Scabies

Scabies is a contagious disease caused by a tiny burrowing mite. This is a small insect that you cannot see with the naked eye. The mite digs tunnels into the surface of your skin and lays eggs there. Your skin then has an allergic reaction to the mite, which causes itching. While scabies isn't an STI, it can be transmitted between sexual partners, or anyone who has prolonged contact. ### Scabies Symptoms Scabies causes itching and blisters and/or bumps. The first time someone becomes infected, it takes two to six weeks before the itching starts. Most of the itch starts at night or when it’s hot. With subsequent infections, the itching can develop after just a few days. Your skin may also develop tiny burrows, blisters and red skin lesions, especially on your ankles, feet and wrists. It can also occur on nipples, genitals and in the armpits (the front crease) and groin. Here it can resemble other skin conditions, such as eczema. ### Scabies Transmission You can get scabies by sharing a bed, clothing or cuddly toys with someone who has scabies. It can also spread if you have more than 15 minutes of skin-to-skin contact with someone who has scabies, for example when you help them bathe or get dressed, have sex with them or sleep with them in the same bed. According to various sources, you are contagious if mites are present on the skin surface. This means that you can be contagious to others once the first new mites mature, from about one to two weeks after infestation. You can therefore also be contagious if you have no symptoms of scabies. Scabies is no longer contagious 12 hours after effective treatment. ### Scabies Treatment Scabies is treated by taking ivermectin tablets or using topical creams. Depending on where you live, the name of the medicine might differ. Someone with scabies complaints should always be treated a second time 7 days after the first treatment. The advice for members of a household, close contacts (>15min skin-skin contact) and sexual contacts also needs a second treatment after 7 days (same for oral and cream treatment). Not only do you just put on cream or take tablets, you also need to wash your clothing and bed linen at 60 °C or put it in a sealed bag for three days. The scabies mite also settles in textiles. It is very important that this washing and sealing textile is done in the right way and order. Scabies does not go away on its own. In case of complaints that indicate scabies, go to the doctor. The treatment of scabies stands or falls with good diagnosis and simultaneous treatment of the patient and family members and close contacts who may be infected. Does the GP confirms that you do indeed have scabies? Inform housemates and people with whom you had intensive contact (longer than 15 minutes). They can also be infected. An inventory of these risk contacts must be made up to 6 weeks before the start of the complaints of the person with scabies. This is because scabies is already contagious before someone has symptoms. It is also very important that all members of your household and close contacts get the treatment at the same time as you, even if they don’t have any symptoms (yet). This is the only way to avoid getting scabies again. - roommates/children/family - people you look after or people who take care of you (for example, think of your hairdresser if you have visited them) - people who slept in your bed - people you sleep with - people you hug or have sex with. Everyone who lives in one house should smear the cream or take pills on the same day. Also do these things so you don't get scabies again: - After everyone has been treated, wash clothes, blankets, bedding and cuddly toys that you have used in the last 3 days at a minimum of 60 degrees - Put non-washable things in garbage bags for 72 hours and close them tightly. This also applies to your sneakers, cuddly toys and rope, for example. ### Scabies and Kink/Sex Have you had physical contact for more than 15 minutes? Then call your GP and tell them this. A prescription will be ready for you at the pharmacy in no time. Do you have a nesting partner, family or other close contact? Then ask the GP what they should do. If in doubt, ask if your nesting partner/family/other can also be treated. Have you had contact for less than 15 minutes? Then keep an eye on it if you don't get itchy spots within 2-6 weeks. Are you still in doubt? Then call your GP. What about tying people? Or what about the sofas and beds at play parties? Does preventive treatment help? Should organizations take precautions? With scabies, a little common sense goes a long way. Do you have an itchy spot and you don't trust it completely? Visit the GP before going to a party. *Informing those around you that you have scabies feels the same as letting them know you have an STI. It isn't easy, but it's important to protect our partners - and also help them not to feel ashamed for revealing their diagnosis. * ### Facts / Fables Here are some facts and myths about scabies: ### Myth: You can get scabies from a handshake, kiss or short hug. This is too short a time to transmit scabies (unless you hold someone's hand for a long time or kiss each other for half an hour).* ### Myth: You can see the mites' tunnels A mite is 0.5 mm in size, so the tunnel under the skin does not have to be that large.* ### Myth: You get scabies due to bad personal hygiene Anyone can get scabies. The only way of not getting it is by not sharing unwashed bed linen or clothing and by avoiding physical contact with anyone who has scabies. ### Myth: Scabies is transmitted through clothing, sofa or bed The chance is smaller than if you come into direct contact with someone with scabies. ### Myth: You can only get scabies once in your life There is no immunity to scabies. ### Resources - RIVM Resource for Scabies - RIVM infographic - GGD Amsterdam