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Scabies is a skin infestation caused by tiny mites (Sarcoptes scabiei) that burrow into our skin to lay eggs. The presence of the mites on the skin and their waste products cause an allergic reaction that produces intense itching. Scabies like warm places and skin folds. They generally occurs on the fingers, toes, hands, wrists, elbows, armpits, breasts, buttocks and male genitals. Sometimes the rash occurs in other areas too such as the lower legs, soles of feet, ankles, knees and female genital area. In children, seniors and those with a low immune system, the rash can also develop on the face and neck.


  • Intense itching which is often worse at night
  • A rash of bites or spots
  • Sometimes crusty sores develop
  • Silver lines on skin where mites have burrowed

What causes scabies?

Scabies occurs when tiny insects (mites) burrow into the skin and lay eggs. The eggs hatch into larvae which move about the skin before maturing into adult mites which lay eggs of their own. The itching associated with the condition is due to our immune system reacting to the saliva, eggs and faeces that the mites secrete onto our skin.

Scabies is caught through skin-to-skin contact with an infected person, through sexual contact or from shared clothing, towels and bedding. As the mites cannot jump or fly, they can only be caught via prolonged physical contact between people.

How is scabies treated?

Scabies is treated with insecticide lotions or scabies creams containing either permethrin or malathion. Permethrin cream is usually recommended as the first treatment and malathion lotion if permethrin cream is ineffective. Both treatments are available from the pharmacist without the need for a prescription.

The lotion or scabies cream is applied over the whole body, especially between the fingers and toes and beneath the nails. If the hands are washed, another application must be applied. Preparations containing permethrin are usually left on for 8 to 12 hours, those containing malathion are usually left on for 24 hours, before being washed off. All members of the household (and all recent sexual partners) should start treatment at the same time, even if they aren’t showing any symptoms.

Clothing and bed linen should be washed at 50°C. Anything that can’t be washed should be placed in a plastic bag for 72 hours to kill the scabies.

Intense itching may persist for several weeks after the mites have been destroyed as dead mites and their waste products remain until the skin is shed. Calamine lotion or oral antihistamines, available without a prescription, will help relieve itching. You could also ask your GP for a mild steroid cream to further reduce itchiness.