Scabies

Patient Information Sheet: Scabies

What is Scabies?
Scabies is a contagious skin infestation caused by a mite known as Sarcoptes scabiei. It spreads through close skin-to-skin contact and can affect anyone regardless of hygiene.

Symptoms:

• Intense itching, especially at night
• Red, pimple-like bumps or rash
• Thin, irregular burrow tracks made by the mites

Diagnosis:
Diagnosis is typically made based on the appearance of the rash and skin examination under a microscope.

Treatment:

1. Medication:
   • Prescription creams (permethrin, benzyl benzoate or sulphur as prescribed) applied to the entire body from the neck down. Apply to all skin folds, in-between the toes and groin. Repeat 1 week later.
   • Ivermectin (dose as prescribed by your doctor), Day 0 and repeat 1 week later.
2. Timing: Leave the cream on for 8-14 hours (overnight if possible) then wash off.
3. Clothing and Bedding: On the day of treatment, wash all clothing, bedding, and towels in hot water and dry on high heat to kill mites.
4. Personal Items: Items that cannot be washed should be sealed in a plastic bag for at least 7 days to kill mites.
5. Repeat: Repeat prescription cream to tablets 1 week later.
6. Close Contacts: Treat all household members and close contacts, even if they don’t show symptoms.
7. Follow-Up: A second treatment may be necessary after 6 weeks if symptoms persist.

Managing Post-Scabies Itch:

• Antihistamines: Over-the-counter antihistamines can help relieve itching.
• Moisturisers: Apply moisturizing lotion or cream regularly to soothe dry skin.
• Avoid Scratching: Scratching can lead to secondary infections and prolong healing.
• Topical steroids: Use topical steroids twice a day to minimise itch.
• Ice Packs: Use ice packs to settle intense itch.

Preventing Reinfestation:

• Avoid close contact with infested individuals until treatment is completed.
• Wash clothing, bedding, and towels in hot water after treatment.
• Vacuum carpets and furniture regularly. Don’t forget to vacuum the car.
• Environmental Cleaning:
  • Vacuum carpets, rugs, and furniture regularly.
  • Clean surfaces that may have come in contact with skin (e.g., chairs, couches) using a vacuum cleaner or damp cloth.
• Pets: Although rare, pets can sometimes get a form of scabies (sarcoptic mange). Consult your veterinarian if you suspect your pet may be affected.

When to See a Doctor:

• If symptoms worsen or persist 6 weeks after treatment.
• If new skin lesions or symptoms appear.