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Scabies is a common, extremely itchy rash caused by a mite called Sarcoptes scabiei. These parasites eat the outer (epidermal) layer of the skin cannot be seen with the naked eye although their tiny burrows might be visible. When a person is initially infected it can take up to 8 weeks before the itching begins as it takes a while for the body to develop an allergic reaction to the mite.
Scabies mites tend to favour warm, moist areas such as the external genitalia, beneath the breasts, between the buttock folds, webs of the fingers or toes and under the fingernails. However, they can be found residing anywhere on the body, including the palms of the hands and soles of the feet, though the face and neck are usually spared. People become infected with the mites either via prolonged direct skin contact with someone who is already infected or, much less commonly, by using infested bath towels, clothing or bedding. Pets do not carry the mites that infect humans and therefore spread from animals to humans does not occur.
Multiple tiny red insect bites in a row are the typical finding with scabies. The superficial burrows created by the mites appear as small curves or lines. Due to the excessive itchiness, scaly inflamed scratch marks may also become visible, and scabies infestation often resembles severe eczema (see image).
Intense itching, particularly at night and in warm environments, is the main complaint with this condition. Though there are generally no serious health consequences of uncomplicated scabies, it is important to seek treatment as soon as possible, otherwise symptoms can persist for months or even years.
A rare, highly-contagious, form of the diease referred to as crusted or Norwegian scabies, which involves extensive areas of the body being infested with a large number of mites can affect those whose natural defence mechanisms are weakened such as people who have cancer or AIDS.
The most well-established treatment for scabies involves the application of a medicated-cream containing permethrin, which is highly effective at killing the mites. However, if this fails to work another lotion containing a medication known as malathion can be used.
Due to the fact that the symptoms are caused by an allergic reaction it can take some time after the eradication of the mite before the itching completely disappears.
For the more severe, crusted form of scabies a tablet-medication called Ivermectin is given.
It is important to avoid close bodily contact or the sharing of items that have been used by others during treatment to prevent re-infection. It is also advisable for all close contacts (household members and sexual contacts) to undergo treatment, even if they have no symptoms, to prevent the condition recurring.
Our Specialist Dermatologists at the Harley Street Dermatology Clinic can offer effective treatment to patients in London (and nationally).
For further information please visit the NHS website and read the British Association of Dermatology Patient leaflet.