Scabies: symptoms, treatment, how long it lasts and how it spreads

The NHS says scabies is not usually a serious condition but it does need to be treated. A pharmacist will recommend a cream or lotion that you apply over your whole body, including the scalp and face (apart from the area around the eyes). Tell the pharmacist if you are breastfeeding or pregnant. The treatment is repeated 7 days later.

NHS inform says the two most common treatments are permethrin cream and malathion lotion. Permethrin is usually recommended first, and malathion is used if permethrin is not effective. The British Association of Dermatologists also mentions a tablet called ivermectin for certain forms of scabies.

The British Association of Dermatologists stresses applying the treatment to all areas of the skin, not just itchy parts, paying particular attention to the skin between fingers and toes, under nails, behind the ears and the genital area. It says treatment should be left on for at least 12 hours.

The NHS lists intense itching, especially at night, and a raised rash or spots. The spots may look red, but are more difficult to see on brown or black skin, where you should still be able to feel them. NHS inform adds that burrow marks are short (1cm or less), wavy, silver-coloured lines with a black dot at one end.

The NHS says the rash usually spreads across the whole body apart from the head and neck, often affecting skin between the fingers and around the wrists, under the arms, and around the waist, groin and bottom. Older people and young children may develop a rash on the head, neck, palms and soles of the feet. Scratching can cause crusty sores and skin infection such as impetigo.

Scabies spreads through direct skin contact, including sexual contact, according to NHS inform, which says it is unlikely to spread through brief contact such as shaking hands or hugging. People are often unaware they have it until 2 to 3 weeks after the infection, which is why it can spread quickly.

NHS inform says mites can survive away from the body for 24 to 36 hours, so infection from clothes, towels or bed linen is possible but rare. The British Association of Dermatologists says it is not caused by being dirty or unhygienic. The NHS says people who live or work closely together in nurseries, university halls of residence or nursing homes are at higher risk.

The NHS describes a rare and very contagious type called crusted scabies, which can occur in people with a weakened immune system and causes a crusted, flaky rash, often on the elbows, knees, hands and feet.

NHS inform describes scabies as a contagious skin condition caused by tiny mites that burrow into the skin. The British Association of Dermatologists says that people affected have an average of about a dozen adult mites, which are mainly found in skin folds, laying eggs in burrows. It says scabies in animals is called mange and is caused by a different mite that cannot live on humans.

The British Association of Dermatologists says that with the right treatment scabies clears up quickly and completely, but if left untreated it can last for months or even years. The NHS says treatment kills the mites quickly, but the itching can carry on for a few weeks.

NHS inform explains that itching may continue for a couple of weeks because the immune system is still reacting to dead mites and their droppings, and suggests contacting your GP if you are still itchy 6 weeks after treatment. The NHS says to see a GP if you are still itching 2 to 4 weeks after finishing pharmacy treatment.

Adults and children aged 5 or over can go back to work or school once treatment has started, but should avoid close contact with others for the first 24 hours, the NHS says. Children under 5 can return to nursery or pre-school 24 hours after the first treatment.

The British Association of Dermatologists says the best way to treat scabies and avoid recurrence is to treat all family members, friends and other close contacts correctly at the same time, even if they have no symptoms, because people with no itch can re-infest others. The NHS adds that anyone you have had sexual contact with in the past 8 weeks should be treated too.

• Wash all bedding and clothing at 60C or higher, ideally with a hot dryer, on the first day of treatment (NHS).

• Put clothing that cannot be washed in a sealed bag for at least 3 days (NHS).

• Do not have sex or close physical contact until the full course of treatment is finished (NHS).

• Do not share bedding, clothing or towels (NHS).

• NHS inform also suggests cleaning floors and vacuuming carpets and furniture.

The NHS and NHS inform both say to let the pharmacist know if you are pregnant or breastfeeding when buying treatment. The British Association of Dermatologists says a doctor may suggest different options for women who are pregnant or breastfeeding and for babies.

The NHS says not to use pharmacy treatments on children under 2 years old, who need to see a GP, and that you should see a GP if your child is under 2 and has symptoms or someone else in the household has scabies. NICE Clinical Knowledge Summaries says scabies is rare in babies under 2 months and that specialist advice should be sought if treatment is needed at that age.

The NHS says to see a GP if any of the following apply.

• your child is under 2 years old and has symptoms of scabies, or someone else in your household has scabies

• you think your skin may be infected, or you have another skin condition such as eczema

• you have a crusted, flaky rash on your elbows, knees, hands or feet

• you have used pharmacy treatment and your skin is still itching 2 to 4 weeks after treatment has finished

Most people with scabies start with a pharmacist, as the NHS advises, and treatment can be bought over the counter. The British Association of Dermatologists notes treatments can be prescribed, bought over the counter or purchased from online pharmacies without a prescription. NHS inform says to contact your local sexual health clinic if you think you or your partner has genital scabies, where you may also be offered tests for sexually transmitted infections.