Experts are urging ministers to order NHS bosses to stock up on a controversial deworming tablet for horses to stop a ‘nightmare’ outbreak of mange

Experts have urged ministers to buy shares of the controversial horse deworming tablet ivermectin to halt a ‘nightmare’ outbreak of scabies sweeping Britain.

Concerns about the disease come amid warnings that people are struggling to access standard treatments, which leading doctors say ‘undoubtedly’ causes infections.

Scabies is caused by tiny mites that burrow into the skin and cause intense itching, a raised rash, and crusty or crusty skin. The condition is spread through close skin contact with others, so often affects entire households and residents of care homes, and can also be transmitted during sex.

Ivermectin, an antiparasitic agent, is used in veterinary medicine – which is why it is commonly called a horse dewormer – but it is also routinely given to children and adults in mainland Europe and beyond to treat or prevent a wide range of serious conditions . parasitic infections, including scabies.

Unlike the standard treatments for scabies used in Britain – skin lotions called permethrin and malathion – ivermectin comes as a pill and is given in two doses per week.

Unlike the standard treatments for scabies used in Britain – skin lotions called permethrin and malathion – ivermectin comes as a pill and is given in two doses per week.

The treatment can kill the beetle and its eggs and keep them from returning for up to two years, studies show.

The drug gained notoriety during the Covid pandemic following claims by fringe medics that it could be a suitable treatment, and even an alternative to vaccination, despite a lack of credible evidence.

The Mail on Sunday first reported that skin specialists had called on ministers last summer to approve ivermectin as a first-line treatment for scabies, and the green light was given in September.

GPs can now prescribe it and pharmacists can sell it without a prescription.

Although supply chain issues related to the war in Ukraine and increased raw material costs have resulted in shortages of permethrin and malathion, such issues are not believed to impact ivermectin.

Dr. Tess McPherson, from the British Association of Dermatologists (BAD), said: ‘The current outbreak of scabies was predicted last year and in light of this, ivermectin was approved as a first-line treatment.

But the government has failed to buy back enough shares, and many GPs and pharmacists still don’t know this is even an option. It must urgently address this problem and ensure there are sufficient supplies of not only ivermectin, but also the topical creams. Otherwise we will have a much larger outbreak of scabies.’

Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies, backs the call: ‘We have seen a surge in scabies recently as care homes have been hit, driving up demand for permethrin and malathion and making supply patchy.

Ivermectin is most commonly used as a dewormer for horses, but some experts think it can combat mange

‘Pharmacists welcome anything that can help patients with their symptoms, rather than keeping them waiting. If it’s safe, why not make it available?’

Scabies is highly contagious and, if not treated properly, can linger for months or even years. The parasite and its eggs can also live in bed linens and towels, which can spread the infection to others.

Diagnosing it can be difficult because it can take eight weeks for the distinctive red rash – which affects the skin folds in the elbow, knee, buttocks and between fingers and toes – to appear. It can also spread throughout the body and may contain ‘spores’: lines under the skin where the mites have burrowed to lay eggs.

Scratching the spots can also aggravate other skin conditions, such as eczema or psoriasis, and lead to bacterial infections. But it is a myth that scabies is linked to poor hygiene.

It usually affects younger people because of the way it is transmitted – some of whom contract it through sexual transmission – and older people in care homes.

Those with weaker immune systems may be vulnerable to crusted scabies, a more severe form of the disease that involves a higher density of mites.

Scabies can often be transmitted through close physical contact, especially if there is intimacy involved

Treating it usually involves applying an anti-parasite lotion all over the body, including under the nails, and leaving it on for eight to 12 hours, reapplying it every time you wash your hands. The process should be repeated seven days later to ensure that all mites and their eggs have been destroyed.

Everyone in the same household and all sexual partners from the past eight weeks should also apply it even if they have no symptoms due to the time it takes to appear.

Despite suggestions that the latest outbreaks were caused by people becoming resistant to the treatments, there is no evidence, says Dr McPherson. The most likely explanation is that people do not apply the cream properly or for long enough.

It means that ivermectin, which is easier to use, is an important alternative and could be particularly useful for controlling outbreaks in care homes, for example.

“For many of my young patients, the solution seems to be using the creams and taking ivermectin on top of that,” she adds. “So we need access to all the medicines that are available to control the infections.”

Anyone who thinks they have scabies should see their GP or pharmacist, who may be able to diagnose it just by examining the skin. They may also prescribe ivermectin or an antiparasitic cream.

If they are unsure, they may refer you to a dermatologist who can perform tests to confirm the diagnosis before prescribing treatment.

Other ways to prevent the disease from spreading or returning in the home include washing clothes, bedding and towels at temperatures above 50 degrees Celsius.

Jo Middleton, a scabies expert from the Brighton and Sussex Medical School, said: ‘The introduction of ivermectin in the UK means people can more easily control their scabies infestation. But it’s a matter of supply. Hopefully the only positive that will come from the surge of cases is the routine use of oral ivermectin for controlling scabies outbreaks.”

The Department of Health and Social Care declined to comment.