Scabies & Pubic Lice Treatments

Scabies is a contagious skin condition caused by tiny mites (Sarcoptes scabiei) that burrow into the outer layer of the skin. Anyone can catch it through close contact with someone who has it, regardless of age or background. The mites trigger an allergic reaction in the skin, causing intense itching and a raised, spotty rash, most often between the fingers, around the wrists and elbows, under the arms and around the waist. Scabies is not usually a serious condition, but it does need treating to clear the infestation and stop it spreading to others. A permethrin-based treatment such as Lyclear Dermal Cream is the standard first-line treatment recommended by the NHS.

The main symptoms of scabies are intense itching, usually worse at night, and a rash made up of small red spots. Scratching can cause the skin to become crusty or sore. Look closely and you may also spot burrow marks - short, wavy, silvery-grey lines around 1cm or less in length, sometimes with a tiny black dot (the mite) at one end. Burrows and rash typically appear between the fingers, on the wrists, elbows, under the arms and around the waist, groin and buttocks. In babies, young children and elderly people, the rash can also affect the face, scalp, palms and soles of the feet, areas usually spared in older children and adults. If you are unsure whether what you are seeing is scabies, a pharmacist can usually advise after a quick look, or you may need a GP for a formal diagnosis.

Several other skin conditions can look similar to scabies, which is why it is not always straightforward to self-diagnose from symptoms alone. Eczema and other forms of dermatitis can cause a similarly itchy, red rash, while insect bites, such as from bed bugs or fleas, can also produce small, itchy spots that are sometimes confused with scabies. Ringworm, a fungal infection, produces a distinct ring-shaped rash rather than burrows and tends to be less intensely itchy. The clearest sign that points specifically to scabies is the presence of burrow marks and a rash concentrated in the classic sites, such as between the fingers and around the wrists. If you are not sure what is causing your symptoms, a pharmacist or GP can help confirm the cause before you start treatment.

Scabies is caused by an infestation of the mite Sarcoptes scabiei, which burrows into the top layer of the skin to live and lay its eggs. The itching and rash are caused by the body's allergic reaction to the mites, their eggs and their waste, rather than by direct damage from the mites themselves. Scabies has nothing to do with poor hygiene. It is a common condition that can affect anyone, regardless of how clean they or their home are, and is simply the result of close contact with someone who is already infested.

Scabies spreads through prolonged, direct skin-to-skin contact with someone who has it, including sexual contact. It is unlikely to spread through brief contact such as shaking hands or a quick hug, but it can pass between people who share a bed, or through other close physical contact within a household. Because of this, scabies is not usually classed as a traditional STI, though sexual contact is one of the ways it can spread. It is very rarely passed on through contaminated clothing, towels or bedding, since the mites do not survive for long away from human skin. Scabies cannot be caught from pets. The mite that causes mange in dogs and cats is a different species that cannot live on human skin.

Scabies is treated with a permethrin-based cream, such as Lyclear Dermal Cream, applied over the whole body and left on for at least 8 hours before washing off. A second application 7 days later is often recommended to catch any mites that hatch from eggs that survived the first treatment. Everyone in your household, and anyone you have had prolonged skin contact with, should be treated at the same time, even if they do not have symptoms, since scabies can take weeks to cause visible signs of infestation. Bedding, towels and clothing used in the 3 days before treatment should be washed at 60°C or higher, or sealed in a plastic bag for at least 72 hours if they cannot be washed. See our Lyclear Dermal Cream page for full application instructions.

No. Despite being widely searched for, products such as Dettol, bleach, tea tree oil and household disinfectants are not clinically proven treatments for scabies, and using them on the skin in this way can cause irritation or chemical burns rather than clearing the infestation. The same applies to home remedies like hot baths, sunbeds or sunlight exposure - none of these reliably kill scabies mites, and some carry their own risks. Permethrin, the active ingredient in treatments such as Lyclear Dermal Cream, is the treatment recommended by the NHS, as it has been specifically formulated and tested to kill scabies mites and their eggs safely on the skin.

If you have never had scabies before, it can take between 2 and 8 weeks after contact with the mites for the itching and rash to appear, and you can pass the infestation on to others during this time without knowing you have it. If you have had scabies before, symptoms can develop much faster, sometimes within a few days, since your immune system already recognises the mites. Treatment kills the mites quickly, but itching can continue for 2 to 4 weeks afterwards, even once the infestation has cleared. This is caused by the skin's ongoing reaction to the remains of dead mites, and does not necessarily mean the treatment has not worked. Speak to a pharmacist or GP if itching persists beyond 4 weeks, or if you notice new burrows appearing.

Scabies mites cannot survive for long away from human skin, generally no more than 2 to 3 days, so it is rare to catch scabies from clothing, bedding or furniture. However, because reinfection is possible during this window, it is sensible to wash any bedding, towels and clothing used in the days before treatment at 60°C or higher. Items that cannot be washed, such as some soft furnishings, can be sealed in a plastic bag for at least 72 hours instead, which gives the mites enough time to die off without needing sprays or chemical treatments on furniture.

Scabies is not usually a serious condition, though it does need treating, both to relieve the itching and to stop it spreading to others. Left untreated, persistent scratching can occasionally lead to a secondary skin infection, which may need separate treatment. People with a weakened immune system, such as elderly or frail individuals, can develop a rare and highly contagious form called crusted scabies, which causes a crusted, flaky rash, often on the elbows, knees, hands and feet, and needs prompt medical attention rather than an over-the-counter treatment alone. See a GP if you have a crusted, flaky rash in these areas, if your skin appears infected, or if itching has not improved 2 to 4 weeks after completing treatment.

Pubic lice, also called crab lice or "crabs", are tiny greyish-brown insects, around 2mm long, that live in coarse body hair, most often pubic hair, though they can also be found in armpit, chest, facial or eyelash hair. They spread through close body contact, most commonly sexual contact, though sharing towels, bedding or clothing can occasionally pass them on too. Pubic lice are not linked to poor personal hygiene. The main symptom is itchy red spots, caused by an allergic reaction to the lice's saliva and droppings, which can take 1 to 3 weeks to develop after contact and is often worse at night. Looking closely, you may be able to see the lice themselves, small bluish-grey specks that grip onto hairs, or tiny pale eggs (nits) stuck near the base of the hairs. You may also notice small blue-grey marks on the skin where they have been feeding, or specks of blood in your underwear from scratching. Lyclear Dermal Cream treats both scabies and pubic lice using the same permethrin-based formula.