Doctors share key signs of scabies as UK mite cases surge

We wouldn’t blame you if you feel itchy just looking at this (Picture: Getty Images)

New year, new insect making the UK’s skin crawl.

Last year was the year of the bed bug, with the blood-sucking tick-size critters boarding Parisian trains and catching movies at the local cinema.

Now it seems 2024 has a new foe, a mite barely visible to the naked eye that causes an almost torturous rash that’s frequently misdiagnosed and mistreated.

Scabies have been on the rise in the UK since July amid a shortage of treatment options due to the Russia-Ukraine war.

The rate was double the seasonal average in November, with nearly three cases per 100,000 people. According to the Royal College of General Practitioners, there were 1.4 cases per 100,000 people in 2018-19.

‘Scabies rates have decreased though they remain above the seasonal norm in all regions,’ the membership body said in a report last month.

With scabies making headlines, here’s everything you need to know about the condition.

What causes scabies?

‘As a pharmacist and skin specialist, I’m often asked about scabies – what causes those itchy mysterious rashes?’ Randall Higgins, a pharmacist and skincare specialist at the acne advice Good Glow, tells Metro.co.uk.

‘Essentially, it’s a pesky skin condition triggered by tiny mites that burrow and lay eggs under the skin.’

These mites aren’t nameless. Sarcoptes scabiei are members of the arachnid family that love to nibble on animals such as dogs or sheep.

Each animal tends to have its own specific variant of the mite, meaning they can’t reproduce in other species. In dogs, for example, a scabies infestation is called mange.

These beautiful-looking mites are behind scabies, with their eggs and, well, droppings behind what makes people itch (Picture: Getty)

The mites can’t jump or fly. But once they land on a new victim, they can crawl at a speed of 2.5cm a minute to hunt down a hiding spot.

For humans, you only need about 10 egg-producing females making a reservation on the all-you-can-eat buffet that is your body to cause itchy agony.

Ten might sound like a lot – surely you can see these hitchhikers on your skin? At just 0.4 millimetres in length, they’re barely visible to the human eye.

Scabies mites secrete a chemical to digest the skin and then (we’re so, so sorry to tell you this) trudge through the mush that’s left – all within three minutes.

Female mites lay up to three eggs a day which hatch into hungry larvae a few days later.

What are the symptoms of scabies?

Just the thought alone of the mites crawling on your skin is enough to make you feel itchy, but this isn’t what causes the symptoms.

Your skin is having an allergic reaction to the eggs and faeces the female mites deposit as they tunnel underneath your skin.

The blotchy ratch that follows can feel like it has come out of nowhere as symptoms take up to weeks to surface.

Scratching the reddened areas may lead to impetigo, a bacterial skin disease with oozing sores, and nighttime scratching is common.

Cases of scabies have been steadily climbing since July, doctors say (Picture: Getty)

Where these angry rashes appear depends a lot on how old someone is.

In adults, Dr Tess McPherson, of the charity British Association of Dermatologists, says: ‘There can be a rash which can appear similar to conditions such as eczema but typically there may be small spots in between fingers, toes and genital areas.’

For the most part, the mites spare the upper back, neck, face, scalp, palms and the soles of your feet. (Anywhere warm and cosy is where the mites love to be.)

While in infants, the scalp, face, palms and soles are where the mites love to infest.

What is ‘crusted scabies’?

Yes, this is about as gross as it sounds.

People with weakened immune systems can develop crusted scabies, formerly known as Norwegian scabies, according to the NHS.

This is when someone’s immune system just can’t keep up with how many mites have infested the body.

While typical scabies cases see people being home to about a dozen or so female mites, people with crusted scabies can have hundreds, even millions, crawling on them.

‘The main symptom is a crusted, flaky rash that often affects the elbows, knees, hands and feet,’ the health service says.

How do you get scabies?

The microscopic arthropod is usually transmitted through direct, prolonged skin-to-skin contact: think sexual intercourse or sharing a house with someone.

The mite can also spread through contaminated clothing, bedding or towels used by an infested person.

While a female mite can live on someone for up to a month, they don’t have the same luck in the outside world, lasting rarely more than three days.

‘So if one person has scabies, their closest contacts should also be evaluated and potentially treated to prevent mite spread or re-infections even without symptoms appearing yet,’ says Higgins.

Do only certain people catch scabies?

‘Anyone can get scabies and it is not caused by lack of hygiene,’ Dr McPherson says, given the misconception that only mucky people get it. (After all, a scabies outbreak happened at a top London fashion university only last month.)

‘There can be a stigma surrounding scabies, this is not helpful and means that people may not tell contacts or seek help.’

Hands are among the areas where scabies tends to appear (Picture: Getty Images)

A big worry for health bosses like Dr McPherson is scabies spreading among elderly people living in retirement communities, nursing homes and extended care facilities.

‘The ease with which it spread, particularly in group living facilities like care homes and university halls of residence, is alarming given some issues with shortage of effective treatments,’ she says.

Some mistake scabies in older people for senile pruritus, another itchy condition caused by degenerative changes in ageing skin.

How do I know for sure that it’s scabies, though?

While scabies can look like other skin diseases – such as eczema, says Dr McPherson – the tell-tale sign is one or more burrows in the skin that look like raised bumps or lines.

Diagnosing scabies is simple enough. Doctors may take a scraping of a lesion and take a good look at it under a microscope to check for any mites, eggs or droppings.

How do I get rid of scabies?

‘The good news – it’s treatable!’ stresses Higgins, who recommends anyone being driven mad by itching see their GP straight away.

Natural insect-killing plant chemicals like permethrin and malathion are the two go-to drugs for treating scabies, but the Russia-Ukraine war has caused a shortage of both.

‘Topical permethrin cream kills mites/eggs,’ says Higgins. These creams are applied everywhere, including the groin and between fingers and toes.

Anti-itch creams such as calamine lotion and antihistamines can also relieve symptoms as ‘skin heals over two to four weeks post-treatment’.

Those suffering from the crusted form may be prescribed the mite-killing oral medication ivermectin, with a second dose given roughly two weeks later.

People suffering from scabies are encouraged to see a GP (Picture: Getty)

Both Higgins and Dr McPherson agree that to ensure all the mites are gone for good, everyone – from members of the same household and sexual partners to care home residents and workers – must be treated.

‘It is important to treat it effectively and ensure that all likely contacts are treated, ideally at the same time, to resolve symptoms and ensure it doesn’t continue to spread,’ says Dr McPherson.

All clothing, bedding and towels used by those infested or potentially infested must also be machine-washed in hot water and dried on high heat or dry-cleaned.

People can seal items that are tricky to throw in the washing machine in bags for up to a week as they wait out the mite’s short life span. Cleaning furniture is strongly advised.

All in all, scabies are a condition that sounds scary and is caused by something that will literally make your skin crawl.

But for Higgins, the solution is simple enough really.

‘Getting properly diagnosed and treated for scabies quickly,’ he says, ‘helps resolve symptoms faster and prevent further spread,’

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Do you miss bed bugs yet?