Cases of the Victorian-era disease scabies are experiencing a dramatic resurgence across the United Kingdom, with health authorities reporting a significant and sustained spike in infections over recent years. The UK Health Security Agency has documented alarming annual increases between 2021 and 2025, with a particularly sharp rise noted since 2023.
Understanding the Scabies Surge
General practitioners across England have reported just under 900 cases of scabies, representing an increase of almost twenty per cent compared to the same period in the previous year. This troubling trend has prompted serious concern among dermatologists and public health experts who warn that a combination of factors is driving the spread of this highly contagious condition.
The Role of Misinformation and Stigma
Professor Tess McPherson, Associate Professor of Paediatric Health and Adolescent Dermatology at the University of Oxford, has highlighted widespread misinformation as a key contributor to the problem. "There is a lot of misinformation with people not knowing what scabies is," she explained, noting that this lack of understanding often leads to delayed diagnosis and treatment.
The stigma associated with scabies presents another significant barrier to effective management. "Unnecessary stigma means people feel embarrassed to share their diagnosis," Professor McPherson told Sun Health. This embarrassment can prevent individuals from seeking timely medical attention, allowing the condition to spread further within communities.
How Scabies Spreads and Who is Most Affected
Scabies is transmitted through prolonged skin-to-skin contact, making it particularly problematic in settings where people live in close proximity. While it can spread between intimate partners, the disease most commonly affects those sharing living spaces.
Professor McPherson identified several high-risk groups:
- University students returning to shared halls after holiday breaks
- Residents of care homes and other group facilities
- People living in shared housing arrangements
- Members of sports teams with close physical contact
The seasonal return of students to university accommodation may partially explain the recent case increases, though experts acknowledge multiple contributing factors including treatment delays and improper use of medications leading to reinfection.
Recognising Scabies Symptoms
Scabies is caused by microscopic mites measuring approximately 0.4mm in diameter that burrow into the skin to reproduce. These tiny parasites can tunnel up to 2.5 centimetres beneath the skin's surface, roughly equivalent to the length of a human fingertip.
The condition typically manifests as an intensely itchy red rash that often begins between the fingers before spreading to other areas of the body. Common sites include the wrists, underarms, waist, groin, and buttocks. The rash may appear bumpy or display characteristic burrow lines created by the mites.
Doctor Leyla Hannbeck, Chief Executive of the Independent Pharmacies Association, explained the variable incubation period: "It usually takes a few weeks for symptoms to appear when someone has been infected for the first time, but symptoms appear much faster in those who have had scabies before."
Treatment Challenges and Resistance Concerns
Traditional treatment for scabies has involved permethrin cream, applied over the entire body and left for twelve hours before being reapplied a week later to eliminate any remaining eggs. However, growing evidence suggests scabies mites are developing resistance to this decades-old treatment, potentially rendering it less effective.
In 2023, the NHS approved ivermectin, an oral anti-parasitic medication that remains effective against the mites. While easier to administer than topical creams, this treatment comes with higher costs and some debate about whether it represents a significant improvement over permethrin.
Prevention and Management Strategies
The NHS recommends several measures to control scabies outbreaks:
- Seek medical treatment promptly if scabies is suspected or if you have been in contact with an infected person
- Visit your GP or local pharmacy for appropriate treatments
- Wash all bedding and clothing at 60°C or higher
- Avoid close contact and stop sharing bedding, towels, or clothing until the mites have been eradicated
Professor McPherson emphasised the importance of community awareness: "There is no shame in having scabies and the more people are aware of this condition and how to manage it, the more likely we can reduce transmission and its impact."
Without proper treatment, scabies can persist for months or even years as mites continue to reproduce within the skin. Scratching the itchy rash can exacerbate other skin conditions like eczema or psoriasis and may lead to secondary bacterial infections, making timely intervention crucial.
The mites can survive outside the human body for up to thirty-six hours, and as few as ten female mites can trigger a significant outbreak, underscoring the highly contagious nature of this Victorian disease that has found new footholds in modern Britain.
