Scabies

Scabies is a contagious skin condition caused by tiny mites called Sarcoptes Scabiei. Using their mouth and front legs, these mites burrow into the skin’s outer layer (epidermis), where they lay their eggs. These eggs hatch within three to four days producing larvae mites, which return to the skin’s surface to mature and repeat the life cycle. This cycle can continue indefinitely unless the correct treatment is sought. Scabies mites are incapable of jumping or flying, the only way they are spread is through direct, prolonged physical contact with an infected person or object. For example:

• Having sex with someone infected with scabies
• Holding hands with an infected individual for prolonged periods of time
• Sharing clothes, towels or bedding with an infected person

If infected by the scabies mite you will experience severe itching and a skin rash on the areas where the mites have burrowed. The itching tends to worsen at night, potentially hindering sleep. The scabies mites thrive in warm conditions, which is why they will often inhabit the warmer areas of the body, such as skin folds, between fingers or toes, around the buttocks and breast creases. In the UK scabies tends to be more common during the winter months. This is attributed to people spending larger amounts of time indoors, hence being in closer quarters with others for longer. It’s difficult to gauge exactly how many cases of scabies affect the UK each year as most people don’t visit their GP, opting instead to self-treat using over-the-counter medicines.

After the initial infection, someone suffering from scabies may take up to eight weeks to present with any symptoms. This is due to the incubation period. After this period the sufferer will start to experience an intense itching accompanied by a red rash. This rash will be the result of the scabies mites burrowing through the outer layer of the skin. The scabies rash will resemble tiny red spots. It is not recommended to scratch the rash as it may result in developing crusty sores. Burrow marks are also a visible symptom. They are small in size and will resemble a wavy, silver-coloured line with a tiny black dot at one end.

For adults infected with scabies, it is common for burrow marks to appear in the following areas:

• Between the fingers and toes
• In and around skin folds
• For men; around the genitals
• For women; around the nipple area
• The sides and soles of the feet
• The elbows & wrists

The scabies rash can affect anywhere on the body with the exception of the head. The most common areas for the rash to appear include:

• The lower buttocks
• The groin
• Female genital area
• Underarms
• The inside of the elbow
• Around the waist
• The knees, lower legs and around the ankles
• The shoulder blades

Infants, young children and the elderly may present with burrow marks in places not usually associated with an infection in a healthy adult. These places include:

• The neck, face and scalp
• The palms of the hands & the soles of the feet

Self-diagnosis of scabies is usually possible through a simple visual inspection of the skin. If necessary, your GP will look for the burrow marks produced by the Sarcoptes scabiei mite. By examining and identifying the scabies rash and burrow marks, the doctor will be able to rule out other skin conditions that may be causing the itchy rash, such as impetigo or eczema.

If you are concerned you may be suffering with genital scabies, or if your partner has already been diagnosed with it, then it will be necessary to visit your nearest sexual health clinic. Here you can be properly examined and provided with the appropriate treatment.

If it has been confirmed that you have scabies, it will be necessary to treat you and your partner as well. This is regardless to whether they are presenting with symptoms or not, as it is highly likely that the infection will have been transmitted through close bodily contact.

Lotions and creams to treat scabies are commonly available over the counter without needing a prescription. One such treatment is Lyclear Dermal Cream. Lyclear Dermal Cream contains Permethrin, which belongs to a group of medicines called pyrethroids. This group of medicines kills the scabies mites.

Lyclear cream is applied all over the body to clean, dry skin, paying particular attention to the difficult-to-reach areas - one 30g tube should be sufficient to treat an adult. If necessary a cotton bud can be used to apply the treatment under the finger and toenails. The cream will then need to be left on for at least eight hours and washed off with soap and water within 12 hours. Usually, one application is sufficient, however, this process can be repeated in one week if necessary. Scabies treatment, such as Lyclear Dermal Cream, is usually recommended for all members of the same household. Treating other household members should take place at the same time as the treatment for the infected person.

Anti-itch cream, such as Eurax - containing crotamiton, helps to soothe the itching and relieve discomfort associated with scabies. It does not treat the infection.

Scabies is best prevented by avoiding direct skin-to-skin contact with an infected person. Also, by avoiding contact with contaminated items that belong to the infected person, such as clothing, bedding and furniture. The scabies mites aren’t able to survive more than two or three days away from human skin, so any clothing or bed linens worn or used by someone infected three days prior to treatment should be washed using hot water and dried at the hottest dryer cycle. Infected objects that cannot be washed, such as furniture, should be avoided or enclosed in a plastic bag for several days.

It’s important to acknowledge that even when following these strict preventative measures it is still possible to contract scabies. The problem being, a person infected for the first time can take up to two months to develop any symptoms. During this time they are still able to unknowingly spread the infection to others. So preventing scabies is possible but even the best preventative measures can fail under certain circumstances.