What is scabies?

Scabies is a common, highly contagious skin condition caused by Sarcoptes scabiei, which are tiny mites that burrow into the skin. This leads to intense itching, rashes and discomfort that often worsens at night.

Whether you’re dealing with a mild case or more severe forms like crusted (Norwegian) scabies, understanding the symptoms, causes and treatment options can help you effectively manage this itchy nuisance!

What is scabies?

Scabies is an infestation of the skin by scabies mites. These tiny, microscopic mites are highly contagious and can spread quickly through close contact, such as skin-to-skin contact, making it common in households, nursing homes and among sexual partners.

The mites burrow into the top layer of the skin to lay eggs, causing an allergic reaction that leads to itching and a distinctive rash.

What does scabies look and feel like?

A scabies rash appears as small, red bumps, often forming in lines where the mites have burrowed. It’s common to see the rash in areas like the wrists, elbows, between the fingers, and around the waistline.

The rash can be more severe and widespread in people with weakened immune systems, such as those with crusted scabies, a rare and very contagious type.

Key symptoms of scabies include:

• Intense itching, especially at night
• Tiny, red bumps or blisters
• Thin, wavy lines that indicate the mites’ burrowing

Types of scabies

Typical scabies

Involves fewer mites and shows symptoms (mentioned above) mainly in the skin folds.

Crusted (Norwegian) scabies

People with crusted scabies often have weakened immune systems. This severe type involves thick, crusty patches of skin teeming with mites. It’s extremely contagious and often requires aggressive treatment.

Nodular scabies

Nodular scabies^[3] is when firm, itchy bumps (nodules) appear, often in sensitive areas like the armpits or groin. These bumps are caused by an allergic reaction to the mites and can last even after the mites are gone.

While they aren’t a sign of active scabies, they can still be very itchy and may need extra treatment, like steroid creams or antihistamines, to help with the discomfort.

Early signs of scabies

Symptoms of scabies may not appear immediately. In fact, it can take up to 4-6 weeks after exposure for signs to show up, especially in people who have never had it before.

Post-scabies symptoms

Even after treating scabies, the itching and rash may linger for a few weeks. This is called post-scabies syndrome and includes:

• Ongoing itching due to the body’s allergic reaction to dead mites and their waste
• Red bumps or nodules that can persist, especially in sensitive areas

If symptoms do not resolve after several weeks, consult your GP, as you may need further treatment.

How do you get scabies?

The mites are spread through prolonged physical contact, making close contact the most common method of transmission.

Scabies are very contagious and can spread rapidly in close-knit environments, especially among young children, sexual partners, and people living in shared spaces.

This can happen during activities like:

• Close physical contact. Prolonged touching, such as hugging or sexual contact with an infested person
• Sharing personal items. Although less common, using infected clothing, towels or bedding can also spread the mites
• Contact in communal settings. Scabies outbreaks are common in places like nursing homes, childcare centres and dormitories

Scabies prevention

Avoid prolonged skin-to-skin contact with anyone showing signs of scabies to reduce the risk. Be sure to wash clothing, bedding and towels in hot water (at least 60°C) and dry them on high heat to kill any lingering mites.

If there has been exposure, regularly disinfect shared surfaces like furniture, carpets and mattresses. Additionally, since scabies are highly contagious, you must treat all household members, even if they don’t have symptoms.

Diagnosing scabies

Diagnosing scabies typically involves a healthcare provider physically examining the affected areas. They may look for characteristic burrows, bumps and red rashes. In some cases, skin scraping might be taken to examine under a microscope for the presence of mites, eggs or mite faeces.

Scabies treatments

The most common treatment for scabies is permethrin cream (also known by the brand name Lyclear), which is applied all over the body and left on for 8-14 hours. Permethrin belongs to a group of insecticides called pyrethroids, which works by paralysing and killing any mite it comes into contact with.