Scabies

Table of Contents

1. What Is Scabies?
2. Symptoms of Scabies
3. Who Is at Risk?
4. How Is Scabies Diagnosed?
5. Treatment Options
6. Preventing Scabies
7. Common Myths
8. Conclusion

Scabies is a common but often misunderstood skin condition that can affect anyone, regardless of age, hygiene, or lifestyle. Caused by tiny mites that burrow into the skin, it leads to intense itching, irritation, and discomfort, especially at night. While the symptoms can be distressing, the good news is that scabies is highly treatable with the right approach.

In this article, we’ll discuss exactly what scabies is, how it spreads, what symptoms to look out for, and the steps you can take to treat and prevent it.

What Is Scabies?

Scabies is a skin infestation caused by a microscopic mite known as Sarcoptes scabiei. These mites burrow into the upper layer of the skin to live and lay eggs, triggering an allergic reaction that results in intense itching and a rash.

It spreads through prolonged skin-to-skin contact, which means it’s most commonly passed between people who live together, sleep in the same bed, or are regularly in close contact. It can also be spread, though less commonly, through shared clothing, towels, or bedding.

Despite how uncomfortable it can be, scabies is not a reflection of personal hygiene. Anyone can get it, and outbreaks often occur in places where people are in close contact, such as households, schools and care homes.

Symptoms of Scabies

The most noticeable symptom of scabies is intense itching, often worse at night, caused by the body’s allergic reaction to the mites, their eggs, and their waste. The itching can start off mild and become more severe over time, especially if left untreated.

The most common signs to watch for are:

• Intense itching, especially at night
• Red, bumpy rash or small blisters
• Thin, wavy burrow lines on the skin (often skin-colored or grey)
• Sores or scabs from scratching
• Crusting or scaling in more severe cases

Scabies tends to appear in warm, soft areas of the body, including:

• Between the fingers and toes
• On the wrists and elbows
• Around the waist, groin, and buttocks
• Under the breasts
• Around the nipples (especially in women)
• On the penis and scrotum (in men)

In babies, the face, scalp, palms, and soles may also be affected.

Who Is at Risk?

Scabies doesn’t discriminate - it can affect anyone, regardless of age, gender, lifestyle, or hygiene habits. However, certain environments and situations can make it more likely to spread from person to person.

People more at risk include:

• Those living in close quarters, such as households, dormitories, care homes, or prisons
• Children and young adults due to frequent skin contact at school or during play
• Elderly or immunocompromised individuals
• Sexual partners, as prolonged skin-to-skin contact spreads mites easily
• Healthcare workers or carers, especially if working in environments where outbreaks occur

Scabies is not a result of poor hygiene, and having it is nothing to be embarrassed about. Because it’s so contagious, it often spreads before symptoms even appear, making fast recognition and treatment important for everyone involved.

How Is Scabies Diagnosed?

Scabies is usually diagnosed based on symptoms and a close examination of the skin. Doctors often look for the characteristic rash and burrow marks, especially in areas where scabies commonly appears.

In some cases, to confirm the diagnosis, a healthcare professional may:

• Scrape the skin gently to collect a sample and examine it under a microscope
• Look for mites, eggs, or mite droppings
• Use a dermatoscope (a tool with a magnifying lens and light) to see burrows more clearly

Scabies can sometimes be mistaken for eczema, allergic reactions, or other skin conditions. If you’re experiencing persistent itching or a rash, it’s best to speak with a healthcare provider for an accurate diagnosis and appropriate treatment.

Treatment Options

Treating scabies effectively requires killing both the mites and their eggs, and preventing reinfestation. Treatment is typically straightforward but needs to be followed carefully to ensure success.

Prescription creams and lotions

Permethrin cream (5%) is the most commonly used treatment. It’s applied all over the body (from neck down in adults) and left on for 8–14 hours before washing off. Other topical treatments include benzyl benzoate, crotamiton, or sulfur-based creams, depending on availability or sensitivity.

Oral medication

Medication such as Ivermectin may be prescribed in certain cases, such as crusted scabies, widespread outbreaks, or if topical treatments haven’t worked. A second application is usually needed 7 days later to kill any newly hatched mites.

It’s essential that all household members and close physical contacts are treated at the same time, even if they don’t have symptoms, to stop reinfestation.

You may continue to itch for a few weeks even after successful treatment. This is known as post-scabies itch and is caused by your immune system’s lingering reaction to the mites.

Soothing products, such as gentle moisturisers, fragrance-free creams, or anti-itch lotions, can help ease discomfort during recovery.

Preventing Scabies

Alongside medical treatment, it’s crucial to take steps at home to prevent scabies from spreading or coming back. The mites can survive for a short time on clothing, bedding, and other fabrics, so thorough cleaning is essential. Here are some steps you can take:

• Wash everything thoroughly. Wash clothes, bed sheets, towels, and pillowcases in hot water (at least 50°C / 122°F) and dry them on a high heat setting. Do this on the same day as you start treatment to avoid reinfection.

• Seal what can’t be washed. Items that can’t be washed (like stuffed animals, coats, or delicate fabrics) should be sealed in a plastic bag for at least 3–7 days to ensure mites die off.
• Vacuum your home. Vacuum carpets, rugs, mattresses, and upholstered furniture thoroughly. Dispose of the vacuum bag or clean the vacuum container immediately afterward.
• Avoid skin contact until treatment is complete. Scabies spreads through prolonged contact, so avoid close skin-to-skin interaction until everyone in the household has been treated and the environment cleaned.

Consistency is key. Treating your skin without cleaning your environment (or vice versa) could result in the infestation coming back.

Common Myths

Myth 1: Scabies only affects people with poor hygiene

Truth: Scabies has nothing to do with cleanliness. The mites spread through close contact, not dirt. Anyone, regardless of how clean they are, can get scabies.

Myth 2: You can catch scabies from pets

Truth: Human scabies is caused by a specific type of mite that only lives on people. Pets can get their own version of mites, but they don’t transmit human scabies.

Myth 3: Scabies will go away on its own

Truth: Without treatment, scabies won’t clear up. The mites will continue to reproduce and spread, and the itching and rash can worsen over time.

Myth 4: If I don’t have a rash, I don’t have scabies

Truth: It can take 4–6 weeks for symptoms to appear in someone who has never had scabies before, but they can still spread it to others during that time.

Conclusion

Scabies can be an uncomfortable and frustrating experience, but with the right treatment and care, it’s entirely manageable. The key is early recognition, proper medical treatment, and thorough home hygiene to stop the cycle of reinfection.

Remember, scabies is common, treatable, and nothing to be ashamed of. If you think you or someone close to you may have it, don’t wait, speak to a healthcare professional and begin treatment as soon as possible. If your skin is feeling dry, irritated, or in need of some extra comfort during recovery, soothing, fragrance-free skincare can help calm and support the healing process. Always check with your doctor or pharmacist before using anything new on treated skin.