Scabies

General Health

At SwiftMedi, we know how distressing scabies can be - from intense itching and red, bumpy rashes to the discomfort of knowing it’s highly contagious. It’s a condition that can take a real toll on your sleep, confidence, and daily life. Fast, effective treatment can bring rapid relief and help stop the spread - so you can feel like yourself again, sooner.

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Scabies

About Scabies

Overview


Scabies is a highly contagious skin infestation caused by the Sarcoptes scabiei mite. These microscopic mites burrow into the skin to lay eggs, triggering intense itching, particularly at night, and a distinctive red, bumpy rash.
Although scabies can affect anyone, it spreads most easily through close skin-to-skin contact or shared bedding, towels, or clothing - making fast treatment essential to prevent it spreading to family or partners.

Living with scabies can be extremely uncomfortable, not only physically but emotionally, due to the stigma and sleepless nights it causes. The good news? It’s easily treatable with prescription-strength medicated creams and lotions that kill both mites and eggs, providing complete relief when used correctly.

At SwiftMedi, our UK-registered prescribers offer discreet, effective treatment such as Permethrin 5% Cream or Derbac-M Lotion, shipped securely to your door - so you can treat the infection quickly, safely, and privately.


Symptoms


Typical signs and symptoms of scabies include:

  • Intense itching, often worse at night
  • A red, blotchy rash or small bumps and blisters
  • Thin, wavy burrow lines on the skin (often on wrists, fingers, or waistline)
  • Sores from scratching
  • Crusted or scaly areas (in more severe or chronic cases)


Commonly affected areas:

  • Between the fingers and toes
  • Wrists, elbows, and underarms
  • Around the waist, groin, buttocks, and breasts
  • In men, the genitals are often affected


Itching can persist for a few weeks even after mites are killed - this is normal and part of the skin’s healing response.


Diagnosis


Scabies is usually diagnosed by examining the rash and discussing symptoms. In some cases, a healthcare professional may take a skin scraping to confirm the presence of mites or eggs under a microscope.

If one person in a household has scabies, everyone in close contact should be treated at the same time, even if they have no symptoms - this prevents re-infestation.


Treatments


Effective scabies treatment involves both prescription medication and environmental hygiene measures.

Topical Treatments


The mainstay of treatment is a mite-killing (scabicidal) cream or lotion, applied to the whole body from the neck down:

  • Permethrin 5% Cream - the first-line treatment for scabies; kills mites and eggs with one or two applications, seven days apart.
  • Derbac-M Lotion (Malathion 0.5%) - an alternative treatment used when permethrin isn’t suitable.


All close contacts should be treated simultaneously, even if they don’t show symptoms.

Important: Apply the medicine to clean, dry skin and leave it on for the recommended time before washing off. Reapply after handwashing.

Itch Relief


Mild antihistamines or soothing creams can help reduce post-treatment itching.


Environmental Decontamination

  • Wash bedding, clothing, and towels at 60°C.
  • Items that cannot be washed should be sealed in a bag for at least 72 hours to kill mites.
  • Vacuum mattresses, furniture, and carpets thoroughly.



Prevention


After successful treatment, scabies can return if preventive steps aren’t followed:

  • Avoid close skin contact until treatment is complete.
  • Treat all household members and close contacts.
  • Maintain good hygiene and wash fabrics regularly.
  • Avoid sharing towels, bedding, or clothing.



Misconceptions


“Scabies only affects people with poor hygiene.”
Completely false - scabies mites can affect anyone, regardless of cleanliness.

“You can catch scabies from animals.”
Human scabies mites only live on humans; animal mites cause different infections.

“If the itching stops, I can stop treatment early.”
Even if symptoms improve, mites and eggs can still survive - always complete the full course.

“It’s not contagious once treated.”
You can remain contagious until after your second treatment, so always follow timing instructions carefully.

Frequently asked questions

  • What is scabies and how do you get it?

    Scabies is a skin infestation caused by microscopic mites that burrow into the upper layers of skin. It spreads mainly through prolonged skin-to-skin contact, and occasionally through shared bedding or clothing. It causes intense itching and a characteristic rash. Anyone can catch scabies regardless of hygiene or background.

  • What are the main symptoms of scabies?

    The most common symptoms are intense itching (especially at night), small red bumps, thread-like burrow marks and a rash in areas like the wrists, waist, groin, and between the fingers. Symptoms usually begin two to six weeks after infestation, or sooner if you’ve had scabies before.

  • How is scabies treated?

    Scabies is treated with prescription-strength creams or lotions such as permethrin 5% or benzyl benzoate. Treatment is applied to the whole body from the neck down and repeated after seven days. Everyone in the household or sexual contacts must be treated at the same time to prevent reinfestation.

  • Can scabies spread quickly within a household?

    Yes. Scabies is highly contagious, and close physical contact makes spread easy between family members or partners. Even before symptoms appear, it can pass from person to person. Treating all household contacts together is essential to stop repeated transmission.

  • How long does it take for scabies symptoms to improve?

    Itching may continue for two to four weeks after successful treatment because of lingering skin irritation. This is normal. The rash clears gradually as the body recovers. If symptoms persist beyond four weeks or worsen, another assessment may be needed.

  • Can scabies be diagnosed without an examination?

    Diagnosis is usually based on symptoms, rash appearance and history of contact. In many cases, healthcare professionals can identify scabies visually. Microscopic confirmation is sometimes used but isn’t always necessary for treatment.

  • Is scabies dangerous or serious?

    Scabies isn’t usually dangerous, but intense scratching can lead to skin damage and infection. Persistent or severe scabies may require prescription treatments. Treating quickly minimises complications and reduces transmission.

  • Why must everyone in close contact be treated, even if they have no symptoms?

    Scabies mites spread before symptoms appear, meaning friends, partners and household members may already be infested. Treating everyone at the same time prevents the mites from cycling back and reinfecting you. This is one of the most important steps in ensuring successful treatment.

  • Can scabies live in bedding or clothes?

    Yes, for 48-72 hours. Washing bedding, clothing and towels at 60°C or sealing items that cannot be washed in a plastic bag for at least three days helps kill mites. These steps reduce reinfection while treatment is ongoing.

  • Can I go to work or school while being treated for scabies?

    Most people can return to work or school 24 hours after starting the first treatment, as the infectious risk begins reducing quickly. However, close contacts still need treating, and environments involving physical contact may require temporary precautions.

  • What if itching becomes worse after the first treatment?

    Increased itching can occur as the immune system reacts to dead mites. This does not mean treatment has failed. Mild antihistamines or soothing emollients may help. If itching persists beyond four weeks, further assessment may be needed.

  • Is crusted (Norwegian) scabies treated differently?

    Yes. Crusted scabies is a more severe form with large numbers of mites and requires specialist management, often with repeated topical treatments or oral medicines. It is highly contagious and needs prompt medical care.

  • Can scabies be transmitted sexually?

    Yes. Although not classified strictly as an STI, scabies spreads easily through prolonged skin contact, including sexual contact. Partners should be treated at the same time, even if symptoms haven’t developed yet.

  • Does scabies always cause burrow tracks?

    No. While burrows are a classic sign, some people-especially children, older adults or those with darker skin-may show mainly small bumps or widespread itching without clear track marks. Diagnosis focuses on symptoms and exposure rather than burrows alone.

  • What happens if scabies is left untreated?

    Untreated scabies typically worsens over time, causing intense itching, widespread rash and secondary bacterial infections from scratching. It can also spread to others. Prompt treatment with permethrin or benzyl benzoate normally resolves symptoms effectively.