Scabies is a highly contagious skin condition caused by a tiny mite that can only be seen through a microscope.

Scabies mites live on the surface of the skin and can stay there for up to two months. Mites mate and females burrow into the skin to lay their eggs. Once the eggs hatch, young mites work their way up to the skin surface and the cycle starts again. Someone who has a scabies infestation usually has between 10 and 15 mites. It presents as itchy skin and a red rash.

Scabies is transmitted if an impregnated female mite gets onto you, or you can get it through light contact with an infected person. You can also get it through contact with bedding or clothing used by an infected person. It’s very uncomfortable and although it jumps very easily from human to human, it is curable.

What are its symptoms?

Scabies symptoms are a result of an allergic reaction to mites, their eggs, their saliva or waste products. This means the symptoms can take four to six weeks to appear if you have never had a previous attack. If you’ve had a reaction before, symptoms may only take a few days to appear.

Symptoms include:

  • Itchy skin: This is usually at night, when mites are active
  • Rash: The scabies rash causes little bumps, pimples or blisters under the skin
  • Raised lines: These are the burrows made by the mite
  • Scaly patches: Some people get areas that are dry and scaly
  • Sores: If the infected person scratches the rash, it can cause sores, which may get infected
  • Crusts on the skin: This occurs with a severe infestation of scabies called ‘crusted scabies’ or ‘Norwegian scabies’.

In babies and young toddlers, scabies affects the head, neck or face, the palms of the hands and soles of the feet.

In older children and adults, the rash can appear in the armpits, on elbows, wrists and between fingers. It may also affect areas which are in close contact with clothing like the nipples, waist or beltline, or the buttocks.

How is it diagnosed?

A doctor will recognise the rash and burrows left by the scabies mite, however, doctors also sometimes remove a mite by scraping the skin or using a needle to get a sample. This is then checked under a microscope to see whether there are either mites or eggs present.

What are your treatment options?

It is very important to treat a scabies infestation, as well as those who have close contact with the infected person, even if they have no symptoms. This is because the scabies mite can remain in the skin forever if left untreated. Treat household members, friends, sleeping or sexual partners at the same time as treating the infected person.

Scabies is usually treated immediately once a diagnosis has been made with topical medicinal ointments applied directly to the skin. Topical medicines must be used at night and be washed off the following morning. This is because the mites are active at night. It is critical to follow your doctor’s instructions if you want to kill the scabies mite.

Scabies treatments also include bathing and scrubbing with Tetmosol soap. The infected person must also then apply benzoyl benzoate (ascabiol lotion) to the skin from the neck down at night for a week. The lotion is washed off in the morning.

There are other medications that will help treat scabies symptoms, including:

  • Antihistamine tablets/syrup or skin creams to reduce the itch
  • Steroid creams to bring down swelling and ease the itch
  • Antibiotics that will kill any infection that has occurred due to scratching.

Can it be prevented?

The only way to prevent scabies infection is to prevent the spread of scabies. Therefore, treating a person who has been diagnosed with scabies is most important. However, one must also treat all those in close contact with that person, even if they don’t show any symptoms – a person who is infested for the first time may not have symptoms for up to eight weeks, yet they can transmit it very easily.
In addition:

  • Anyone being treated must follow instructions carefully when it comes to medication for scabies that’s prescribed by a doctor. 
  • Use the hottest water setting possible on the washing machine when washing clothing, towels and bedding that have been in contact with an infected person, and dry them in a hot dryer. If something can’t go into the washing machine, seal it in a plastic bag for a week and the mites will die. (Mites can live for a few days on clothing, bedding or towels.)
  • Vacuum the home on the first day of treatment. This includes loose carpets, carpets and upholstered chairs or lounge suites. Once everything is clean, throw away the bag from the vacuum cleaner.
The accuracy of this information was checked and approved by physician Dr Thomas Blake in June 2015