Scabies

‍Also known as: Mate māngeongeo riha

• Scabies is an extremely itchy rash that occurs as a result of a mite tunneling under the surface of the skin.
  
• The rash is an allergic reaction to the insect, its eggs and faeces.
  
• Scabies is passed on to others through close contact. It’s very likely to spread throughout a household.
  
• Scabies is fairly common.
  
• Many people think that scabies is a result of poor hygiene but this isn’t true – anyone can catch it.
  
• Scabies won’t go away unless it’s properly (and thoroughly) treated.

• Scabies is caused by a microscopic insect called a mite that tunnels under the surface of the skin and lays eggs.
  
• The mites live under the skin, laying eggs and dropping faeces – this causes an allergic reaction which manifests as a very itchy skin, sometimes with a  rash.
• For those who have never had scabies before, the rash will usually start 3–6 weeks after mites have burrowed under the skin.
• For people who have had scabies before, symptoms may begin after as little as 1–3 days.
  
• Scabies is spread by skin-to-skin contact. The contact needs to be for a reasonable amount of time – hugs and handshakes usually don’t last long enough to transfer scabies.
  
• Scabies can also be transferred by sharing beds, linen or clothes.
  
• Scabies spreads really easily in homes and places like daycares where people are in frequent contact.

In adults

• Extremely itchy skin, often with a rash, that gets even itchier when it’s heated.
  
• The rash usually appears as a patch (or multiple patches) of small red or dark bumps.
  
• Scabies can appear anywhere on the body, but some areas are particularly common.

These include:

• Elbow creases
• Wrists
• Armpits
• Stomach
• Bottom
• Genitals
• In between the fingers

In children

• Scabies may appear on a child’s head but this is quite unusual in adults.
  

For adults

• Scabies is usually treated with an insecticide ointment called permethrin, which kills the mites.
  
• Permethrin can be bought over-the-counter at a pharmacy or be prescribed by a doctor.
  
• It is normally safe for pregnant people, those who are breastfeeding, and kids who are older than 2 months of age.
  
• Every person living in a household must use permethrin at the same time in order to get rid of the infestation – even if a person doesn’t have a rash themselves. It’s very important that the label instructions are followed and the ointment is applied correctly.
  
• A second application is normally required a couple of weeks later. Permethrin shouldn’t be used more than twice unless advised by a doctor.
  
• While the mites will normally be killed after applying the first and second treatment, the rash may last longer. If this is the case, antihistamines and/or mild steroid creams can be used to relieve any itchy patches.
  
• After applying the permethrin, all clothes, bedding and towels in the house that have been used within the last week should be washed at a temperature of at least 50ºC. If possible, they should be dried in a tumble drier, at the hottest setting.
  
• For anything that can’t be washed at a high temperature, put it in a sealed plastic bag in the freezer for a day. If the sealed bag can’t go in the freezer, leave it for a week. Dry cleaning is also an option, but be sure to inform the dry cleaners of the infestation.
• Scabies needs to be treated properly or else it will continue to spread.

For children

• Treatment is the same for children over 2 months old as it is for adults.

Medication

Permethrin is an insecticide ointment used to treat scabies.

Common over-the-counter medications

• Permethrin is available over-the-counter.
  
• Antihistamine creams are also available over-the-counter. These can be used to relieve lingering rashes after scabies have been treated.

Proactive protection

If you know someone who has scabies that lives outside of your household, avoid close contact with them until after they have been treated.

• If you still have a rash 6 weeks after you’ve been treated, see a doctor.

Permethrin isn’t the best option for everyone. If any of the following applies to you, see a doctor – they may suggest a different treatment:

• You’re pregnant
• You’re looking after a child who is younger than 2 years old
• You’re bed bound
• Your skin has become infected
• You have open sores
• Your scabies are crusty

Which specialist should I visit?

Dermatologist

After treatment, the itchiness will usually subside within a week. Sometimes the rash may take 4–6 weeks to clear.