Scabies

Scabies is a common skin condition caused by tiny mites that burrow into the skin, leading to intense itching and a rash. It spreads easily through close contact, but with the right treatment it can be cleared effectively.

Treatment usually involves prescription creams or lotions that eliminate the mites and help relieve symptoms. It’s important that close contacts are treated at the same time to prevent re-infection.

Through 123Meds, you can receive expert-approved treatments for scabies via our UK-registered online pharmacy service, with prescriptions reviewed by clinicians and delivered discreetly straight to your door.

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Scabies is a common and highly contagious skin condition caused by microscopic mites (Sarcoptes scabiei) that burrow into the top layer of the skin. This leads to intense itching—particularly at night—and a red, bumpy rash that may appear in areas such as the wrists, hands, waistline, underarms, and between the fingers.

Scabies spreads easily through close skin-to-skin contact, and occasionally through shared items like bedding, towels, or clothing. Outbreaks are more common in places where people live or sleep in close quarters, such as households, care homes, and schools.

Treatment for scabies usually involves prescription creams or lotions, such as permethrin 5% or malathion, applied to the whole body. It’s essential that all close contacts are treated at the same time, even if they have no symptoms, to prevent reinfection.

At 123Meds, you can access scabies treatment discreetly through our online consultation service. Our UK-registered clinicians will review your assessment and, if appropriate, prescribe treatment to be delivered directly to your door.

Scabies spreads mainly through prolonged skin-to-skin contact with someone who already has the condition. It can also spread by sharing bedding, towels, or clothing, although this is less common. Because scabies can spread before you even notice symptoms, it often affects whole households, families, or people living together in close quarters.

Intense itching, especially at night or after a hot bath
Rash of small red bumps, spots, or blisters
Thin, wavy, silvery lines on the skin – these are the burrows made by the mites
Sores or scabs caused by scratching
Irritated skin around folds, such as between the fingers, wrists, elbows, armpits, waistline, buttocks, and genitals

Symptoms may take 2 to 6 weeks to appear after first exposure, but spread can begin before symptoms develop. In people who’ve had scabies before, symptoms may appear much sooner (within 1 to 4 days).

If you suspect scabies, prompt treatment is important to relieve symptoms and prevent spreading it to others.

Scabies is treated with topical prescription medications that kill the mites and their eggs. The most commonly used treatments in the UK include:

Permethrin 5% Cream

First-line treatment for most cases
Applied to the entire body from the neck down (and the scalp in children or elderly)
Left on for 8–12 hours, then washed off
A second application is usually repeated after 7 days to ensure all mites and eggs are eliminated

Malathion Lotion (Derbac M)

Used if permethrin isn’t suitable (e.g. allergy)
Applied to the whole body and left on for 24 hours
Also repeated after 7 days

Oral Ivermectin (off-label in the UK)

Occasionally prescribed for severe, widespread, or crusted scabies, or if topical treatments have failed
Not currently licensed for scabies in the UK but may be prescribed on a case-by-case basis by a doctor

Important Treatment Advice

All close contacts (including household members and sexual partners) must be treated at the same time, even if they don’t have symptoms
Bedding, clothing, and towels should be washed at 60°C or sealed in a bag for 72 hours to kill mites
Itching can continue for several weeks after treatment – this is normal and does not mean the treatment has failed

At 123Meds, you can access scabies treatments discreetly by completing an online consultation. Our UK-registered prescribers will review your assessment and, if appropriate, arrange delivery of your treatment straight to your door.

Frequently asked questions

What is scabies?
Scabies is a contagious skin condition caused by tiny mites (Sarcoptes scabiei) that burrow into the skin, causing intense itching and a red, spotty rash.
How do you catch scabies?
Scabies is spread through prolonged skin-to-skin contact with someone who has the condition. It can also occasionally be passed on through shared clothing, bedding, or towels.
What are the symptoms of scabies?
Scabies usually causes intense itching, which is often worse at night. A red, bumpy rash or small spots may appear, and thin silvery lines on the skin can sometimes be seen where the mites have burrowed. Repeated scratching may also lead to sores. Common areas affected include the skin between the fingers, the wrists, waist, genitals and underarms.
How is scabies treated?
Scabies is treated with prescription creams or lotions, such as permethrin 5% or malathion. These are applied to the whole body and usually repeated after 7 days. In some cases, oral medication may be required.
Do I need to treat everyone in my household?
Yes. To prevent reinfection, all close contacts, including household members and sexual partners, must be treated at the same time—even if they don’t have symptoms.
How long does it take for symptoms to go away?
Itching may continue for up to 2–4 weeks after successful treatment, even though the mites are gone. This is a normal immune response and doesn’t mean the treatment has failed.
Can I go to work or school with scabies?
You should avoid close contact with others until 24 hours after starting treatment. Most people can return to work or school the following day if properly treated.
Do I need to wash my bedding and clothes?
Yes. Wash all clothing, towels, and bed linen used in the 48 hours before treatment at 60°C. Items that can’t be washed should be sealed in a plastic bag for at least 72 hours.
Can scabies come back?
Yes, if not all contacts are treated or if the environment isn't properly cleaned. Reinfection is also possible through new contact with someone who has scabies.