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Scabies is a contagious skin condition that causes intense itching. It is caused by tiny mites called sarcoptes scabiei, which burrow into the skin.
Scabies can be spread through close physical contact and, less commonly, through secondary contact with clothes and bed linen.
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If you have never had scabies before, the symptoms will begin 2-6 weeks after you are initially infected by the scabies mite. This is because your immune system -which is thought to produce the symptoms of itchiness associated with scabies - needs time to react to the infection.
If you have had scabies in the past, your symptoms will begin within 48 hours of infection because your immune system will have 'learnt' to react to a scabies infection.
Scabies causes your skin to feel intensely itchy. The symptoms tend to be worse at night, and after a hot shower, or bath.
The scabies mites will also leave small red blotches and lines on your skin, which are the marks caused by them burrowing into your skin.
Burrow marks can be found anywhere on the body but, in adults, they typically appear on:
- the folds of skin between your fingers,
- your wrists,
- your armpits,
- around your waist,
- the inside of your elbow,
- your buttocks,
- the soles of your feet,
- your knees,
- your shoulder blades,
- around your breasts (in women), and
- around your genital area (in men).
In infants and young children, burrow marks tend to appear at different locations around their body including the:
- face,
- head,
- neck,
- trunk,
- scalp.
- palms of the hands, and
- soles of the feet.
Scabies is caused by the human parasite known as sarcoptes sabiei. An infestation starts when a female mite burrows into your skin. The mite can burrow into your skin within 30 minutes.
Male mites move between different burrow sites looking to mate with an unfertilised female. Once mating has taken place, the male mite dies and the female mite begins to lay eggs, which will hatch in approximately 3-4 days. The eggs take 10-15 days to grow into adult males, or females.
Without effective treatment this life cycle can continue indefinitely. Scabies mites are resistant to soap and hot water, and they cannot be scrubbed out of the skin.
The exact cause of the intense itchiness that is associated with scabies is unknown, but most experts believe that the itchiness is caused by the immune system reacting to the mites, and their saliva, eggs, and faeces.
How scabies is transmitted
Scabies mites cannot fly, or jump, so they can only move from one human body to another if two people have direct and prolonged physical contact. For example:
- prolonged hand holding,
- sexual intercourse, or
- sharing a bed.
Transmission by brief and limited physical contact, such as a handshake, or a hug, is unlikely.
Scabies mites can survive outside the human body for between 24-36 hours, so it is possible to become infested by coming into contact with contaminated clothes, or bed linen. However, this is a far less common way of acquiring the condition.
Scabies infestations can quickly spread because people are usually unaware that they have the condition until 2-6 weeks after the initial infection has taken place. In confined environments, such as schools, or nursing homes, where people are in close proximity to one another, there is an increased risk of catching scabies.
People often regard scabies as a condition that results from poor personal hygiene and living conditions, but there is no evidence that this is the case. Scabies can affect people from all walks of life.
The two most widely used treatments for scabies are permethrin cream (Lyclear)and malathion lotion (Derbac M). Permethrin is usually recommended first, and malathion lotion is used if the permethrin cream proves ineffective. Both medications contain insecticides that kill the scabies mite.
Applying the medication
It is important that all members of your household, and any close contacts (including all your sexual partners over the last six weeks or, if you have had scabies before, any sexual person that you have had sex with within the previous 48 hours), are treated at the same time, even if they do not have any symptoms. If they are not treated, re-infection could occur.
Follow-up treatment after seven days is advised to make sure the treatment is successful. This is to ensure that any mites that have hatched from existing eggs will be killed by the second application.
