PATIENT INFORMATION LEAFLET

SCABIES

WHAT ARE THE AIMS OF THIS LEAFLET? WHAT DOES SCABIES FEEL AND LOOK
LIKE?
This leaflet has been written to help you
understand more about scabies. It explains Itching is the main symptom of scabies, and it
what it is, what causes it, what can be done is often worse at night. It can take about a
about it, and where more information can be month from the beginning of the infestation
found about it. for the symptoms to appear.
WHAT IS SCABIES? The itching can affect the whole body apart
from the head and neck. The elderly and
Scabies is an extremely common and very
infants may develop a rash in these areas. It
itchy skin rash caused by a tiny mite (insect)
is common for several people in the same
called Sarcoptes scabiei. There are records of
family and their friends to become itchy at
scabies affecting humans since ancient times
roughly the same time.
(at least 494 BCE).
A person affected by scabies will usually have
WHAT CAUSES SCABIES?
a mixture of scratch marks and tiny red spots
The mites that cause scabies are tiny on their skin. Scratched areas may develop
parasites (an organism – a parasite that lives crusty sores which can become infected and
on or inside another organism – the host) develop into small pus-filled spots. A
which are smaller than a pinhead. They are widespread rash similar to eczema is very
usually spread by direct skin-to-skin contact common. The itchy rash can cover much of
with someone who already has scabies and the body, but the mites are mainly found in
sometimes, but rarely, from shared clothing, the folds of skin: between fingers and toes,
towels or bedding. People affected by scabies the palms of the hands, the wrists, ankles and
have an average of about a dozen adult mites soles of the feet, groins and breasts. The
on/in their skin; a few may carry many more. scabies mites burrow into the skin in these
Anyone can get scabies as it is very easily areas to lay their eggs, leaving tiny spots and
spread between people. It is not caused by silver-coloured lines, called burrows, on the
being dirty or unhygienic. skin. Adult mites are tiny, only about 0.4 mm
long which, when looked at through a
Rarely, a variant of scabies known as ‘crusted
magnifying lens or dermatoscope, appear as
scabies’ (previously called Norwegian scabies)
a tiny dark dot at the end of a silver line.
can occur in people who have a poor
immune system or who are elderly and ill due HOW IS THE DIAGNOSIS OF SCABIES
to other conditions. There are thousands of MADE?
scabies mites on the skin in this variant and it
The clinician will usually be able to diagnose
is therefore highly contagious.
scabies based on the history provided and
Scabies in animals is called ‘mange’. It is examination of the skin. You may have been
caused by a different type of mite and in contact with someone who has been
therefore cannot live on/in humans. diagnosed with scabies and has the typical
symptoms.
IS SCABIES HEREDITARY?
CAN SCABIES BE CURED?
No, but it is common for several members of
a family to have scabies at the same time as it Yes, with the right treatment, it clears up
spreads easily when people live together. quickly and completely; but if it is not treated,

