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Scabies cases have soared over the past few months following medication shortages including permethrin and malathion, according to the Royal College of GPs.
At the end of November, the rate of scabies was three cases per 100,000 of the population – double the seasonal average.
Dermatologists and GPs have told the Guardian that the “nightmare” situation poses a major public health threat, with the north of England currently the worst affected.
The misconception that scabies is associated with poor hygiene
Scabies is a contagious skin condition caused by tiny mites that burrow into the skin. Patients typically present with a pruritus, a raised rash or spots which usually spreads across the whole body, apart from the head and neck.
Scabies is very infectious and spreads through close skin contact. However, it can also be spread through items such as clothing, bedding or towels that have been used by someone with scabies. It can therefore quickly spread through nursing homes, residential homes and university accommodation.
While RCGP Chair, Professor Kamila Hawthorn, says that scabies is not a “serious condition”, she notes that is can be very itchy and irritating, and can easily spread if left untreated.
“If not properly treated, it can spread and increase a patient’s risk of complications like skin infections or make existing skin conditions like eczema worse. It can also affect a patient’s quality of life, so quick treatment is important.
“Unfortunately, a level of social stigma remains around the condition, likely due to the misconception that it is contracted through poor personal hygiene,” she said.
Two common scabies treatments have been in short supply or unavailable since September
Prof Hawthorn says GPs have seen a growing rate of scabies cases since July at a consistently higher level than the five-year average and the seasonal norm.
A survey by the British Association of Dermatologists (BAD), commissioned by the Guardian, found that eight of its nine regional representatives had reported an increase in scabies in their area this year.
Scabies is usually treated with permethrin five per cent cream or malathion 0.5 per cent lotion, but permethrin has been in short supply since September and malathion is still unavailable.
At the time, the BAD warned that these shortages posed a significant public health threat and urged the manufacturers of these treatments to increase production, but the problem persisted.
Prof Mabs Chowdhury, the president of the BAD, told the Guardian that dermatologists are now particularly concerned about the potential for scabies to spread across communal living facilities, as if even one person is not treated properly, everyone can become reinfected.
“Given the challenges in social care and the treatment shortages, public health bodies need to plan for outbreaks in care facilities,” he said.