The UK is facing an eruption of scabies, an itchy skin infestation caused by mites. Dermatologists across the country are reporting a rise in scabies cases, fueled by shortages of the medications most commonly used to treat it. These cases are disproportionately affecting vulnerable populations, such as those living in elder care facilities and other crowded environments.
Scabies is specifically an allergic reaction to the human itch mite, which is a variant of Sarcoptes scabiei (other variants infest different mammal species). These microscopic arachnids bury themselves into our skin, where they live out their lives, mate, and lay a new generation of eggs. The most common symptoms of scabies are pimple-like rashes and intense itching, which tends to get worse at night. Scabies usually doesn’t cause severe illness, but people with weakened immune systems are more susceptible to heavy mite infestations, which can then cause a more serious form of the disease called crusted scabies.
Scabies mites are found everywhere in the world, and anyone can get them through direct and prolonged skin-to-skin contact with an infected person. But the UK has been seeing a surge in scabies over the past year. In a survey conducted by the British Association of Dermatologists and commissioned by the Guardian, eight of nine regions experienced an increase in diagnosed scabies cases in 2023. Local physicians have also reported encountering large scabies outbreaks in care homes, nursing homes, and college dorms, with one doctor telling the Guardian that the situation has become an “absolute nightmare.”
The increase seems to be linked to a rise in demand for scabies treatments in Europe, which has subsequently led to shortages of two frontline topical treatments in the UK: permethrin 5% w/w cream and malathion liquid. These shortages were first reported dating back to May 2023 and became widespread by early September 2023. That same month, the British Association of Dermatologists warned that the lack of available medication would only worsen outbreaks and cause a “snowballing public health issue” in the country. In the same survey, shortages of the two drugs were reported in seven out of nine regions.
Other reasons for the shortage include supply chain issues, a rise in the cost of raw materials, and the war in Ukraine, the Guardian reports.
In the U.S., these medications appear to be in ample supply—for now, at least. Other countries in Europe have reported a rise in scabies over the past 10 to 20 years, which may have been further exacerbated by the covid-19 pandemic. It’s estimated that about at least 200 million people worldwide are affected by scabies at any one time, but many countries don’t require doctors and healthcare systems to track the prevalence of the disease, so we’re underestimating how common it is and the harm it’s causing. In 2017, the World Health Organization added scabies to its list of neglected tropical diseases.
Things are expected to get worse before they get better in the UK, thanks to the winter months forcing people closer together. The British Association of Dermatologists has called for drug manufacturers to increase production and for regulators in the UK to do everything possible to help them. Doctors are also advising people not to avoid seeking medical care if they suspect they have scabies, since people might fear being branded as unhygienic.
“We must reduce any stigma associated with having scabies so that people do seek treatments when needed,” Tess McPherson, the president of the British Society for Paediatric and Adolescent Dermatology, told the Guardian.