Scabies

Scabies is a contagious skin condition caused by infestation with the microscopic mite Sarcoptes scabiei, which burrows into the skin and causes intense itching. It spreads easily through close skin-to-skin contact.

• Intense itching, typically worse at night
• Small red bumps or burrow lines, commonly between fingers, on wrists, elbows, armpits, and around the waistline
• In infants, lesions may also appear on the palms, soles, face, and scalp
• Scratching can lead to secondary bacterial skin infection

• Infestation with the Sarcoptes scabiei mite.
• Spread through prolonged, direct skin-to-skin contact with an infested person.
• Can also spread, less commonly, through shared bedding or clothing.
• Risk is increased by overcrowded living conditions and close household contact.

• Mainly a clinical diagnosis, based on the pattern and distribution of itchy lesions and burrows, along with a history of itching among close contacts or household members.
• Skin scraping for microscopic identification of mites, eggs, or faecal pellets can confirm the diagnosis where available, though it is often diagnosed clinically.

Topical permethrin cream, applied to the whole body from the neck down (and including the scalp in infants and young children) and left on as directed before washing off, is the first-line treatment.

Benzyl benzoate lotion is used as an alternative where permethrin is not available.

All household members and close contacts should be treated at the same time, even if they have no symptoms, to prevent reinfestation.

Bedding, clothing, and towels used in the days before treatment should be washed in hot water or set aside for several days.

Secondary bacterial skin infection from scratching is treated with an appropriate antibiotic if present.

• Treat all household members and close contacts simultaneously when a case is identified.
• Avoid sharing bedding, clothing, and towels.
• Wash bedding and clothing in hot water after treatment.
• Maintain good personal hygiene and avoid overcrowded sleeping arrangements where possible.