Scabies in gay and bisexual men
What is scabies?
- It is a skin infestation caused by a tiny mite called Sarcopetes scabiei.
- Mites burrow into the skin where they live and lay eggs – the offspring crawl out onto the skin and make new burrows and perpetuate the cycle.
- Scabies leads to intense itching particularly at night.
- Scabies is spread by direct skin contact.
- Any part of the body can be affected.
- Scabies can be treated with creams or lotions.
- If you have scabies we recommend an STI screen and HIV test as there is evidence that you are more likely to have an STI
How common is scabies
- Scabies is common – it is found world wide and affects people of all age, race and social class.
- Scabies can spread more rapidly in crowded conditions or institutions where close body and skin contact is more frequent.
How do you catch scabies?
- By direct skin-to-skin contact with someone that has scabies.
- Intimate or sexual contact is a common way of catching scabies.
- Mites may survive up to 72 hours off the human body (e.g. on clothing)
What would I notice if I had scabies?
- If someone has never had scabies before symptoms usually take 4 to 6 weeks to develop.
- But someone can still pass on scabies during this time.
- Common things you may notice:
- intense generalised itching particularly at night
- a pimple like itchy rash commonly affecting the genital area (where the pimples are often nodule like), between the fingers, wrists, elbow creases and around the nipples
- tiny burrows in the skin –silvery lines particularly between the fingers
How do I get tested for scabies?
- An experienced doctor can make a diagnosis on clinical examination – we can do this at the Wolverton.
- It can sometimes be confirmed by taking a skin scraping and examining under a microscope for a mite.
How is scabies treated?
- With either:
PERMETHRIN 5% cream
MALATHION 0.5% aqueous lotion
- These should be applied to the whole body from neck downwards and left on for at least 12 hours (usually overnight) before washing off.
- Clothing or bedding that may be contaminated should be washed at high temperature (>50¢ªC).
- Itching may continue for 2-4 weeks after treatment – if bad your doctor can prescribe something to help relieve the itch.
- All treatments from the Wolverton are free and supplied directly to you in the clinic.
What about my partner?
- All current sexual partners and household contacts should be examined and treated at the same time.
- Previous partners in the last 2 months will also need to be treated.
What problems can untreated scabies lead to?
- Itching will persist and the skin is likely to become secondarily infected from constant scratching.
- Large itchy nodules may appear particularly in the genital area.
Will scabies come back again after treatment?
- Sometimes the treatment fails because:
- either the skin was not totally covered with the cream /lotion
- the lotion was not applied for long enough
- partners / contacts were not treated at the same time
- the person was re-infected
- A severe form of scabies called Norwegian scabies exists which is very infectious and can be difficult to treat.
- Norwegian scabies usually affects the elderly or people who are very immunosuppressed (e.g. HIV).
- Your doctor would recognise this form of infection.
- It is treated with tablets called Ivermectin.