Embarrassing Illnesses

Although over-the-counter (OTC) treatments are available for scabies, it is recommended that you visit your GP if this is the first time you have had a scabies infestation. This is because other, more serious skin conditions can cause similar symptoms to scabies. It is therefore important for your GP to rule these out as a cause of your symptoms.

However, if another member of your household has already been diagnosed with scabies, you will not need to visit your GP and should proceed with treatment.

Creams and lotions

The two most widely used treatments for scabies are permethrin cream and malathion lotion. Permethrin is usually recommended first, and malathion lotion is used if the permethrin cream proves ineffective. Both medications contain insecticides that kill the scabies mite.

Applying the medication

It is important that all members of your household, and any close contacts (including all your sexual partners over the last six weeks or, if you have had scabies before, any sexual person that you have had sex with within the previous 48 hours), are treated at the same time, even if they do not have any symptoms. If they are not treated, re-infection could occur.

• Treatment should be applied to cool, dry skin and not after a hot bath (applying after a hot bath increases absorption into the body and removes the drug from the treatment site).
• Apply it to the whole body from the chin and ears downwards, paying particular attention to the areas between the fingers and toes and under the nails and areas where there are skin folds. Treatment can be massaged under fingernails and toenails using an old toothbrush (which should be sealed in a bag and thrown away afterwards).
• People with a weak immune system, the very young and elderly people should apply the treatment to the whole body including the face and scalp.
• Permethrin needs to be left on for eight to 12 hours.
• Malathion needs to be left on for 24 hours. 
• If you wash during this time (for example, washing your hands), you should reapply the treatment.
• Follow-up treatment after seven days is advised to make sure the treatment is successful. This is to ensure that any mites that have hatched from existing eggs will be killed by the second application.

If you are breastfeeding, the cream or lotion will need to be thoroughly washed off before feeds and reapplied if necessary.

You should talk to your GP or pharmacist about using Malathion on children under six months and before using Permethrin on children aged below two years.

If you are embarrassed about contacting your previous sexual partners, your GP surgery may be able to inform anyone who may have been affected that they may have been exposed to scabies, without giving them your identity.

Infection control

On the same day that you first apply the cream, you should also wash all clothes, bed linen, and towels, at a temperature of above 50C (122F). If you are unable to wash certain items, place them in a plastic bag for at least 72 hours, by which time the mites will have died. It is not necessary to fumigate furniture, pets, or carpets.

If you have been diagnosed with scabies, you should avoid any close and prolonged physical contact with other people until you have applied the cream for the first time. You should also avoid close contact with other household members until their treatment has been completed.

Children and adults can return to school, or work, after the first application of cream has been completed.

Itchiness

Your GP should also be able to prescribe creams, such as a mild steroid creams, that can help relieve the symptoms of itchiness. The over-the-counter (OTC) remedy, calamine lotion, may also help to relieve itchy skin.

Oral antihistamines can help to control symptoms of itching and help with sleeping. These can be bought over- the counter (OTC) at your local pharmacy. However, they might cause drowsiness, so avoid driving, or operating heavy machinery, if you are affected in this way. If you unsure, check with your GP, or pharmacist.

The symptoms of itchiness can persist for several weeks after treatment because your immune system is still reacting to the presence of dead mites and their waste products. See your GP if the symptoms of itchiness persist for more than six weeks.

Side effects of treatment

• Permethrin 5% dermal cream
  Side effects can include itching, numbness, a tingly feeling, stinging on application or skin irritation. You should talk to your GP or pharmacist if these side effect don't go away.
• Malathion 0.5% aqueous liquid
  Skin irritation can occur. You should talk to your GP or pharmacist if this worsens or doesn't go away.

There is no evidence that complementary therapies can cure scabies.

There is no evidence that complementary therapies can cure scabies.

 If you delay seeking treatment you risk passing the condition on to someone else.

You should avoid sex or close body contact until you and your partner have both completely finished the treatment, otherwise you could be reinfected.

view information about Scabies on www.nhs.co.uk »