Scabies is a contagious skin condition caused by infestation with a mite called Sarcoptes scabieri.
Scabies mites burrow into the skin and lay eggs (known as larvae). The larvae live under the skin causing an allergic itch and rash in some people.
Scabies can spread rapidly in settings where there is frequent close body contact.
Signs and symptoms include:
Symptoms usually occur four to six weeks after infestation in someone who has not previously experienced scabies.
An infested person can transmit scabies, even if they do not have symptoms.
Crusted scabies is a severe form of scabies that can occur in some people who have a weakened immune system or are elderly, disabled or debilitated. It is also called Norwegian scabies and presents as thick crusts of skin that contain large numbers of scabies mites and eggs.
Individuals with crusted scabies are more contagious to other persons and can spread the infestation easily both by direct skin-to-skin contact and by contamination of items such as their clothing, bedding and furniture.
Persons with crusted scabies may not show the usual signs and symptoms of scabies such as the rash or itching.
Scabies is spread from direct and usually prolonged skin-to-skin contact.
It is unlikely to be transmitted via short contact such as shaking hands. Scabies is also unlikely to be spread via bed linen as the mites die quickly when away from the skin. Spread through linen may occasionally occur in cases of crusted scabies.
Scabies is treated using a skin cream or lotion prescribed by your GP. This is applied to all areas of the body taking care to avoid the eye and mouth area and paying particular attention to between fingers and toes, under fingernails and genital areas. Two applications of the treatment should be applied a week apart ie Day 1 and Day 8.
The prescribed cream or lotion should remain on the skin for the recommended time and should be carefully reapplied to any areas that may be washed during this time, eg hands.
An itch may persist for up to six weeks after the initial treatment. In severe cases antihistamine medication may be required for the itch.
All close contacts, carers and family members should be treated with the skin cream/lotion, even in the absence of symptoms. Ideally, everyone should be treated on the same day.
Those displaying symptoms should have treatment re-applied seven days after the first treatment ie Day 1 and Day 8.
One treatment of skin cream/lotion is sufficient for close contacts not displaying signs of infestation.
Clothes, towels and bed linen should be washed at the highest possible temperature (according to garment care label) after the first treatment is applied. These items should be washed separate to other items.
Alternatively, clothes can be ironed with a hot iron, dry cleaned or tumble dried as per garment care label.
Items that cannot be dry cleaned or laundered immediately should be stored in a closed plastic bag for several days to a week and then washed as per garment care label.
Scabies is prevented by avoiding prolonged direct skin-to-skin contact with an infested person or with items such as clothing or bedding used by an infested person. Scabies mites generally do not survive more than 2 to 3 days away from human skin.
Children and adults can usually return to child care, school or work the day after their first treatment is completed.
If you require further advice or information, please contact the hospital's Infection Prevention and Control Team or a member of the ward/care home staff.
Infection prevention and control is everyone's responsibility.
Healthcare workers, patients and visitors all have an important role to play in preventing the spread of healthcare associated infections.
HSC Public Health Agency
DHSSPS Department of Health, Social Services and Public Safety
Produced by the Public Health Agency, 12-22 Linenhall Street, Belfast BT2 8BS. Tel: 028 9032 1313.
05/13