and symptoms or identifying burrows on the top of the skin.

Sometimes, scabies is confirmed by taking a skin scraping and identifying the mites and eggs under a microscope.

Scabies treatment

Scabies are treated with a special cream or lotion available from a pharmacy (chemist).

To effectively treat scabies:

• Apply the cream or lotion after a bath or shower. Dry yourself with a towel for better absorption.
• Apply a thin layer of the treatment to your entire body surface, from the chin down. Pay attention to the areas between the fingers, under the nails, soles of the feet and between the buttocks. (Avoid the eyes, nose and mouth.)
• Do not wash your hands after applying the treatment.
• If possible, ask someone else to apply the cream for you so the entire body surface is covered. A pastry brush may make it easier to apply.
• Leave the treatment on for 12 to 24 hours and then wash thoroughly. It may be easier to apply the cream in the evening and leave it on overnight.
• If you need to wash any part of the body within the 12 to 24 hour treatment period, re-apply cream to that area.
• Repeat the treatment after 7 days to kill recently hatched mites.

If any pimples or spots become infected, antibiotics may be necessary.

Treatment for scabies may vary for some

Treatment for scabies is different for some people, including:

• babies and children under 2 years
• pregnant women
• people with sensitive skin
• elderly people.

Check with your GP or pharmacist about what kind of treatment is recommended for people in these groups.

Treat clothing and bedding for scabies

Any clothing, bedding or towels used in the last 2 days should be washed on a hot cycle and dried in the sun, tumble-dried or dry-cleaned.

Seal items that cannot be washed (such as clothing and shoes) in a plastic bag for one week.

Treat sexual partners and household members for scabies

If you have scabies, your sexual partners and all members of your household need to be treated. If treatment is not effective, scabies infection can lead to a persistent itch.

Excess scratching can turn to skin sores that may become infected and need further treatment.

Preventing scabies and reinfection

To prevent reinfection and passing scabies on to others, follow treatment instructions carefully. Make sure all close contacts are treated at the same time.

Where to get help

• Your GP (doctor)
• Sexual Health Victoria (SHV). To book an appointment call SHV Melbourne CBD Clinic: (03) 9660 4700 or call SHV Box Hill Clinic: (03) 9257 0100 or (free call): 1800 013 952. These services are youth friendly.
• Melbourne Sexual Health Centre Tel. (03) 9341 6200 or 1800 032 017.
• Victorian Sexual Health Network – where to get tested – visit Melbourne Sexual Health Centre's GP partner clinics for STI check-ups and treatment
• Thorne Harbour Health (formerly Victorian AIDS Council) Tel. (03) 9865 6700 or 1800 134 840
• Ballarat Community Health Sexual Health Clinic Tel. (03) 5338 4500
• Bendigo Community Health Sexual Health Clinic Tel. (03) 5434 4300 Or (03) 5448 1600
• Gateway Health Clinic 35, Wodonga Tel. (02) 6022 8888 or 1800 657 573
• Sunraysia Community Health Services Tel. (03) 5022 5444
• Barwon Health Sexual Health Clinic Tel. (03) 5226 7489
• Women's sexual and reproductive health hubs (throughout Victoria)
• 1800MyOptions Tel:1800 696784 is a statewide phone service for information about sexual health as well as contraception and pregnancy options