Instructions for the self-treatment of scabies

Scabies is a human parasitic disease caused by a mite (Sarcoptes scabiei) that is transmitted from person to person through skin contact, including through sex or through bed linen and clothing. Animals have their own scabies mites, which are rarely transmitted to humans. Outside the human body, the mite dies within 48–72 hours.

Children and the elderly are more susceptible to the infection. The female scabies mite burrows into the skin, forming tunnels between the fingers as well as in the wrists, armpits, groin and genital area. Scabies tunnels can also be found in the palms of the hands and soles of the feet from the soft skin of a child.

All family members, even those who are asymptomatic, and others in close contact with an infected person, such as sexual partners, must be treated at the same time.

It is advisable to inform the daycare centre about a child’s scabies infection. The infected person may attend daycare, school or work the day after the first treatment session. However, in the case of crusted scabies, physical contact with others should be avoided until both treatments carried out a week apart have been completed.

If an employee suspects a work-related infection, they can contact their occupational health care provider.

Symptoms

The main symptom of scabies is very intense itching due to the body’s reaction to the mite’s secretions. An infected person will start to have symptoms for the first time 3–4 weeks after the infection. A person infected for a second time has been sensitised, and the itching will start within days.

The itching will occur all over the body from the neck down. In children, the palms, wrist folds, soles of the feet, armpits and lower back will be particularly itchy. The itching is most intense in the evening and at night. Children over the age of 5 rarely have itching on the face.

The skin will have spots, small water blisters and scratch marks, as well as scabies tunnels. In adults, itching and scratch marks will be concentrated between the fingers as well as in the armpits, groin and midriff. Scabies can already be passed on in the early stages, even if the infected person is still asymptomatic.

Self-treatment of scabies

A non-prescription medical ointment (5% permethrin) is used for the self-treatment of scabies.

• One 30-g tube of the ointment will be enough for an adult and a child over the age of 12, to be applied to the whole body.
• For children aged 6–12 years, half a tube or about 15 g of the ointment will usually be enough.
• For children aged 2 months to 5 years, a quarter of a tube will be enough.
• Pregnant and breastfeeding women may use the permethrin ointment.
• If only a child under the age of two is suspected of having scabies, a doctor should be contacted before treatment to confirm the diagnosis.

Asymptomatic family members and other people in close contact will be treated with the permethrin ointment at the same time. Both symptomatic infected persons and asymptomatic close contacts will be treated according to the same instructions.

Treatment should be repeated after 7 to 10 days.

Aftercare

Itching can persist for more than a month after treatment. This is not a sign of failed treatment. If necessary, itching can be relieved with hydrocortisone ointment, which can be bought over the counter from a pharmacy.

When to see a doctor?

• If the scabies infection is severe, widespread, inflamed or if self-treatment does not help, your doctor may prescribe a tablet medication and other medical ointments.
• If only a child under the age of two is suspected of having scabies, a doctor should be contacted before treatment to confirm the diagnosis.
• If a baby under 2 months of age has been infected or exposed to scabies.
• You should consult a doctor if the itching persists for more than a month after the treatment. The doctor will assess the success of the treatment and make the correct diagnosis.

These instructions were prepared by: Epidemiological Operations Unit.