Scabies

Scabies is a skin infestation caused by very small mites called Sarcoptes scabiei. The mites burrow into the skin to lay their eggs. New insects hatch from the eggs and can be spread to other parts of the skin by scratching.

Scabies is spread by direct, prolonged physical contact including sexual activity. It is thought that about 20 minutes of touching is required. Scabies mites can survive away from humans for about 24–36 hours, so it is possible to get scabies from infected articles such as bed linen and clothing, although this is much less common. Scabies is common around the world and can affect anyone. Pets do not cause human scabies infections.

Symptoms
The main symptoms of scabies are:

* Intense itching, typically worse at night and after a hot bath or shower
* Visible burrows on the skin between the fingers and in skin creases such as armpits and genitals
* A bump or pimple-like rash, which is often difficult to see.
* Small, clear, fluid-filled spots or lesions.

Usually there is not much rash to be seen because the mites bury into the skin. In elderly people, the rash may appear more widespread. In children, areas such as the face, scalp, palms and soles of the feet are often affected.

Infection times may vary
Symptoms usually develop two to four weeks after infection. However, people who have previously been exposed may develop symptoms within 24–48 hours, because the immune system takes less time to respond.

Generally, a person is no longer infectious 24 hours after treatment.

Diagnosis
Diagnosis is based on observing the signs and symptoms or identifying the burrows on the top of the skin. Sometimes scabies is confirmed by taking a skin scraping and identifying the mites and eggs under a microscope.

Treatment
Treatment involves applying a cream or lotion specifically used for treating scabies. This is available from the pharmacist.

Follow these instructions carefully to effectively treat scabies:

* Creams are better absorbed after a shower and towel drying.
* Apply a thin layer of the treatment to your whole body surface, from the chin down. Avoid your eyes, nose and mouth and pay particular attention to the areas between your fingers, under your nails, the soles of your feet and between your buttocks. A pastry brush may make it easier to apply.
* Do not wash your hands after treatment.
* Leave treatment on for 12–24 hours and then wash thoroughly. People often choose to apply the cream in the evening and leave on overnight.
* Re-apply cream to any area that has been washed within 12–24 hours.
* If possible, ask someone else to apply the cream for you. This will make sure your whole body surface is covered with cream.
* The treatment may need to be repeated in one week’s time to kill recently hatched mites.

If the pimples or spots become infected, antibiotics may be necessary.

Some people require different treatment
Treatment is different for some groups of people, including:

* Babies and children under two
* Pregnant women
* People with sensitive skin
* Elderly people.

Check with your doctor or pharmacist about what kind of treatment is recommended for people in these groups.

Treat clothing and bedding
Any clothing, bedding or towels used in the last two days should be washed on a hot cycle or dry-cleaned.

Sexual partners and household members also need treatment
If you develop scabies, your sexual partners and all members of your household will also need to be treated.

The itch may last for a few weeks
The itch may persist for two to three weeks after treatment, even if the scabies have been effectively treated. This is because the itch is caused by the body’s immune system responding to the mites and may take time to settle down.
You can talk to your pharmacist about treatments available to help with the itch.

If symptoms persist for longer than two to three weeks, you should see your doctor for review.