Dr Phil Kieran: I'm worried my children will get scabies

Scabies is caused by the Sarcoptes mite.

I got scabies years ago as an adult and it took months to clear. I’m now a parent of two young children and worried about the reports of an outbreak in Ireland. What steps can I take to minimise the risk of picking up the skin condition?

Scabies is an intensely itchy skin condition caused by the Sarcoptes mite. These mites burrow under the skin and live, breed and die in their tiny burrows. The itch is caused by an immune reaction to their faeces and dead bodies as they don’t live very long. Because the itch is not directly due to their activity, the symptoms often take some time to present after infection. The itch tends not to subside until the layers of skin they have burrowed into are replaced. This usually happens about six weeks after treatment starts.

The itch is typically worst at night and usually occurs in the groin or buttocks region and between the fingers and toes.

The treatment for scabies is the application of permethrin cream to the body. It must be applied to the whole body from below the chin and the hairline at the back of the neck. The cream is left on for eight hours (usually overnight) and washed off in the morning. It’s available over the counter without a prescription and should be repeated after seven days.

You should change your sheets and wash everything you were wearing in a hot wash to kill any mites in your clothes. Anything that can’t be washed can be disinfested by placing them in a plastic bag for at least seven days in a warm environment. It is essential that everyone in the house is treated as it is easy for household contacts to reinfect each other.

A significant increase in scabies cases has been reported recently, with 27 outbreaks in 2023 compared to nine in 2022, according to the Health Protection Surveillance Centre (HSPC).

Scabies are spread by skin-to-skin contact for longer than five minutes. The condition can also be picked up from contaminated clothing items in direct contact with the skin. To reduce the risk of scabies, it is critical to start treatment as soon as the signs are spotted and treat everyone in the household regardless of whether or not they have symptoms.

The risk of transmission is a little higher for creche-aged children than for older children (though still low). This is why creches will usually have policies on notification of scabies cases. After creche age, children tend to have less consistent skin-to-skin contact. (Toddlers hug and hold onto each other a lot).

People often panic when they experience an ongoing itch, but be reassured that though there are more incidents of scabies than usual, the risk remains very low for an individual child.

• If you have a question for Dr Phil Kieran, please send it to [e-mail]