Scabies information sheet

What is scabies?

Scabies is an infestation caused by the microscopic mite Sarcoptes scabiei. It is found worldwide and affects people of all races and social classes. Scabies spreads rapidly in conditions where there is frequent skin-to-skin contact between people, such as aged care facilities, childcare centres and residential facilities.

The female mite, which is only a few millimetres long, burrows into the top layer of the skin where she lays her eggs. The eggs hatch into larvae after 10 to 14 days and travel back up to the surface of the skin. Female mites live for about two months, laying three eggs a day and travel up to three centimetres a minute.

What are the symptoms of scabies?

The main symptoms are:

pimple-like irritations, burrows or rash of the skin, especially the webbing between the fingers; the skin folds on the wrist, elbow, or knee; the penis, the breast, or shoulder blades.
intense itching, especially at night and over most of the body.
sores on the body caused by scratching. These sores can sometimes become infected by bacteria.

How do you get scabies?

By direct, prolonged, skin-to-skin contact with a person already infested with scabies. Contact must be prolonged (a quick handshake or hug will usually not spread infestation). Infestation is easily spread to sexual partners and household members. Infestation may also occur by sharing clothing, towels, and bedding. Anyone can get scabies regardless of age, sex, race or standards of personal hygiene.

Did my pet spread scabies to me?

No. Pets become infested with a different kind of scabies mite. If your pet is infested with scabies, (also called mange) and they have close contact with you, the mite can get under your skin and cause itching and skin irritation. However, the mite dies in a couple of days and does not reproduce. The mites may cause you to itch for several days but you do not need to be treated with special medication to kill the mites. Until your pet is successfully treated, mites can continue to burrow into your skin and cause you to have symptoms.

Who is at risk for severe infestation?

People with weakened immune systems and the elderly are at risk for a more severe form of scabies, called crusted or Norwegian scabies.

How long does it take until symptoms start?

It may take 4 to 6 weeks for symptoms to develop in people who haven't had scabies before. People who have had scabies before usually develop symptoms much more quickly if they are exposed again, usually within one to four days.

How long are people with scabies infectious to others?

People with scabies can pass on the scabies mite until the day after they have commenced their treatment for scabies. The scabies mite can live for two to three days on the clothes, bed linen and other personal items of people who have scabies.

How is scabies diagnosed?

Diagnosis is commonly made by examining the characteristic burrows or rash. The diagnosis may be confirmed by scraping the burrows with a needle or scalpel blade and identifying the mites or eggs under a microscope. A negative result on skin scraping is not always conclusive as the infested person may have few mites (on average 10 to 15) and these can easily be missed on skin scraping.

Can scabies be treated?

Yes. A number of effective anti-scabies lotions or creams are available from your local pharmacist. A prescription from your doctor is not required.

Recommended treatments include permethrin preparations (e.g. Lyclear cream or Quellada lotion) or benzyl benzoate 25% preparations (e.g. Ascabiol, Benzemul 25%).

Note that:

Lyclear cream or Quellada lotion should not be used during pregnancy, lactation, for children less than two or in those with extensive dermatitis
for children under 2 months of age sulfur 5% cream or crotamiton 10% cream (e.g. Eurax) are alternatives
Ascabiol and Benzemul 25% preparations should be diluted for children less than 2 years of age (dilute with 3 parts water) and for children 2 to 12 years of age and adults with sensitive skin (dilute with equal parts water)
the anti-scabies preparations should be used according to the manufacturer?s directions
ensure that all household members are treated simultaneously.

The lotions or creams are applied to the whole body from the neck to the toes. The treatment may also need to be applied to the face and scalp if these areas are clearly involved. Avoid contact with the eyes, nose and mouth.

People will no longer be infectious within 24 hours of treatment, but it can take up to two months until the skin lesions and itch to disappear completely.

A repeat treatment may be advised 14 days after the first treatment, particularly for moderate to severe infestations.

Antihistamines, calamine lotion and Eurax are sometimes useful to counteract itchiness. Antibiotics may be needed if there is secondary bacterial infection from scratching.

What else should I do to stop the spread of scabies?

Preventing the spread of scabies requires:

maintaining good personal hygiene
not sharing clothes, towels or bed linen with others
excluding affected children from school and child care centres until treatment has commenced
limiting close physical contact with others until appropriate treatment has commenced.

As the scabies mite can live on the bed linen, clothes, towels and other personal used by the person with scabies prior to starting their treatment, these items should be machine washed in hot water. Blankets can be dry cleaned or placed in a tumble dryer on a hot setting for half an hour. Alternatively, scabies mites can be killed by sealing these items in a plastic bag for one week before laundering, as the mite cannot survive lengthy periods off the human body.

Further information

Your local doctor
Better Health Channel
Victorian Department of Human Services, Telephone: 1300 651 160

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