If you’re feeling a little itchy, please don’t ignore it. And please, please don’t scratch it.
This is what doctors are saying as cases of scabies are rising. From the year to April, there were 3,689 confirmed hospital cases of the skin disease, up from 2,128 the previous year.
Cases of this torturous rash are likely even higher. Professor Kamila Hawthorne, chair of the Royal College of GPs (RCGP), told that ‘social stigma’ puts people off from going to the GP.
With scabies making headlines, here’s everything you need to know about the condition.
‘As a pharmacist and skin specialist, I’m often asked about scabies – what causes those itchy mysterious rashes?’ Randall Higgins, a pharmacist and skincare specialist at the acne advice Good Glow, says.
‘Essentially, it’s a pesky skin condition triggered by tiny mites that burrow and lay eggs under the skin.’
These mites aren’t nameless. Sarcoptes scabiei are members of the arachnid family that love to nibble on animals such as dogs or sheep.
Each animal tends to have its specific variant of the mite, meaning they can’t reproduce in other species. In dogs, for example, a scabies infestation is called mange.
The mites can’t jump or fly. But once they land on a new victim, they can crawl at 2.5cm a minute to hunt down a hiding spot.
For humans, you only need about 10 egg-producing females making a reservation on the all-you-can-eat buffet that is your body to cause itchy agony.
Ten might sound like a lot – surely you can see these hitchhikers on your skin? At just 0.4 millimetres in length, they’re barely visible to the human eye.
What are the symptoms of scabies?
Just the thought alone of the mites crawling on your skin is enough to make you feel itchy, but this isn’t what causes the symptoms.
Your skin is having an allergic reaction to the eggs and faeces the female mites deposit as they tunnel underneath your skin. The blotchy ratch that follows can feel like it has come out of nowhere as symptoms take up to weeks to surface.
‘While not a serious condition, scabies can be very itchy and irritating,’ explained Professor Hawthorne.
‘If not properly treated, it can spread and increase a patient’s risk of complications such as secondary skin infections or make existing skin conditions worse, she adds, such as impetigo, a bacterial skin disease with oozing sores.
Where these angry rashes appear depends a lot on how old someone is.
In adults, Dr Tess McPherson, of the charity British Association of Dermatologists, says: ‘There can be a rash which can appear similar to conditions such as eczema but typically there may be small spots in between fingers, toes and genital areas.’
For the most part, the mites spare the upper back, neck, face, scalp, palms and the soles of your feet. (Anywhere warm and cosy is where the mites love to be.)
In infants, the scalp, face, palms and soles are where the mites love to infest.
How do you get scabies?
The microscopic arthropod is usually transmitted through direct, prolonged skin-to-skin contact: think sexual intercourse or sharing a house with someone.
The mite can also spread through contaminated clothing, bedding or towels used by an infested person.
While a female mite can live on someone for up to a month, they don’t have the same luck in the outside world, lasting rarely more than three days.
‘So if one person has scabies, their closest contacts should also be evaluated and potentially treated to prevent mite spread or re-infections even without symptoms appearing yet,’ says Higgins.
Do only certain people catch scabies?
‘Anyone can get scabies and it is not caused by lack of hygiene,’ Dr McPherson says, given the misconception that only mucky people get it. (After all, a scabies outbreak happened at a top London fashion university last December.)
‘There can be a stigma surrounding scabies, this is not helpful and means that people may not tell contacts or seek help.’
A big worry for health bosses like Dr McPherson is scabies spreading among elderly people living in retirement communities, nursing homes and extended care facilities.
‘The ease with which it spread, particularly in group living facilities like care homes and university halls of residence, is alarming given some issues with shortage of effective treatments,’ she says.
Anyone can get scabies, which is why Professor Hawthorne says there’s no reason to be ashamed if you are infected.
‘We recognise that patients may be apprehensive to seek treatment given the social stigma that surrounds the condition, but it is important that they don’t ignore their symptoms as this could lead to them getting worse and risks transmitting the condition to other people – particularly if they are living in close proximity to others such as on a university campus,’ she says.
Where are scabies cases rising?
Cases are highest right now in the north of England and lowest in the Midlands and East, according to the RCGP.
Professor Hawthorne says: ‘The rate of scabies presentations in general practice is above the five-year average and rising, with the north of England seeing a spike in cases, but incidences are still infrequent.’
Newcastle Council only yesterday put out a video urging locals to remain vigilant, though there’s nothing to suggest the North East of England is seeing a spike.
How do I get rid of scabies?
Yes, it’s treatable! What a relief, huh?
‘The treatment for scabies is a topical cream or lotion – the most commonly used are permethrin cream and malathion lotion – that can be purchased in pharmacies, or by prescription in general practice,’ says Dr Hawthorne.
These creams are applied everywhere, including the groin and between fingers and toes.
‘If symptoms persist following treatment, then a patient should contact their GP. We are aware that the symptoms can affect a patient’s quality of life so we will try our best to ensure an individual receives prompt and effective treatment,’ she adds.
Those suffering from the crusted form may be prescribed the mite-killing oral medication ivermectin, with a second dose given roughly two weeks later.
Every expert spoke with said that to ensure all the mites are gone for good, everyone – from members of the same household and sexual partners to care home residents and workers – must be treated.
Dr Will Welfare, Director of regions at the UK Health Security Agency, did too.
‘If you have scabies, there are steps you can take to stop it from spreading during treatment, including washing all bedding and clothing in the house at 60C or higher on the first day of treatment and putting clothing that cannot be washed in a sealed bag for three days until the mites die,’ he says.
‘Do not share bedding, clothing or towels with someone with scabies and don’t have sex or close physical contact until you have completed the full course of treatment.’
All in all, scabies are a condition that sounds scary and is caused by something that will literally make your skin crawl.
But for Higgins, the solution is simple enough really.
‘Getting properly diagnosed and treated for scabies quickly,’ he says, ‘helps resolve symptoms faster and prevent further spread,’
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