Overview
Scabies is an infestation of the skin by the mite Sarcoptes scabiei var hominis 1. It is characterized by intense itching and a characteristic rash 1.Diagnosis
Diagnosis is primarily clinical, based on the presence of characteristic burrows, papules, and intense pruritus, often worse at night 1.
Microscopic identification of mites, eggs, or scybala in skin scrapings can confirm the diagnosis 1.Management
First-line treatment typically involves topical scabicides 1.
Permethrin cream 5% is a commonly recommended first-line agent 1.
Ivermectin, given orally, is an alternative first-line treatment, particularly for widespread infestations or when topical therapy is impractical 1.
Treatment should be repeated as per product instructions or guideline recommendations to ensure eradication 1.
All close contacts should be treated simultaneously, even if asymptomatic 1.Special Populations
The guideline provides recommendations for adults and children aged 13 or above attending sexual health services 1.Key Recommendations
Diagnosis is primarily clinical, supported by skin scrapings if necessary 1. (Evidence: Expert opinion)
Topical permethrin 5% cream or oral ivermectin are recommended as first-line treatments for scabies 1. (Evidence: Strong)
Simultaneous treatment of all household and sexual contacts is crucial for effective control 1. (Evidence: Expert opinion)References
1 Morris G, Haddow L, Sashidharan PN, Savary-Trathen A, Soni S, Bigland C et al.. British Association for Sexual Health and HIV National Guideline on the Management of Scabies in adults 2025. International journal of STD & AIDS 2025. link