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Scabies

Scabies in heterosexual men

What is scabies?

  • It is a skin infestation caused by a tiny mite called Sarcopetes scabiei.
  • Mites burrow into the skin where they live and lay eggs – the offspring crawl out onto the skin and make new burrows and perpetuate the cycle.
  • Scabies leads to intense itching particularly at night.
  • Scabies is spread by direct skin contact.
  • Any part of the body can be affected.
  • Scabies can be treated with creams or lotions.
  • If you have scabies we recommend an STI screen and HIV test as there is evidence that you are more likely to have an STI.

How common is scabies

  • Scabies is common – it is found world wide and affects people of all age, race and social class.
  • Scabies can spread more rapidly in crowded conditions or institutions where close body and skin contact is more frequent.

How do you catch scabies?

  • By direct skin-to-skin contact with someone that has scabies.
  • Intimate or sexual contact is a common way of catching scabies.
  • Mites may survive up to 72 hours off the human body (e.g. on clothing) 

What would I notice if I had scabies?

  • If someone has never had scabies before symptoms usually take 4 to 6 weeks to develop.
  • But someone can still pass on scabies during this time.
  • Common things you may notice:
    • intense generalised itching particularly at night
    • a pimple like itchy rash commonly affecting the genital area (where the pimples are often nodule like), between the fingers, wrists, elbow creases and around the nipples 
    • tiny burrows in the skin – silvery lines particularly between the fingers 

How do I get tested for scabies?

  • An experienced doctor can make a diagnosis on clinical examination – we can do this at the Wolverton.
  • It can sometimes be confirmed by taking a skin scraping and examining under a microscope for a mite.

How is scabies treated?

  • With either:

PERMETHRIN 5% cream (Lyclear cream)

or

MALATHION 0.5% aqueous lotion (Derbac-M)

  • These should be applied to the whole body including scalp, face, ears and neck and left on for 12 hours before washing off. If you wash your hands during the 12 hour treatment period you will need to reapply lotion or cream.
  • Permethrin is safe during pregnancy and breast feeding.
  • Clothing or bedding that may be contaminated should be washed at high temperature (>50¢ªC).
  • Occasionally the treatment may need to be repeated 7 days later.
  • Itching may continue for 2-4 weeks after treatment – if bad your doctor can prescribe something to help relieve the itch.
  • All treatments from the Wolverton are free and supplied directly to you in the clinic.

What about my partner?

  • All current sexual partners and household contacts should be examined and treated at the same time.
  • Previous partners in the last 2 months will also need to be treated.

What problems can untreated scabies lead to?

  • Itching will persist and the skin is likely to become secondarily infected from constant scratching.
  • Large itchy nodules may appear particularly in the genital area.

Will scabies come back again after treatment?

  • Sometimes the treatment fails because:
    • either the skin was not totally covered with the cream /lotion
    • the lotion was not applied for long enough
    • partners / contacts were not treated at the same time
    • the person was re-infected
  • A severe form of scabies called Norwegian scabies exists which is very infectious and can be difficult to treat.
  • Norwegian scabies usually affects the elderly or people who are very immunosuppressed (e.g. HIV).
  • Your doctor would recognise this form of infection.
  • It is treated with tablets called Ivermectin.

More information

www.bashh.org

 Click here for further information on scabies