Scabies – Frequently Asked Questions

What is scabies?

Scabies is a common skin infestation caused by a tiny mite called Sarcoptes scabiei. The mites burrow into the skin and cause an itchy rash.

Scabies can affect anyone, regardless of age, gender, ethnicity or living circumstances.

Scabies is not caused by poor hygiene and does not mean that a person or home is unclean.

What are the symptoms?

Common symptoms include:

• intense itching, especially at night
• an itchy rash
• small red bumps or spots
• scratch marks or crusting from scratching
• fine thread-like lines (burrows) on the skin

The rash most commonly affects:

• fingers and between the fingers
• wrists
• hands
• elbows
• armpits
• around the waist
• buttocks
• genital area
• feet.

In infants, older adults and some people with weakened immune systems, the scalp, face, palms and soles may also be affected.

Scabies can look different on black or brown skin and may be more difficult to recognise.

When do symptoms start?

Symptoms usually develop 2 to 6 weeks after first becoming infected.
People who have had scabies before may develop symptoms more quickly.

How does scabies spread?

Scabies spreads through prolonged skin-to-skin contact with an infected person.

Prevention relies on early diagnosis, treatment of affected individuals and treatment of close contacts where indicated.

It commonly spreads between:

• household members
• sexual partners
• people sharing a bed
• people providing close personal care.

Scabies is not usually spread through brief handshakes, hugging someone briefly, or casual contact.

Who needs treatment?

To prevent reinfestation, everyone who requires treatment should be treated at the same time.

This usually includes:

• everyone living in the same household
• current sexual partners
• people who have had prolonged skin-to-skin contact with the affected person during the previous 6 weeks
• other close contacts identified by a healthcare professional.

Why do people without symptoms need treatment?

People can carry scabies for several weeks before symptoms appear. This means someone may spread scabies without realising they are infected.

For this reason, close contacts may be advised to have treatment even if they have no itching or rash.

Treating close contacts at the same time helps prevent scabies spreading to others and reduces the risk of reinfestation.

How is scabies treated?

Scabies is usually treated with a medicated cream or lotion applied to the skin.

Some people may be prescribed an oral medicine instead.

Your GP, pharmacist or other healthcare professional will advise which treatment is most appropriate for you.

Treatment works best when:
✔ everyone who needs treatment is treated at the same time
✔ treatment instructions are followed carefully
✔ close contacts are treated where appropriate
✔ clothing, bedding and towels are managed on the day treatment begins.

Applying treatment correctly

Treatment must be applied exactly as directed.

Useful information for treatment applied to the skin.

• Apply to the entire body including the neck, face and scalp as advised by your healthcare professional. The product advice may suggest not treating the scalp and face, but it is best that all these areas are treated.
• It is best to apply before bedtime.
• Ensure skin is clean, dry and cool before putting on the cream. Do not apply treatment immediately after a hot bath or shower.
• Pay particular attention to:
  • between fingers and toes
  • under fingernails and toenails
  • wrists
  • armpits
  • groin area
  • buttocks
  • skin folds.
• Before applying treatment, all clothes and jewellery should be removed. If you cannot remove a ring, move it to apply to the skin surface underneath).
• When applying to the head, avoid the eyes and, in young children, avoid the mouth area where the cream or lotion may be licked off.
• You may need help applying treatment to difficult-to-reach areas.
• Brush some of the product under the nails with a soft nail brush as mites can easily escape treatment in the thickened skin there. Nails should be trimmed and kept short for the duration of treatment.
• Apply to the soles of your feet last after application to the body has dried. This is best done with your feet resting on top of or dangling over the side of a bed or chair.
• Reapply treatment to the hands if they are washed during the treatment period.
• Follow the instructions provided regarding how long treatment should remain on the skin (for example, Lyclear® (Permethrin) cream should remain on the skin for 12 hours).
• Let the cream or lotion dry (this takes 10-15 minutes) before getting dressed or it may rub off.
• Remember to repeat the treatment after 7 days, as two treatments are required.

How to wash off treatment applied to the skin.

• After the product has been on for the appropriate time, it should be washed off, initially with cool water and no soap. Once everything is washed off, a shower or bath with soap may be taken.
• Use clean towels to dry the skin and wash towels after use.

Washing clothes, bedding and towels

On the day treatment begins:

• wash clothing, bedding and towels used during the previous few days at 50°C or higher
• alternatively, tumble dry using a hot cycle
• items that cannot be washed or dry cleaned should be sealed in a plastic bag for at least 4 days.

Normal household cleaning is usually sufficient.

Tell your close contacts
If you have scabies, it is important to tell people who may also require treatment.
This may include:

• people living in your household
• sexual partners
• anyone who has had prolonged skin-to-skin contact with you during the previous 6 weeks.

Prompt treatment can help prevent scabies spreading to others and reduce the chance of it returning.

Can I go to work, school or childcare?

Yes.

Adults and children can usually return to work, school, childcare or normal activities 24 hours after their first treatment has been completed.

Am I still contagious after treatment?

Most people are no longer considered infectious 24 hours after completing their first treatment, provided treatment has been used correctly and close contacts have also been managed appropriately.

Can I get scabies again?

Yes. Having scabies does not provide long-term immunity. A person can become infected again following contact with someone who has scabies.

Itching after treatment

Itching can continue even when treatment has worked
It is common for itching to continue for up to 6 weeks after successful treatment.

This does not necessarily mean the treatment has failed.

The skin may continue to react to dead mites and mite debris after infestation has been cleared.

Speak to your GP or pharmacist if itching is causing significant discomfort.

Calamine lotion, emollients or antihistamines may help to relieve itchy skin.

When should I seek medical advice?

Contact your GP, pharmacist or healthcare professional if:

• symptoms are not improving after treatment
• new rash or burrows continue to appear after treatment
• symptoms return after initially improving
• you are pregnant or breastfeeding and require treatment advice
• the affected person is younger than 2 months of age
• you have a weakened immune system
• you think you may have crusted scabies.

Pregnancy and breastfeeding
Treatment options are available during pregnancy and breastfeeding.

If you are pregnant, breastfeeding or think you may be pregnant, discuss treatment with your GP, pharmacist, midwife or other healthcare professional before starting treatment.

What is crusted scabies?

Crusted scabies is a rare but severe form of scabies.

It is more likely to occur in people who:

• have weakened immune systems have reduced mobility
• have neurological conditions
• require long-term care.

Crusted scabies can spread very easily and requires specialist medical treatment.

Seek medical advice promptly if crusted scabies is suspected.

Scabies in care facilities and shared accommodation

Scabies can spread more easily in places where people live closely together, such as:

• nursing homes
• residential care facilities
• disability services
• homeless accommodation
• prisons and places of detention
• other shared living environments.

Additional measures, including coordinated treatment of residents, staff, and close contacts, may sometimes be required to control spread in these settings.

Published: September 2026