Scabies: How can you prevent infection?

If there's no reason to believe that any of your close contacts have scabies, it is neither necessary nor possible to prevent infection. For instance, condoms can protect against other sexually transmitted infections, but not against scabies. Shaving your private parts or body hair can at most protect you from pubic lice, but scabies mites burrow into the skin and don’t need any hair to cling onto.

Some people can't avoid close contact with people who are at higher risk of scabies infection, for example because their work involves caring for others. Wearing clothes with long sleeves and disposable gloves can then help to prevent infection. If you do still have skin-to-skin contact with an infected person, it’s important that you wash your hands and arms thoroughly.

If you have been diagnosed with scabies, along with getting the right treatment it is also important that you don’t pass the parasites on to others. That means not having sex, cuddling or having any other close bodily contact until your treatment is finished. But you can still do things that involve brief contact, like shaking hands.

Scabies treatment usually only lasts one day, but experts recommend repeating it about seven to ten days later. Children can go back to kindergarten or school the day after their first treatment, just as adults can go back to work, and people needing care can return to their care home. But it's important to avoid close physical contact until after the second treatment.

The mites are usually killed by the treatment. To make sure you don't become infected again straight away, for instance through your partner ("ping-pong effect"), it's important that all affected people and close contacts have the treatment at the same time and avoid close bodily contact for at least 36 hours after the treatment. Experts also recommend that you have a medical check-up two weeks after finishing the treatment. If everything is okay, no further restrictions are needed.

People are normally already contagious for several weeks before they develop typical symptoms such as itching and a rash. This means you may have infected other people before you found out you have scabies. Because of this, it's important to inform the people who you had very close bodily contact with or share a household with, and they should have the treatment too.

The itching often lasts for a few weeks after the treatment, even if the treatment was successful. It can then be difficult not to scratch yourself. You can avoid scratching your skin open by keeping your fingernails short and filing them down smoothly. Some people also find it helpful to wear cotton gloves at night.

It is rare, but possible, for scabies mites to be passed on through textiles. If they are, then usually through used bedding, towels, and clothes. Living scabies mites can also be found in carpets and upholstered (soft) furniture. But experts believe that scabies mites can only survive for about two days outside of the human body at normal room temperature (21 degrees Celsius, or about 70 degrees Fahrenheit).

If you use the same bedding straight after treatment as you were using before, the “waiting” mites might then be able to get back onto your body. Other people who sleep in the same bed or use the same towels can then, of course, also become infected in this way.

It is important to wash bedding and all other used textiles at 60 degrees Celsius (140 degrees Fahrenheit) to kill the mites. Delicate textiles and other things that can't be put in the washing machine – like soft toys and shoes – can be put in a sealed plastic bag for three to four days. The scabies mites then die in there. Alternatively, you can put the plastic bag in the freezer for at least five hours at minus 10 degrees Celsius (14 degrees Fahrenheit).

To make sure that no mites are left behind, you should clean all washable surfaces and vacuum soft furniture, cushions, beds, mattresses, carpets, floors and car seats, then avoid skin contact with them for three days. It is advisable to wear disposable gloves when doing so.

You don't have to thoroughly disinfect smooth surfaces like toilet seats or completely disinfect rooms with sprays.

People often get a fright when they first hear that someone they know has scabies. But there is no reason to give that person any blame or react with rejection or disgust. It can be helpful to think about how close your contact with them actually was, though. That will affect what you should do next.

To become infected with scabies, you usually need to have skin-to-skin contact for at least 5 to 10 minutes. The risk of infection is particularly high during sex. Scabies mites can also be passed on when breastfeeding, cuddling or sharing a bed with somebody who has scabies. People who care for somebody with scabies and help them to get dressed or washed might also become infected.

The following people are considered to be close contacts: partners and people the affected person has had sex with in recent weeks, people who live in the same household, and carers.

Experts recommend that close contacts also have treatment, preferably at the same time. That is especially important if it is very likely that they have also become infected or if first symptoms are already appearing. But treatment is still recommended for contacts who don't have any typical symptoms (yet). The costs of this purely preventive treatment generally aren't covered by health insurers, though, so you have to pay for it yourself. If contacts get treatment in good time, they can avoid having to tell their own contacts.

There is only a very low risk of scabies mites being passed on through things like shaking hands, a quick kiss or a brief hug to say hello. But people who are still worried can check whether symptoms appear in the following five to six weeks, avoiding close contact with others during that time.

This is different if you have had contact with somebody who has a very severe kind of scabies known as crusted scabies. It develops in people with a weakened immune system, leading to a lot of scaly and crusty skin all over the body. People with crusted scabies have a large number of mites on their body. Because of this, even brief contact can result in infection.