Scabies

• Intense itching, often worse at night

• A rash of small red spots or bumps, especially between fingers, wrists, elbows, underarms and around the waist

• Fine, thread-like burrow marks in the skin

• Skin irritation and scratch marks

• In severe cases (crusted scabies), thick, scaly patches

Scabies is usually diagnosed from the characteristic itch pattern, rash distribution and any visible burrows. A skin scraping can confirm the diagnosis under a microscope if needed, particularly for unclear or crusted cases

A topical treatment such as permethrin cream is applied to the whole body (from the neck down, or including the head in young children and older adults) and left on as directed, then repeated after a week to kill newly hatched mites. All household and close contacts should be treated at the same time, even without symptoms

• Treat all household members and close contacts simultaneously

• Wash bedding, clothing and towels on a hot wash on the day of treatment

• Avoid close skin contact until treatment is complete

• Vacuum soft furnishings that can't be washed

• Expect itching to continue for a few weeks after successful treatment, as this doesn't mean treatment has failed

• Seek advice if symptoms persist beyond a few weeks