What is scabies?

Scabies is a very itchy skin condition caused by a tiny mite (bug).

Scabies is very contagious and spreads quickly. If you have scabies, your whole family may need to be treated.

What are the symptoms of scabies?

Scabies causes intense itching, threadlike tracks on your skin and sometimes a rash. The rash looks like tiny red lumps and is caused by an allergic reaction to the mite.

The scabies mite prefers to burrow and lay its eggs in skin that is soft and protected. Common areas to get scabies are:

• your wrists
• between your fingers and toes
• in your armpits
• your elbows
• your groin
• the creases of your bottom

The itching is usually worse at night and can cause sleep disturbances. Your symptoms may not develop until 6 weeks after you have been infected with the mites.

What causes scabies?

A tiny mite called Sarcoptes scabiei causes Scabies. The mites burrow under your skin where they lay eggs. Scratching your skin spreads the newly hatched mites over your body.

You can spread scabies to people you have close contact with. You only need 20 minutes of close contact for scabies to spread.

Anyone can get scabies, but it's more common in school-aged children, Aboriginal and Torres Strait Islander communities, and closed communities, such as residential aged care facilities.

When should I see my doctor?

See a doctor if you have very itchy skin or a rash that doesn't go away.

However, there are other skin conditions that can cause itchy skin, such as bed bugs, and flea and mosquito bites.

How is scabies diagnosed?

Your doctor will examine your skin. They will also ask you about your symptoms and whether anyone you live with has itchy skin.

Your doctor may put ink from a pen over a burrow entrance. If the ink moves along the burrow, this confirms scabies.

The doctor may also take a small scraping from your skin to confirm the diagnosis.

How is scabies treated?

Scabies is easily treated with either ivermectin tablets or permethrin cream.

• To buy ivermectin from a pharmacy, you will need a prescription from your doctor.
• You can buy permethrin from a pharmacy without a prescription.
• If you develop crusted scabies, you may need treatment with more than one medicine.

Ivermectin

Adults and children over 15kg can take ivermectin. You take a single dose, which is repeated after 7 days.

Permethrin cream

It's important to follow the directions on how to use the cream carefully. Speak with your pharmacist to make sure you buy the correct cream.

How to apply the cream:

• It works best if you apply the cream after having a shower.
• In the shower, use warm water and gently scrub your skin.
• Then pat your skin dry and apply the cream to your whole body, except for your head and neck.
• You may need help to apply it to hard-to-reach areas.
• Leave the cream on your skin for 8 to 14 hours.
• During this time, if you wash your hands, reapply the cream to your hands.
• After the 8 to 14 hours has passed, rinse your skin thoroughly to ensure the cream has been washed off.

You should repeat the treatment 7 days later.

Everyone in your house should be treated at the same time.

If you live in central and northern Australia or you're treating children (older than 6 months) and elderly, you should also apply the cream to the face and scalp (avoid eyes, nose and mouth). This is because scabies above the neck is common in these groups.

Check with your doctor or pharmacist about which treatment to use, if you:

• have a child under 6 months of age
• are pregnant or breastfeeding
• have sensitive skin
• are older than 65 years

If the itching doesn't clear up in a few weeks, see your doctor. You may be allergic to the mites or have been re-infested

As well as treating scabies with medicines there are other ways you can help prevent reinfection or spreading scabies to others. For details see 'Can scabies be prevented?'

Complications of scabies

Scabies is usually treated effectively with no long-term complications.

Some people have an immune reaction to the mites, their eggs or faeces (poo) that causes itching for 4 weeks after treatment. If this happens, see your doctor. They may prescribe you other medicine.

Scratching your skin can lead to infections, such as impetigo or cellulitis. If this happens, see your doctor. They will usually prescribe antibiotics.

Can scabies be prevented?

If you have scabies, there are ways you can help to prevent spreading it to other people.

You should treat all household contacts over the last month. All sexual partners in the last month should also get treatment.

The day after your first treatment:

• wash all your towels and bedding in water that is 60°C or higher
• wash all your clothes in water that is 60°C or higher
• any clothes or items that can't be washed should be put in a sealed bag for 8 days
• if possible, place mattresses, pillows and blankets in the sun
• thoroughly vacuum the house and soft furnishings, such as lounges
• you should have no body contact for 3 days with items that cannot be washed or put in the sun

If you have scabies, you should stay home until 24 hours after treatment. This is when you are no longer infectious. Read about how long you should keep your children home from school.

Resources and support

Read about scabies in your language on the South Australia Government website.

If you need more health advice, call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.