Scabies Te waihakihaki
Scabies is a skin condition caused by a parasitic mite (a living thing). Scabies usually produces a very itchy rash.
Scabies mites
The scabies mite is so small that it cannot be seen by the naked eye. The female mite burrows under the skin and lives there. It lays eggs and leaves behind poos and chemicals that irritate the skin. The skin becomes inflamed and itchy.
The scabies mite lives on human skin, and does not live on cats, dogs or other animals. It can survive for up to 4 days on other surfaces like bedding or clothing. Most of the time mites will die if they have been off human skin for over 2 days. But if it is cold they might last up to 4 days.
Symptoms of scabies
An itchy rash usually develops between a few days and 6 weeks after a person has caught scabies. The itch mostly affects the arms, legs and trunk. It is usually worse at night or after a hot shower or bath.
The rash commonly appears between the fingers and toes, around the wrists, in the groin, around the nipples and under the armpits. It does not usually affect the face and scalp unless the person is a young child or infant.
Images of scabies rash — DermNetexternal link
You can be infected with scabies without having any symptoms.
Diagnosing scabies
Scabies is very hard to diagnose because its symptoms can vary widely between people. It can be confused with:
- allergies
- fleas
- bed bugs
- skin infections
- eczema or other skin diseases
- a reaction to a medication.
Your healthcare provider usually diagnoses scabies after examining your skin. Sometimes they might arrange for a skin scraping to be tested.
Treating scabies
Scabies is usually treated with a cream (permethrin) to kill the scabies mite and get rid of scabies from the household. The cream is available from a pharmacy without a prescription. Sometimes a tablet (ivermectin) is used.
Permethrin — My Medicinesexternal link
Ivermectin — My Medicinesexternal link
Your healthcare provider might also prescribe antihistamines and topical (rub-on) steroid creams to reduce the itching.
To get rid of scabies and make sure it does not come back, you need to carefully treat every member of the household and household items like bedding and clothing, all at the same time.
Members of the household need to be treated with creams or lotions called scabicides. The most common one is permethrin, which is available on prescription from your healthcare provider. Permethrin is safe for infants. It is also safe if you are pregnant or breastfeeding.
Permethrin — My Medicinesexternal link
Follow the specific instructions on the medication package. The instructions are likely to include these steps. It is best applied before bed.
- Apply the lotion to every member of the household. People who live outside the house who have close skin contact with members of the household should also apply the lotion. It is important that everyone applies the lotion at the same time, even if they do not have a rash or itch.
- Massage the cream over the whole body, including the ears, scalp, hair, neck and face. This is particularly important for young children who are more likely to have scabies above their neck. Avoid the eyes and mouth. Pay special attention to between the toes and fingers and under the nails. Use a soft brush to get under the nails. When anyone washes their hands in the next 12 hours, they must reapply the lotion.
- Wash the cream off 10 to 12 hours later.
- Reapply permethrin 1 week after the first application even if the members of your household do not have any symptoms.
Household members can return to work or school one day after treatment.
Treat all fabric items that household members have worn or touched in the last 4 days. Do this the day after you have applied the lotion, and then again in a week, after the second treatment.
Linen, towels, flannels, clothes and soft toys
Where possible, wash all items in hot water (in water at a temperature of 50 degrees Celsius or more).
Alternatively, put dry clothes in a dryer for at least 10 minutes on a hot setting. Or items can be put in the freezer for at least 5 hours.
You do not need to wash mattresses, duvets, pillows and underblankets if you have used sheets and pillowcases.
Carseats
Children’s carseats can be put in a plastic bag for 4 days, or hot wash any removable coverings and vacuum or wipe the hard surfaces. Vacuum seats in cars.
Vacuum carpeted floors and upholstered furniture
Vacuum clean carpets, mats, sofas and other soft furnishings each day for 4 days.
Things that could stop the treatment working
There are several things that could stop the treatment working or make it look like the treatment has not worked.
- If you do not follow all the treatment steps, you might not get rid of the scabies.
- Someone who has not been treated could reinfect the household.
- Even if the treatment worked well, the itch usually continues for up to 6 weeks. If you have completed the treatment correctly for the whole household, try to wait until the itch goes away.
- The treatment might not have worked because the diagnosis was wrong, and the rash and itch have another cause.
After treatment
At around 10 to 14 days after treatment, check all of your household members for new itchy spots or rash.
Go back to see your healthcare provider if the rash and itch have not improved.
Go back to see your healthcare provider if the itch does not go away after 6 weeks or comes back.