The Lambda Clinic - Sexual Health Advice - Patient Information Leaflet
http://www.lambdaclinic.co.uk/scabies.html
Scabies
What causes scabies?
Scabies is caused by a tiny insect (mite) about 0.4 mm long (smaller than a pinhead) which lays eggs that hatch into mites after a few days.
How does one get scabies?
Scabies is passed on by direct body contact with someone who has scabies and therefore can be passed on during sex as the mites are found in the genital area, wrists and elbows, arms, breasts, fingers, feet, ankles and buttocks. The mites live for up to 72 hours off the body and so occasionally scabies can spread from bedding, clothing and towels.
Both women and men can get scabies to pass the problem on.
Symptoms of scabies
Not everyone will have any visible signs or symptoms of scabies, or not be aware of them.
If symptoms occur, there is usually an itch and rash due to an allergy to the mites. The symptoms usually last for between 2 6 weeks after being infected.
If you do get symptoms they may include:
ˇ Itch which can often be quite disabling and intense. Itchy skin tends to be in one area at first (usually the hands) which then spreads elsewhere. The itch is worse at night and often worse after a hot bath.
ˇ Scratching breaks the skin which then increases the risk of bacteria infection and presents as a red, inflamed, hot and tender infection.
ˇ Rash usually appears after the itch starts. It is typically a blotchy red rash appearing anywhere on the body, but most obvious on the inside of the thighs and ankles and abdomen.
ˇ Mite burrows are fine, silvery or dark lines about 2 - 10 mm long. Commonly affected areas are the loose skin between the fingers, fronts of wrists and elbows, armpits, groin, under breasts, scrotum and penis.
There is usually a misconception that if you are infested with scabies that you are 'covered in mites'. Usually there are only a few mites on the skin and despite this an intense itch and rash all over can occur.
Who should be treated for scabies?
Everyone in contact with the infected person i.e. all household members and sleeping / sexual partners even those who have no symptoms as it can take up to 6 weeks to become infected.
How to diagnose scabies?
ˇ A thorough examination of the skin can often reveal scabies. Also taking a skin flake from one of infected areas to examine it under the microscope can be easily done.
ˇ It is advisable to be tested for other sexually transmitted infections if sexual contact is the likely cause of scabies.
Treatment for scabies
Cream containing permethrin or a lotion containing malathion usually kills the mite. These preparations can be bought over the counter or by prescription. Application all over with re-application after seven days helps to ensure that all the mites are killed. During this time you should avoid sex or close body contact until the second treatment application is complete.
The following is a general guide for successful treatment:
ˇ The whole skin should be treated including the soles of the feet, back, fingers and toes, scalp, fingernails, neck, ears, face and genitals. This requires at least 30g of cream or 100 ml lotion for each application to cover the whole body.
ˇ Application should be on a cool dry skin and not after a hot bath.
ˇ Sometimes using cotton wool or a small paintbrush is good for sensitive areas such as the penis. Using a water based lotion is preferable rather than an alcohol based lotion as the latter may sting.
ˇ Children should stay off school until after the first application of treatment.
ˇ The application should be left on for the recommended 8 to 24 hours depending on the type of cream or lotion used.
ˇ A re-application of the treatment is necessary if you wash your hands or any other part of the body during the treatment period.
ˇ Treatment should be avoided if you are pregnant or breast feeding or using it for babies under 6 months (mittens should be used on babies to stop them licking the cream or lotion).
ˇ All clothes, bed linen and towels should be machine washed (at 50ēC or above) after the first application of treatment. Items that cannot be washed should be kept in plastic bags for at least 72 hours to allow the mites to die off naturally.
ˇ If bacterial infection occurs then this can be treated with antibiotics.
Note: it is not uncommon to remain itchy for a while even after successful treatment
It is not unusual to take up to 2 3 weeks for the itch to go away completely. A soothing cream such as crotamiton may help until the itch eases. An antihistamine medicine such as chlorpheniramine may also be useful to help you sleep if itching is a problem at night (particularly for children).
If the symptoms persist past 2 3 weeks after treatment then you should seek a doctor's advise. A change of treatment may help. However, the common reasons why treatment fails, or for scabies to recur are:
ˇ Failure to properly fully apply the cream or lotion, or
ˇ A close contact is not treated at the same time, and the infection is passed back and forth.
ˇ Currently, there is no evidence that complementary therapies can treat scabies.
How will I know how long I have had scabies?
This is sometimes impossible to know because your partner may have scabies and not know. You might never know whether you got it from your current or a previous sexual partner. This can often be difficult to handle. Do not be afraid to talk to the Lambda Clinic staff about how you feel.
BMI The Edgbaston Hospital
22 Somerset Road
Edgbaston
B15 2QQ
Telephone: 0121 452 2815