Scabies is a parasitic skin condition caused by tiny mites that burrow into the skin to lay eggs, causing severe itching and a rash. While it can affect anyone, outbreaks are more common where people are in crowded living condition.
Once infected, symptoms usually appear within two to six weeks in individuals who have not been previously exposed, though those previously infested may show symptoms within days.
Scabies is not a disease of poor hygiene, although good hygiene practices can help reduce the risk of secondary infections from scratching.
The main symptom of scabies is intense itching, which is often worse at night. The itching is due to an allergic reaction to the mites, their eggs, and their faeces.
Common signs and symptoms include:
While scabies is generally not life-threatening, severe scratching can lead to skin damage and secondary bacterial infections such as impetigo.
Crusted scabies, a more severe form, can occur in immunocompromised individuals and is highly contagious. It can lead to widespread infection, may require more intensive treatment and can be life threatening.
Scabies is primarily spread through prolonged direct skin-to-skin contact with an infested person. Indirect transmission through infested clothing, bedding, or towels is possible, particularly in cases of crusted scabies, but this is less common.
Treatment involves killing the mites and their eggs using prescription medications. The most common treatments include permethrin cream or malathion lotion.
All household members and close contacts should be treated, even if they don’t have symptoms. Bedding, clothing, and towels should be washed in hot water and dried at high heat or sealed in plastic bags for a week to kill the bugs. Itching may persist for several weeks after treatment.
Preventing scabies focuses on avoiding prolonged skin-to-skin contact with infested individuals.
Good hygiene practices, prompt treatment of confirmed cases, and thorough cleaning of items such as bedding and clothing can reduce the risk of spread. In communal living environments, early detection and treatment can prevent the infection running out of control.
Humans have been affected by scabies for millennia – in the Divine Comedy Dante describes forgers and alchemists condemned to suffering he disease for their sins. Thomas Moffett, a physician, is thought to have identified the mite in the 16th century. Contrary to popular belief the disease is not down to poor hygiene, although it is common in crowded living conditions.
In October 2024 GPs in the UK reported a spike in scabies infestations, particularly among university students, alongside a shortage of treatment.
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