The shortage of anti-scabies drugs is “a major public health problem” and cases of the highly contagious skin condition could snowball, experts warn.
Scabies is an intense, itchy, 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 affect shared accommodation, such as university residences, nursing homes, prisons and immigration detention centres, causing major outbreaks.
Dermatologists today warned that the UK faces a serious health risk due to shortages of the only two drugs commonly used to treat an otherwise incurable infection.
Earlier this month, the Department of Health issued an alert warning that permethrin, a cream designed to treat scabies, was in short supply and that an alternative treatment, liquid malathion, was also unavailable.
A graphic showing a Sarcoptes scabiei mite that causes the contagious skin infection scabies.
Scabies causes a red, itchy rash and is highly contagious, capable of spreading throughout a home or in shared accommodation settings such as dormitories, nursing homes and prisons (file image)
These two medicines represent the most commonly available, affordable and effective scabies medicines used in Britain.
Supplies are believed to have been affected by an increase in demand for scabies treatment in both the UK and Europe, as well as an increase in the cost of raw materials.
President of the British Association of Dermatologists, Professor Mabs Chowdhury, said the threat of scabies must be taken seriously.
“The shortage of treatments for scabies is a major public health problem,” he said.
‘The ease with which it spreads highlights the urgency of maintaining an adequate supply of effective treatments. “This is not a problem that is just going to go away.”
What is scabies?
Scabies is a skin condition caused by an immune reaction to the Sarcoptes scabiei mite and its saliva, eggs and feces.
Typical signs of infection are intense itching associated with burrows, nodules and redness of the skin.
The incubation period is up to eight weeks after contact with an affected person.
Penetration into the skin is usually visible as small linear burrows containing the mites and their eggs.
Scabies is most often spread through prolonged or frequent skin-to-skin contact, such as sex or sharing towels, bedding, or clothing.
The infection is incurable without treatment.
As well as urging manufacturers of permethrin and malathion to “do everything possible” to increase supply, he urged the Government to act.
“We also call on regulators, such as the Medicines and Healthcare products Regulatory Agency, and the Government to provide the necessary support to manufacturers and suppliers to enable them to quickly resolve the issue.”
Dr Tess McPherson, director of the British Society of Pediatric and Adolescent Dermatology, also urged action.
He said: ‘Scabies disproportionately affects the most vulnerable in society, including young people.
‘It is important to state that you don’t get scabies because you don’t have hygiene, and we need to reduce any stigma associated with scabies so that people seek treatment when necessary.
“Any reduction in access or availability of treatments will have a significant impact.”
Scabies is a common condition, but it often goes undiagnosed, as the rash can be confused with a variety of other skin conditions. This increases the risk of an infected person passing it on to others.
It is primarily transmitted through shared clothing or bedding, as well as through skin-to-skin contact, such as during sexual intercourse.
The itchy rash is caused by mites hiding under the skin to lay eggs, the presence of eggs, and the creatures’ feces.
This oviposition can be seen as a line with a dot at one end before developing into a rash.
While 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 it on to others.
The rash usually spreads to the entire body, except the head.
Scabies is incurable without treatment and people should avoid work or school until they receive medication, experts say.
While scabies is not dangerous on its own, scratching the rash can lead to secondary bacterial skin infections.
People with compromised immune systems, such as cancer patients receiving chemotherapy, are vulnerable to hyperinfestations called crusted scabies.
While estimates of the prevalence of scabies are unreliable, analysis of data from UK GPs suggests that there are 2.81 cases per 1,000 women and 2.27 per 1,000 men.
The UK Health Security Agency (UKHSA) notes that it is estimated that one in 50 long-term care facilities, such as nursing homes, will experience a scabies outbreak each year.
A Department of Health spokesperson said: “We are aware of the current difficulties in obtaining a supply of 5 per cent permethrin cream due to an increase in demand for the product.”
“Manufacturers continue to provide it and we are working with them to ensure deliveries are accelerated and increased wherever possible.”