Edith Hejberg
Crowded living conditions and physical closeness make it easier for the infestation to pass from person to person.
Scabies is spreading rapidly in the UK, with doctors seeing a sharp increase in cases. Recent surveillance shows consultations for the condition are now double the five-year national average.
In just one week, nearly 900 cases were reported in England, almost 20% more than the same week last year.
A highly contagious skin condition
Scabies is caused by microscopic mites that burrow into the skin. The infestation triggers an allergic reaction, resulting in severe itching and a telltale rash.
According to Dr Giuseppe Aragona, “Scabies is very contagious and can affect anyone, regardless of age, background, or hygiene.”
Close contact is the main driver
The mites spread through prolonged skin-to-skin contact, which is why households, schools, care homes, and close relationships are especially vulnerable.
Crowded living conditions and physical closeness make it easier for the infestation to pass from person to person.
Post-COVID contact patterns play a role
One reason for the increase? The return to normal life after COVID. More socialising and physical contact means more opportunity for the mites to spread. “It’s likely due to a combination of factors,” says Dr Aragona, “including increased close contact since restrictions lifted.”
Treatment delays are fuelling outbreaks
Scabies is often missed at first, allowing it to spread before the correct diagnosis is made.
Dr Aragona warns that misused treatments, or treatment not reaching all household contacts, can allow infestations to linger and return, especially in group living situations.
Three key symptoms to watch for
The most common symptom is intense itching, particularly at night. Scabies also causes a rash made up of small red bumps, scratch marks, and fine burrows, tiny lines where the mites have tunnelled under the skin.
Where the rash usually appears
The rash tends to show up in warm, soft areas of the body: between the fingers, around the wrists, elbows, armpits, waist, buttocks, and genitals. In young children and older adults, it can also appear on the scalp, face, palms, and soles.
Scratching can cause more problems
Relentless itching often leads to broken skin. This creates an opening for bacteria, raising the risk of a secondary infection.
Left untreated, this can become more serious and may require antibiotics in addition to scabies treatment.
How scabies is treated
Permethrin cream is the go-to treatment. It works by paralysing and killing the mites and their eggs.
It must be applied across the whole body and left on for 8–14 hours before being washed off. A second application is usually needed one week later.
Treat everyone in close contact
Scabies treatment isn’t just for the person with symptoms. “All close household contacts should be treated at the same time, even if they have no symptoms,” says Dr Aragona.
This helps stop the mites from spreading again or reinfesting the household.
Home hygiene is key to stopping the cycle
To break the cycle, wash all clothing, towels, and bedding used in the past three days at 60°C or hotter.
Seal non-washable items in a plastic bag for at least 72 hours, and vacuum carpets, sofas, and mattresses thoroughly.
When stronger treatment is needed
For stubborn or severe cases, like crusted scabies, oral medication such as ivermectin may be prescribed.
This is usually done under the guidance of a specialist, particularly when topical treatments haven’t worked.
Itching may continue after treatment
Even after the mites are gone, itching can last for weeks due to the body’s lingering allergic response.
“This doesn’t mean the treatment has failed,” reassures Dr Aragona. Relief takes time, and patience is key while the skin recovers.
