Scabies a very common, very itchy skin infestation that needs treating as quickly as possible, because it can spread very rapidly.
Here’s how to spot the signs and symptoms of scabies, plus the latest advice on what to do if you think you child has it – from our expert GP Dr Philippa Kaye.
What is scabies?
“Scabies is a mite infestation – where tiny mites called Sarcoptes scabiei burrow into your skin and lay eggs,” says Dr Philippa.
“About 1 in 1,000 people in the UK get scabies each month. Those at highest risk are people who spend time in settings where people interact closely together – places such as old people’s homes, universities and nurseries.”
What are the symptoms of scabies?
It’s unlikely that you’ll spot the mites themselves. “They’re very, very small – about half a millimetre long,” says Dr Philippa, “making them extremely difficult to see with the naked eye.” So the first symptom you’ll notice is probably an intense itching – and therefore a strong urge to scratch.
The itching is mostly likely, at first, to be centred around the wrists and between the fingers, and is often worse when your child is hot (so, after a bath or at night, for example).
You might also see little silvery lines. “When the mites lay eggs in your skin,” says Dr Philippa, “they produce burrows, which can look like fine silvery lines under the skin, generally with a dot at one end.
“After the fine lines, a red rash can develop, which then turns spotty (looking a bit like acne or mosquito bites) and can spread across the whole body. But it can take up to 8 weeks for the rash to appear.”
What’s the treatment for scabies?
Scabies is not serious but it does need to be treated – with an over-the-counter cream or lotion.
“Go to your local pharmacist and they will give you an over-the-counter lotion or cream containing permethrin or malathion, which needs to be applied to the whole body in 2 doses, a week apart,” says Dr Philippa.
“Everyone else in the household – and anyone who has daily close contact with any of you (including anyone you have had sexual contact with in the past 8 weeks) – needs to be treated, too, even if they aren’t itching. This is because scabies is so infectious, and you can’t always tell who has it as it can take 6 to 8 weeks for the rash to appear.”
If you’re treating a baby or toddler, it can help to cover their hands with socks or mittens to stop them sucking off the cream.
You might also want to ask your pharmacist if there’s anything your child can safely use or take to reduce the itching.
“You should only need to see your GP,” says Dr Philippa, “if the itching is still there 4 weeks after treatment or if the rash becomes oozy or blistered – this could be a sign of a skin infection that may need treating with antibiotics.”
Is there anything else I’d need to do? Disinfect clothes or bedding?
Yes! Scabies mites can live for 2 to 3 days on clothes, bedding and towels. “After you’ve put the 1st application of treatment on, machine-wash everyone’s bed linen, towels and clothes at 50°C or above to kill the mites,” says Dr Philippa.
If you have any items of clothing or bedding (such as duvets) that can’t be washed or can’t be washed at that high a temperature, then you can also kill the mites if you:
- Put them in a plastic bag for at least 72 hours
- Iron them with a hot iron
- Put them into the tumble dryer on a hot cycle for about 30 minutes
Pets do not need to be treated: they can’t get scabies from humans. (Pets can get scabies but, if they do, it’s from a different type of mite – one that can’t reproduce in human skin.)
A scabies mite, seen under a microscope
Should your child stay off school or nursery with scabies?
“Yes, please,” says Dr Philippa. “Stay off until 24 hours after the first application of treatment.”
It’s fine to go back after that. But it may take the itching and rash about 6 weeks to resolve, even once the infection has been treated.
Will my child get scabies again?
“It’s possible,” says Dr Philippa. “You can get scabies more than once.”
Dr Philippa Kaye works as a GP in both NHS and private practice. She attended Downing College, Cambridge, then took medical studies at Guy’s, King’s and St Thomas’s medical schools in London, training in paediatrics, gynaecology, care of the elderly, acute medicine, psychiatry and general practice. Dr Philippa has also written a number of books, including ones on child health, diabetes in childhood and adolescence. She is a mum of 3.