Scabies

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WHAT CAUSES SCABIES? 

Scabies is an infestation of the skin by a tiny eight-legged mite called Sarcoptes scabiei.  

HOW IS IT TRANSMITTED? 

It is usually transmitted by skin-to-skin contact. This can be sexual, or other close contact (such as parents holding babies). Scabies mites can survive away from humans for about 24-36 hours, so it is possible to contract scabies from sources such as bed linen and clothing, although this is much less common.  

WHAT ARE THE SIGNS AND SYMPTOMS? 

The main symptom of scabies is itching. This is usually intense, typically worse at night and after a hot shower or bath, and can involve large areas of the body. Usually there is little rash to see, even though the itch is severe. Scabies mites burrow into the skin, and the burrows may be visible particularly between the fingers, on the wrists, armpits, stomach and genitals. These too are often difficult to see. In the genital area bumps may be present.  

HOW LONG UNTIL SYMPTOMS DEVELOP? 

Symptoms typically develop 3-4 weeks after infection. However in people who have previously been exposed they may occur within 24-48 hours, because the immune system takes less time to respond.  

HOW DO YOU TEST FOR SCABIES? 

Scabies is often recognised by its typical signs and symptoms. In some cases a skin scraping may be taken to confirm diagnosis.  

HOW IS SCABIES TREATED? 

Scabies is usually treated by applying a topical antiscabetic cream to the skin. At Melbourne Sexual Health Centre 5% Permethrin (Lyclear, Quellada) is usually used. 

For the scabies to be effectively treated you should follow these instructions carefully: 

  • Creams are better absorbed after a shower and towel drying. 
  • Unless the health professional treating you tells you otherwise, apply the cream to the whole body from the chin down, paying special attention to the spaces between the fingers, under the nails, the soles of the feet and between the buttocks. This may be easier with a sponge or pastry brush. 
  • Do not wash your hands afterwards. 
  • The cream should be left on for 12-24 hours (e.g. overnight). You can wash it off after that time. If washed off sooner it should be reapplied. 
  • Wash bedding, recently worn clothing and towels in hot water at the same time as your treatment. Because mites die if they are not in contact with a human for some time, storing clothes and shoes for a week is also effective. 
  • Close contacts such as family members and sexual partners should be treated at the same time. 
  • The treatment may need to be repeated in one week to kill mites which have recently hatched. 
  • It is important to contact any sexual partners or other close contacts so that they can be treated too.

I FOLLOWED THE TREATMENT INSTRUCTIONS CAREFULLY, SO WHY AM I STILL ITCHY? 

Symptoms can persist for around 2-3 weeks, even if the scabies has been effectively treated. The itch is caused by your body’s immune system responding to the mites, and this can take time to settle down. There are treatments available to help with the itch, so talk to your doctor or pharmacist if it is a problem. If symptoms persist for longer than 2-3 weeks you should see your doctor for review.  

CAN I STILL INFECT OTHERS AFTER I’M TREATED? 

Scabies usually stops being infectious 24 hours after treatment.  

HOW DO I AVOID GETTING SCABIES AGAIN? 

The best way to avoid getting reinfected is to follow the treatment instructions carefully, and make sure all close contacts are treated at the same time.  

DOES HAVING SCABIES MEAN THAT SOMEONE HAS POOR PERSONAL HYGIENE? 

No. Scabies can infect anyone, regardless of how often you wash. 

DISCLAIMER:
This fact sheet is designed to provide you with information on Scabies. It is not intended to replace the need for a consultation with your doctor. All clients are strongly advised to check with their doctor about any specific questions or concerns they may have. Every effort has been taken to ensure that the information in this pamphlet is correct at the time of printing.
Last Updated August 2012