Doctors report ‘nightmare’ surge in highly contagious itchy skin condition caused by tiny mites

A 'nightmare' surge in scabies cases poses a major public health problem, experts warned today.

Scabies is an intensely itchy and bumpy rash caused by the saliva, eggs and feces of the parasitic mite Sarcoptes scabiei, with symptoms sometimes lasting for months.

It is highly contagious and can spread in shared accommodations such as university buildings, care homes, prisons and immigration detention centres.

The number of infections in Britain has doubled in a year, with doctors fearing that failure to treat the condition quickly amid drug shortages could fuel the outbreak.

Experts also fear that the resurgence of Dickens' disease could be caused by the parasite becoming resistant to existing drugs, or by patients failing to properly treat their condition.

The latest surveillance data from the Royal College of General Practitioners (RCGP) shows there were three cases per 100,000 people in November, double the seasonal average.

In the week starting November 27, 27,484 cases were recorded by 500 GP practices in England and Wales monitoring results.

In comparison, only 56 cases were recorded in the same week in 2021, while 94 cases were recorded in that week in 2022.

Professor Mabs Chowdhury, chairman of the British Association of Dermatologists, told MailOnline: 'Scabies is a common but highly contagious skin condition.

'The ease with which the disease spreads, especially in group homes such as nursing homes and university residences, is alarming given the shortage of effective treatments.

'We have called on regulators, such as the MHRA and the Government, to provide manufacturers and suppliers with the necessary support to reduce bottlenecks in production.

'While we have been told that more supplies of permethrin and malathion will become available early this new year, we need to ensure that sufficient effective treatments are maintained.'

He said: 'There is very little research into cases of scabies and people are often ashamed to talk about it.'

'Given the challenges in social care and treatment shortages, public health authorities must plan for outbreaks in healthcare settings.'

He added: 'The public health calculation is not particularly complicated: scabies spreads easily and if people are not treated the disease will continue to spread.'

NHS guidelines recommend using permethrin or malathion creams, which should be rubbed all over the body, including under the nails.

It should be kept for a maximum of 24 hours and repeated after a week.

Alternatively, evidence suggests that ivermectin – taken in pill form – is safe and equally effective.

European regulators recommend it in two doses two weeks apart for standard scabies. It can be used in addition to the creams for more severe cases.

In Britain, however, a prescription can only be issued by a specialist – usually a dermatologist – for severe cases or to treat an outbreak, according to the UK Health Security Agency (UKHSA).

But in September, the Ministry of Health issued a warning that permethrin was in short supply, while malathion liquid was also unavailable.

Stocks are believed to have been hit by a surge in demand for scabies treatment in both Britain and Europe, as well as a spike in the cost of raw materials.

Research published today by the British Association of Dermatologists, commissioned by The Guardian, shows that eight out of nine regional representatives had reported an increase in scabies in their area last year.

Seven of the nine reported permethrin and malathion deficiencies.

Dermatologists who spoke The guard said the situation had become an 'absolute nightmare'.

But experts also warned that the rise in infections could be partly caused by the inability to properly treat the condition, causing 'pseudoresistance'.

Claire Fuller, co-founder of the Scabies Alliance, shared The times If people repeatedly fail to treat the condition correctly because they are not properly instructed, this can cause resistance.

Last month, scabies forced four studios at Central Saint Martins, University of the Arts London (pictured), to close ahead of the Christmas deadline. At least two cases were reported among students, forcing the university to organize a deep clean of the studios and textile room

Cases of scabies also vary dramatically across the country, top doctors said today, with the north of England seeing more 'pronounced' rates than the rest of the country.

Professor Kamila Hawthorne, chair of the RCGP, told MailOnline: 'Since July, GPs have seen an increasing number of scabies cases, at consistently higher levels than the five-year average and seasonal norm.

'This is particularly pronounced in the north of England.'

She added: 'When prescribed medicines are unavailable or in short supply, this is worrying for GPs, pharmacists and patients alike.

'GPs and pharmacists are already under enormous pressure to provide care to their patients during the peak season, and any drug shortages, even temporary, will worsen the situation.'

Guidelines in Britain recommend using permethrin or malathion creams, which should be rubbed all over the body, including under the nails. Alternatively, evidence suggests that ivermectin – taken in pill form – is safe and equally effective

Although scabies is a common condition, it often goes undiagnosed as the rash can be mistaken for a variety of other skin conditions. This increases the risk that an infected person will pass the disease on to others.

It mainly occurs through shared clothing or bedding, but also through skin-to-skin contact, such as during sex.

Last month, scabies forced four studios at Central Saint Martins, University of the Arts London, to close ahead of the Christmas deadline.

At least two cases were reported among students at the university forced to organize a deep cleaning in the studios and fabric room.

Meanwhile, in September, several migrants who had moved to a former RAF site near Braintree, Essex, were diagnosed with scabies.

The itchy rash is caused by mites burrowing under the skin to lay eggs, the presence of eggs and the creatures' feces.

This egg laying may resemble a line with a dot at one end, before developing into a rash.

Although it is highly contagious, it can take up to eight weeks for the most obvious sign, the rash, to appear, meaning people can unknowingly pass the disease on to others.

The rash usually spreads to the entire body, minus the head.

Scabies is incurable without treatment and people should avoid work or school until they receive medication, experts say.

Although scabies itself is not dangerous, scratching the rash can lead to secondary bacterial infections of the skin.

People with compromised immune systems, such as cancer patients undergoing chemotherapy, are vulnerable to hyperinfections called scabies.

The UKHSA notes that an estimated one in fifty long-term care facilities, such as care homes, will experience an outbreak of scabies each year.