Scabies

Some people won't have any visible signs or symptoms at all, or may not be aware of them.

It can take up to 6 weeks after coming into contact with scabies before signs and symptoms appear. You might notice:

• intense itching in the affected areas which may only be noticed at night, or which becomes worse in bed at night or after a hot bath or shower
• an itchy red rash or tiny spots – sometimes this can look like other itchy conditions such as eczema
• inflammation or raw, broken skin in the affected areas – usually caused by scratching.

Scabies mites are very tiny and impossible to see with the naked eye. Fine silvery lines are sometimes visible in the skin where mites have burrowed.

Sometimes scabies will be noticed during a routine genital or medical examination.

Scabies is easily passed from one person to another by close body contact or sexual contact with someone who has scabies.

The mites which cause scabies can be found in the genital area, on the hands, between the fingers, on the wrists and elbows, underneath the arms, on the abdomen, on the breasts, around the nipples in women, on the feet and ankles, and around the buttocks.

The mites can live for up to 72 hours away from the body, so it's possible for scabies to be spread by clothing, bedding and towels.

You can only be certain you have scabies if you have a check-up.

You can have a check-up as soon as you have signs or symptoms for a doctor or nurse to look at, or if you think you might've been in contact with scabies.

Some people won’t develop visible signs or symptoms straight away, and you may be asked to come back for another appointment later on.

What does the check-up involve?

A doctor or nurse can often tell if you have scabies just by looking at the affected areas.

They may gently take a skin flake from one of the areas and look at it under a microscope to see if there's a mite present.

In some cases, treatment will be suggested if scabies is suspected, even if it can't be confirmed.

Where can I get a check-up?

There are a number of services you can go to. Choose the one you feel most comfortable with.

A test can be done at:

• a genitourinary medicine (GUM) or sexual health clinic
• your general practice
• some contraception clinics and young people’s services.

If you know you have scabies you can go to a pharmacy for advice and treatment.

The treatment's simple and involves using a special cream or lotion. The doctor, nurse or pharmacist will advise you on what treatment to use and how to use it.

• You apply the cream or lotion usually to the whole body from the neck downwards. This ideally should be done overnight.
• The treatment should be rinsed off after 12 hours.
• You should wash clothing, bedding and towels in a washing machine on a very hot cycle (60°C or higher) to kill the mites and avoid re-infection.
• You can also buy treatments for scabies from pharmacies. These are useful if you're sure you have scabies and wants to self-treat. The pharmacist will be able to advise if you have any questions, or are unsure how to use the treatment.
• If you decide to treat yourself, you may still want to consider having a sexual health check, to make sure you don’t have a sexually transmitted infection.
• Do tell the doctor, nurse or pharmacist if you are, or think you might be, pregnant or if you're breastfeeding. This will affect the type of treatment you're given.
• There's no evidence that complementary therapies can cure scabies.
• Close contacts in your household should be treated at the same time, as well as your sexual partner, even if they don't have any signs or symptoms.

Will I have to pay for tests and treatment?

All tests are free through NHS services. Treatment is also free unless you go to your general practice when you may have to pay a prescription charge for the treatment.

You'll have to pay for treatments that you get directly from the pharmacy.

When will the signs and symptoms go away?

If you use the treatment according to the instructions, it's rare for it not to work.

Even after successful treatment, the itching or rash may continue for a few weeks. Special tablets or creams (antihistamines), or anti-irritant lotions such as calamine, can ease the itching.

Do I need to have a check-up to see if the scabies has gone?

You may need to go back to check the scabies has gone away and that you haven't come into contact with scabies again.

If you have any questions, ask the doctor, nurse or pharmacist.

Can scabies go away without treatment?

No. And if you delay seeking treatment you risk passing the condition on to someone else.

If you have scabies then it's important that your current sexual partner(s) and any other recent partners are also checked and treated. The staff at the clinic or general practice can discuss this with you.

How soon can I have sex again?

It's strongly advised that you don't have any sexual intercourse, including vaginal, anal or oral sex, or close body contact, until you and your partner(s) have finished the treatment and any follow-up treatment. This is to help prevent you being re-infected or passing the infection on to someone else.

Will I know how long I’ve had scabies?

Sometimes it can be difficult to know where you got scabies from. The check-up can't tell you how long you've had it.

If you feel upset or angry about having scabies don’t be afraid to discuss how you feel with the staff at the clinic or general practice.

Does having scabies affect my fertility?

No.

What happens if I get scabies when I’m pregnant or while I’m breastfeeding?

Scabies can be treated while you're pregnant or breastfeeding, but not all types of treatment can be used. Your doctor, nurse or pharmacist will advise you.

Permethrin cream is safe to use but if you're breastfeeding will need to be thoroughly washed off before any feed and re-applied if necessary.

Does scabies cause cervical cancer?

No. Scabies doesn't cause cervical cancer.

It's possible to get a sexually transmitted infection (STI) by having sex with someone who has an STI, even if they have no symptoms.

The following measures will help protect you from most STIs including chlamydia, gonorrhoea and HIV.

If you have a sexually transmitted infection they’ll also help prevent you from passing it on to someone else.

• Use external condoms or internal condoms every time you have vaginal or anal sex. How to use condoms.
• If you have oral sex, use a condom to cover the penis, or a latex or polyurethane (soft plastic) square to cover the anus or female genitals.
• Avoid sharing sex toys. If you do share them, wash them or cover them with a new condom before anyone else uses them.