Bug of the Season

What is scabies

Scabies is a skin condition caused by a mite that burrows under the skin causing an allergic reaction, which can result in severe itching. Although mostly found on the hands, typically between the fingers, the mites can be at a number of sites. They are too small to be seen with the naked eye.

What are the symptoms?

Severe itching, often worse at night. Itching may not start for 2-6 weeks after infestation for people who have not had scabies before, or between 1-4 days after infestation for those that have. A symmetrical rash may appear anywhere on the body but it is particularly common on the wrists, waist, inner thighs and ankles. In children the head, neck, palms and soles may be affected. Elderly people and some people with severe illnesses may have more of a generalised rash and only a small amount of itching or even no itching at all (Atypical Scabies).  The rash may look scaly, like eczema (Crusted Scabies).  Both of these conditions are more infectious than classical scabies because there are a large numbers of mites on the skin or in the crusts.

How is it spread?

It is passed from person-to-person through direct, frequent skin-to-skin contact such as holding hands. Clothing, bedding or towels should not spread scabies mites and normal laundering is required. However mites may be present in the large skin scales as with Crusted Scabies, therefore thorough removal of the shed scales from the environment through cleaning is important.

Diagnosis

Appropriately trained professionals who will look for burrows and/or mites can make a clinical diagnosis. Usually there are only a few mites on the entire body and therefore evidence of infection can easily be missed. Recovering the mite from its burrow by taking skin scrapings and identifying it microscopically may establish diagnosis. However scabies should always be suspected in the presence of the following symptoms:

•    intense itching, particularly at night
•    a symmetrical unexplained rash
•    burrows and other lesions on the sites mentioned above

How is it treated?

The treatment is with a lotion or cream that is applied to the skin for a number of hours and then washed off. Your family doctor should provide you with a prescription for you and your family. Also most treatments can also be bought from a chemist, although some are only available through a doctor’s prescription.

All residents in care homes and other residential settings, including staff and close contacts of residents and staff with symptoms must be treated as they may have scabies but not have symptoms. For those who have been diagnosed with a scabies rash, treatment should be undertaken twice, one week apart.