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 be spread to other parts of the skin by scratching. Scabies is spread by direct, prolonged physical contact including sexual activity. Scabies mites can survive away from humans for about 24–36 hours, so it is possible to get scabies from infected articles such as bed linen and clothing, although this is much less common. Scabies is common around the world and can affect anyone. Pets do not cause human scabies infections.
Symptoms of scabies
The main symptoms of scabies are:
- intense itching, typically worse at night and after a hot bath or shower
- visible burrows on the skin between the fingers and in skin creases such as armpits and genitals
- a bumpy or pimple-like rash, which is often difficult to see
- small, clear, fluid-filled spots or lesions
- very itchy bumps on the scrotum or labia.
Usually, there is not much rash to be seen because the 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.
The itch may last for two to three weeks
The itch may persist for two to three weeks after treatment, even if the scabies have been effectively treated. This is because the itch is caused by the body’s immune system responding to the mites and may take time to settle down. You can talk to your pharmacist about treatments available to help with the itch.
If symptoms persist for longer than two to three weeks, see your doctor for a review.
Scabies infection times may vary
Symptoms usually develop two to four 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.
Diagnosis of scabies
Diagnosis is based on observing the signs and symptoms or identifying the 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.
Treatment for scabies
Treatment involves applying a cream or lotion specifically used for treating scabies. This is available from a pharmacist.
To effectively treat scabies:
- Apply creams after a shower and towel drying for better absorption.
- Apply a thin layer of the treatment to your whole body surface, from the chin down. Avoid your eyes, nose and mouth and pay particular attention to the areas between your fingers, under your nails, the soles of your feet and between your buttocks. A pastry brush may make it easier to apply.
- Do not wash your hands after applying the treatment.
- Leave the treatment on for 12–24 hours and then wash thoroughly. One way to achieve this is to apply the cream in the evening and leave it on overnight.
- If you need to wash any part of your body within the 12–24 hour treatment period, re-apply cream to that area after washing.
- If possible, ask someone else to apply the cream for you. This will make sure your whole body surface is covered with cream.
- Repeat the treatment after seven days to kill recently hatched mites.
If the pimples or spots become infected, antibiotics may be necessary.
Treatment for scabies may vary
Treatment is different for some groups of people, including:
- babies and children under two
- 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
Any clothing, bedding or towels used in the last two days should be washed on a hot cycle and dried in the sun, tumble-dried or dry-cleaned. Items that cannot be washed should be sealed in a plastic bag for 72 hours.
Treat sexual partners and household members for scabies
If you develop scabies, your sexual partners and all members of your household will also need to be treated.
Where to get help
This page has been produced in consultation with and approved by:
Melbourne Sexual Health Centre
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