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scabies can last for months or even Treatment is best applied at night – see
years. Prompt treatment of all those affected, below for tips on how to use:
and any possible contact, is required to
manage symptoms and prevent 1. Remove all clothes.
complications and spread. 2. Wash before treatment with cool (not
hot) water, ensuring the skin creases
HOW SHOULD SCABIES BE TREATED? and areas under nails are cleaned
The best way to treat scabies and avoid thoroughly. It is best to cut nails short.
recurrence is to ensure that all family 3. Apply treatment to clean, cool and dry
members, friends, and other close contacts skin.
(see below) are treated correctly at the same 4. Apply to ALL areas of the skin, including
time, even if symptoms are not present. all of the body, neck, scalp and face
(only avoiding areas around the eyes).
Who should be considered a ‘contact’? The product advice may suggest not
Scabies can spread easily through skin-to- treating the scalp and face, but it is best
skin contact with other people. Contacts will that all these areas are treated.
likely include all household members and 5. Certain areas of skin need particular
sexual partners. It could also include any attention for treatment to be successful
other skin contacts such as members of – ensure the product is applied
sports teams and individuals who do not live generously to:
in an affected household but provide care, • skin between fingers and toes
e.g. visiting family members, child minders o ideally, remove all jewellery, or
and adult day care providers. Not all make sure to apply to the skin
individuals with scabies have itch and rash. under jewellery
Asymptomatic people will re-infest their o apply the product to soles of
contacts if they are not treated concurrently. feet last
It is important to recognise that some will feel • genital skin
shame or guilt, which may have an impact on • skin behind ears
use of treatments, however, in reality, anyone • nipples
can be infested by scabies. Informing and • under fingernails and toenails
reassuring relevant contacts so that they can (using a soft toothbrush can help
receive effective treatments is vital to stop with this).
the spread of scabies. 6. Once applied, leave 10-15 minutes for
the product to dry before dressing.
WHAT TREATMENTS ARE AVAILABLE FOR Treatment should be left on the skin for
SCABIES? at least 12 hours.
Several treatments are available including 7. Some people may benefit from a further
topical (applied to the skin) and oral (tablets). application 12 hours later, this will
ensure the medication is on their
Effective topical treatments include skin for 24 hours. If any skin is washed
permethrin cream, malathion (spray) and during this time (most likely to be the
benzoyl benzoate (currently licensed only in hands), the product should be
Ireland). The doctor may suggest different reapplied.
options for women who are pregnant or 8. The product should be washed off
breast-feeding, and for babies. These can be without soap initially, i.e. just water.
prescribed, bought over the counter, or Once completely showered, soap
purchased from on-line pharmacies without and/or moisturisers or emollients can
a prescription. be used.
9. Once treatment has been used you can
Advice for application of topical treatments
return to all normal activities.
The mites may be anywhere on the skin, so
10. Treatments should be repeated as
the treatment must be applied to ALL areas
above 7 days later to ensure both the
of the skin, and not just to the itchy parts.

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 scabies mite and the scabies eggs have
been destroyed.
For certain forms of scabies, a tablet called Please note that the British Association of
Ivermectin can be prescribed. Dermatologists (BAD) provides web links to
In most cases, the mites will not survive for additional resources to help people access a
long on bed linen, towels and clothes. Normal range of information about their treatment or
washing of these is recommended at the skin condition. The views expressed in these
same time as treatment. Any item that external resources may not be shared by the
cannot be washed should be placed in sealed BAD or its members. The BAD has no control of
bags for 3 days.
and does not endorse the content of external
When scabies has been caught from a sexual links.
partner, a full sexually transmitted infection
(STI) check is advised.
WHAT SHOULD I DO IF MY SYMPTOMS
DO NOT IMPROVE?
Even after the mites have been killed by
treatment, the itching usually carries on for a
few weeks before settling.
This leaflet aims to provide accurate
Scabies treatments applied to the skin can
information about the subject and
cause skin irritation: this can be one cause of
an ongoing rash and itch. Moisturisers is a consensus of the views held
(emollients), topical corticosteroids (steroid by representatives of the British
creams or ointments) and antihistamine Association of Dermatologists and the
tablets may be used if needed. British Society of Paediatric and
A recurrence of scabies is, unfortunately, Adolescent Dermatology: individual
quite common, especially if not all contacts patient circumstances may differ, which
are treated at the same time. If scabies is might alter both the advice and course of
ongoing or recurrent, then all cases and all therapy given to you by your doctor.
relevant contacts will need further treatment.
If skin problems do not settle 6-8 weeks after
This leaflet has been assessed for
treatment or if there are any ongoing
concerns, then a review of the skin by a readability by the British Association of
health worker should be arranged. Dermatologists’ Patient Information Lay
Review Panel
WHERE CAN MORE INFORMATION BE
FOUND ABOUT SCABIES?
Website links to other relevant sources: BRITISH ASSOCIATION OF
DERMATOLOGISTS
[Link]
PATIENT INFORMATION LEAFLET
[Link] PRODUCED | AUGUST 2004
/scabies-update-september-2016-lay- UPDATED | MAY 2010, SEPTEMBER 2013,
[Link] SEPTEMBER 2016, SEPTEMBER 2020,
[Link] OCTOBER 2023
z/diseases-and-treatments/q---t/scabies NEXT REVIEW DATE | OCTOBER 2026
[Link]/conditions/[Link]

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