Scabies is a common and very itchy skin condition caused by a tiny mite called Sarcoptes Scabiei.

The scabies mite are tiny parasites, smaller than a pinhead that live on the skin and burrows into it.

Scabies can be passed from one person to another through close skin-to-skin contact. The skin-to-skin contact however needs to be for a reasonable time to catch the mite (usually at least 15-20 minutes) and most cases of scabies are thought to be caught from prolonged skin to skin contact with an infected person (the hands are the most common site to be first affected).

Close skin-to-skin contact when having sex with someone is a common way of catching scabies. The mites live in skin and can survive away from the host human for about 24-36 hours

It can take up to eight weeks for the symptoms of scabies to appear after the initial infection. This is known as the incubation period.

You are unlikely to catch scabies from an infected person by casual short contact such as a handshake or a hug. You are also unlikely to catch scabies from bedding and towels unless you share them or use them immediately after being used by someone with scabies. However, just in case, it is best to treat bedding and towels by hot washing.

• Itching. This is the main symptom of scabies. This is often severe and tends to be in one place at first (often the hands), and then spreads to other areas. The itch is generally worse at night and after a hot bath. You can itch all over, even with only a few mites, and even in the areas where the mites are not present.
• Mite tunnels (burrows). These may be seen on the skin as fine, dark, or silvery lines about 2-10 mm long. They most commonly occur in the loose skin between the fingers (the web spaces), the inner surface of the wrists, and the hands. However, they can occur on any part of the skin. You may not notice the burrows until a rash or itch develops.
• Rash.  The rash usually appears soon after the itch starts. It is typically a blotchy, lumpy red rash that can appear anywhere on the body. The rash is often most obvious on the inside of the thighs, parts of the tummy (abdomen) and buttocks, armpits, and around the nipples in women. The appearance of the rash is often typical. However, some people develop unusual rashes which may be confused with other skin conditions.
• Scratching. Scratching due to intense itching can cause minor skin damage. In some cases, the damaged skin becomes infected by other germs (bacteria). This is a secondary skin infection. If skin becomes infected with bacteria it becomes red, inflamed, hot, and tender.
• Aggravation of pre-existing skin conditions. Scabies can worsen the symptoms of other skin conditions, particularly itchy skin problems such as eczema, or problems such as psoriasis. Scabies can be more difficult to diagnose in these situations too.

Note: the itch and rash of scabies are due to a reaction (allergy) to the mites (or their saliva, feaces or eggs). Scabies symptoms usually take 2-6 weeks to occur after you are first infected. The itch and rash can develop on any part of the skin, away from where the mites are actually burrowing. This means that you are infectious and can spread scabies before you even know you have scabies.

Your GP can diagnose you if you think you have scabies. If you think you have genital scabies or your partner has been diagnosed with it, visit one of our nurse led sexual health clinics, where you’ll be examined and, if necessary, treated. Scabies will usually be diagnosed just by looking at the rash which a doctor/nurse will often be able to recognise via typical appearance.

To confirm the diagnosis, a skin sample may be gently scraped from the affected area so it can be examined under a microscope for evidence of scabies mites, their eggs and feaces.

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Scabies is curable.

Various treatments are available but none will completely get rid of the itching immediately. The most common treatment is the application of an insecticide cream. Treatment decisions must be made in consultation with your doctor/nurse as these medications are usually on prescription.

The cream should usually be left on for eight hours and re-applied to hands and under fingernails if they have been washed during that eight hours. The cream is then showered off after eight to fourteen hours and only clean towels, linens and clothes should be used. Itching may persist for several weeks after treatment due to a hypersensitivity reaction and does not mean the scabies are still alive and require more insecticidal cream.

Cleaning of clothing and bedding which might have been infested should be done on a hot wash to eliminate all the mites.

Hot baths, and scrubbing with soap and water alone will NOT cure a scabies infestation. Insecticide cream must be used.

Note: you will still be itchy for a while after successful treatment. It is normal to take up to 2-3 weeks (and sometimes up to six weeks) for the itch to go completely after the mites have been killed by treatment

See a doctor if the itch persists longer than 2-3 weeks after treatment.