In 2017, the WHO formally designated scabies a neglected tropical disease.1 The prevalence of scabies is estimated to be >200 million cases worldwide. A UK study using data from the Health Information Network estimated the prevalence of scabies to be 2.27–2.81 per 1000.2 Risk factors for scabies include close contact with an infected individual, high levels of deprivation, crowded living conditions and winter months. Complications of scabies include secondary bacterial infection and the psychosexual impact.

Scabies, caused by the human ectoparasite Scarcoptes scabiei, is an intensely itchy infestation characterised by the burrowing of mites into the epidermis and subsequent tunnelling through the stratum corneum. The mite’s lifecycle lasts 4–6 weeks, during which the female mite lays around 25 eggs before dying, with the eggs maturing to adulthood in 10–15 days.3

Diagnosis of scabies is primarily made through clinical examination identifying burrows, mites, eggs or mite faeces. Microscopic examination of skin scrapings has low sensitivity.

Permethrin is recommended first-line treatment for scabies in the …