GPs are still seeing higher than expected cases of scabies this summer – the highly contagious rash caused by the miniscule scabies mite.
We've consulted a range of experts - from pest control specialists to doctors and pharmacists - to help you recognise and treat the symptoms of scabies mite infestation, as well as offering you tips on keeping your home free from this pesky parasite.
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Scabies is caused by the scabies mite, a whitish-brown, oval-shaped parasite that digs into the skin's epidermis (top layer), digging track-like 'linear burrows' to lay eggs that develop into adult mites within one to two weeks.
While bedbugs are up to 7mm long when fully grown, scabies mites are a microscopic 0.5mm or less – around the size of the point of a pin – and invisible to the naked eye.
Although the average infected person will have just 10-15 scabies mites on them, this is enough to lead to unpleasant symptoms, including a rash.
While cases have fallen from the peak seen in January 2024, the Royal College of General Practitioners told Which? they remain above the five-year average, with two cases per 100,000 of the population (three per 100,000 in the north of England) being reported.
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You usually see symptoms around 4-6 weeks after infestation, when the body starts to have an allergic reaction to mite proteins and droppings. Telltale signs include:
When a case of classic scabies infestation ramps up and the number of mites reaches thousands or even millions, it's classified as crusted scabies.
Vast numbers of mites inhabit crusty scabs created by their activity under the skin and when these are shed the mites fall with them, each seeking a new host.
This extremely contagious form of scabies is mainly seen in people with suppressed immune systems or other conditions.
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Anyone can catch scabies. The scabies parasite is transmitted through direct, prolonged skin contact with someone who is already infected – someone you sleep in the same bed with, for example.
Scabies can also be commonly spread in places like nurseries, playgroups or schools where children often play in close contact, as well as residential homes.
It's also more prevalent in the winter months, when people huddle together and cooler temperatures enable mites to survive for longer away from their host.
Treatment for scabies is topical permethrin cream or malathion lotion from your pharmacy or on prescription from your GP and in the case of crusted scabies you'll probably be prescribed oral medication too.
Everyone in the household should be treated at the same time (even those without symptoms) to prevent them passing on the infection. Treatment should be repeated to kill newly hatched mites and stop the lifecycle.
Continue with treatment as directed and don't stop without guidance, even if your symptoms appear to be improving.
Although scabies clears up quickly with the right treatment, it's common for itchiness to worsen for one to two weeks after treatment begins. You may get some relief from taking antihistamines (like those commonly used for conditions such as hayfever).
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In January, the British Association of Dermatologists said a surge in demand for treatments across Europe, supply chain issues and increases in the cost of raw materials were contributing to a shortage of permethrin cream and malathion lotion.
When Which? spoke to the Royal Pharmaceutical Society at the end of June, a spokesperson told us that currently there are no reported shortages of treatment for scabies, although if you do run across difficulties getting hold of it you should first consult with your healthcare provider or pharmacist for guidance on alternative treatments or sourcing options.
There is no evidence to suggest summer is worse for the spread of scabies - in fact, public health data comparing five-year average statistics appears to show a lull in cases in the spring and summer .
However, heat intensifies itching for many people with skin conditions where itch is a symptom, including scabies.
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Scabies mites can only survive for two or three days away from human skin, which is why infestation most commonly occurs from skin-to-skin contact.
Although it's rare, there are other situations in which you can pick up scabies without being in direct contact with another human, including exposure to scabs shed by someone with crusted scabies or picking up a mite from an item such as bedding.
Here are some potential problem areas in the home plus how to keep them clean.
Wash and dry bedding and clothing that's been in contact with an infested person to kill both mites and eggs, but make sure the machine cycle is 50°C or above.
Natalie Bungay of the British Pest Control Association, says: 'Using 30 degree cycles or lower may be a popular choice but scabies eggs are hardy and might survive this, even if the mites don't. So the hotter the washing cycle, the better.'
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While bedbugs can survive on mattresses for up to four months, scabies mites can only live on them for up to three days.
This means so you should be able to get rid of them rather than having to go to the bother and expense of throwing your mattress away.
Vacuum every side and seam of each mattress that's being used in your home, put all bedding on a hot wash immediately and use a plastic mattress cover – if any mites remain, this physical barrier will prevent them from reaching you before they quickly perish.
Natalie says: 'You can also steam clean your mattress to kill scabies mites long as it's safe to do it and the label advises you that you can.'
You can find out how to keep your mattress looking and smelling clean with our expert guide on how to clean a mattress.
How often should you wash your bedding? Follow these steps to keep your bed linen, pillows, duvet and mattress free from dirt, dust mites, dead skin cells and sweat
Cleaning your lounge furniture may be especially important if you're the sort of family that piles on the same sofa to watch TV as scabies mites revel in any opportunity to transfer from one host to the next – here's how to clean up.
Read our expert advice on how to vacuum your home effectively, with tips on how to clean every corner of your floors, carpets and furniture with less effort.
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Natalie Bungay says: 'Scabies mites don't like hard finishes so you shouldn't need to deep clean or disinfect surfaces such as countertops, bath tubs or sinks.'
However, there's an outside chance an opportunistic mite could latch on to a host from a hard surface, such as a child playing on a wooden floor.
If you've been shaking out or rearranging throws and blankets during a known infestation or when someone has highly infectious crusted scabies, you could vacuum the floor of that room as a precaution.
Scabies isn't to do with untidiness or poor hygiene.
Dr Tess McPherson, president of the British Society for Paediatric and Adolescent Dermatology, says: 'It is important to state you do not get scabies because you are unhygienic, and we must reduce any stigma associated with having scabies so that people do seek treatments when needed.'
Let your child's school or nursery know if they have scabies and keep siblings off school until treatment has started to prevent passing it on to others – you or your child can go back to work or school 24 hours after the first treatment.
Natalie says: 'Mange in dogs is a form of scabies but although the mites involved can get on to you, they can't breed and complete their life cycle. So they may irritate your skin but then they'll just die.'
Equally, human scabies mites could jump ship from you onto your pet. But they, too, won't be able to breed unless they can quickly get back to human skin.
As a precaution, especially if a family member has crusted scabies and you think scabs may have dropped into your pet's bed or basket, wash their bedding on a hot wash as per the guidance for human bedding above and speak to your vet for further guidance.
Scabies mites are human-centric pests, so do some basic detective work to find out whereabouts in your home you might need to clean in the wake of an infestation.
Look for places in your home where you and others like to hang out – such as soft furnishings – and that's where scabies mites are most likely to be found.
If you've got a child who likes to sit in a nook or cranny to read a book, make sure you clean that space if they've got scabies.
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