Scabies is a common and very itchy skin condition caused by a tiny mite called Sarcoptes Scabiei. It can affect people of any age but is most common in young people when it affects the genitals.

The mites are usually spread by direct skin-to-skin contact with someone who already has scabies and sometimes, but rarely, from shared clothing, towels or bedding. Scabies on pets is caused by a different type of mite and, therefore,cannot infect humans.

People with scabies are generally in good health with anaverage of a dozen adult mites on their skin. Rarely, people with a poor immune system or who are elderly and ill due to other conditions, develop a more extensive variant called crusted scabies (Norwegian scabies) with thousands of scabies mites on the skin. This is highly contagious.

Itching is the main symptom of scabies, usually starting about a month after the mites are picked up. The itching can affect the whole body but usually spares the head and neck and is often worse at night.

The rash of scabies is a mixture of scratch marks and tiny red spots. Scratched skin may become infected and appear as pustular spots. A widespread rash similar to eczema (dermatitis) is very common. The mites are found mainly in the folds of skin between fingers and toes, the palms of the hands, the wrists, ankles and soles of the feet, groins and breasts. The scabies mites burrow into the skin in these areas to lay their eggs. The mites burrow into the skin leaving tiny spots and silver coloured lines on the skin. On the scrotal skin, larger red spots are often seen.

Scabies is diagnosed by clinical examination and sometimes confirmed by examining a scraped off superficial section of skin under a microscope.

If not treated, scabies lasts for months or even years. However, even after the mites have been killed by treatment, the itching usually continues for a few weeks before settling. Household members and sexual contacts are usually treated at the same time whether they have symptoms or not.

Permethrin cream and malathion liquid are the treatments most commonly used in the UK, applied in adults to all areas of skin below the neck and not just to the itchy parts. The treatment should be left on for at least 12 hours before being washed off. Two treatments, one week apart, are necessary to kill all mites that may have hatched out from eggs after the first application. Bedding and clothing should be washed on a normal high temperature to eradicate mites and items that cannot be washed or dry cleaned should be sealed in a plastic bag for at least 1 week or put in a freezer.

Ensure that all close contacts are treated at the same time to avoid catching scabies again which is, unfortunately, quite common.

Links:

http://www.aad.org/dermatology-a-to-z/diseases-and-treatments/q—t/scabies

www.medinfo.co.uk/conditions/scabies.html