Scabies outbreak in UK linked to drug shortages, experts confirm: 'Progressively worse'

U.K. doctors are sounding the alarm about a surge in scabies cases across the country, according to reports.

A shortage of scabies medications — which dates as far back as May 2023 —is thought to be a contributing factor in the outbreak.

The British Association of Dermatologists (BAD) confirmed to Fox News Digital on Friday that it's received reports of scabies cases being on the rise, and that the current shortage of medicines is exacerbating the situation. 

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"At the end of November, according to the Royal College of GPs, the rate of scabies was three cases per 100,000 of the population, which is double the seasonal average," said Paula Geanau, a spokesperson for BAD.

"The situation in the U.K. is constantly changing, so it is difficult to say with certainty," she added. 

Outbreaks are more common in group living situations, although Geanau emphasized that anyone can get scabies.

"It is not a question of poor hygiene," she said. "Because of the nature in which it spreads, via skin-to-skin contact, it disproportionately affects people in group living facilities, such as care homes and student accommodations."

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Scabies is everywhere and is not just limited to the U.K., noted Dr. Susan Massick, a board-certified dermatologist at The Ohio State University Wexner Medical Center.

"There are always cases in the U.S. at any given time," she told Fox News Digital. "Current cases that arise now in the U.S. are not related to the outbreaks in the U.K."

What to know about scabies 

Scabies is a rash that occurs when a tiny, eight-legged mite called Sarcoptes scabiei burrows into the skin, causing intense itching.

The disease is highly contagious, often spreading quickly through schools, households and nursing homes.

In addition to severe itching, a primary symptom is tiny blisters of bumps that form thin, wavy tunnels, according to Mayo Clinic.

Symptoms are usually delayed, appearing up to six weeks after exposure for those who have never had the infection. 

People can spread scabies even if they don’t have symptoms.

"Scabies is different than bedbugs, but often equally itchy and difficult to eradicate," Massick said. 

"The itching gets progressively worse from week to week as new eggs hatch and the number of mites grows."

"Scabies is different than bedbugs, but often equally itchy and difficult to eradicate."

Scabies mites are microscopic and can’t be seen with the human eye, the doctor said — but the skin will react to the bites and become more and more inflamed, extremely itchy and often scab over due to the natural tendency to scratch. 

Scabies is primarily spread through direct skin-to-skin contact, Massick said, but it can also easily be transmitted through clothing, furniture and bedding that contain the mites.

"Cases continue to spread beyond the original person infected, and it is difficult to eradicate without appropriate treatment," she noted.

People living in close quarters without access to routine clothes washers and dryers are most at risk of contracting scabies, she said — "a common scenario is a college dormitory," Massick said.

To prevent contracting the disease, the doctor recommends avoiding direct contact or sharing of clothing, bedding and close quarters with those infected.

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For those who contract scabies, the mites can’t simply be washed away. 

"Showering will not rid you of a scabies infestation — you need treatment," Massick said. "Due to the life cycle of the scabies mites, with eggs hatching every five to seven days, you need to re-treat yourself one week after your initial treatment to ensure full eradication."

It is possible to get re-infected even after treatment if you're exposed again to the mites, the doctor said.

There are multiple topical and oral treatments for scabies. 

"Seek treatment if you suspect you have it, have been exposed or are experiencing unrelenting itching with accompanying rash," Massick advised.

In addition to getting treatment, people should wash clothing, bedding, sheets, towels and pillows in hot water and dry them in a dryer, she said.

"The shortage of treatments for scabies is a major public health concern."

"Mites can't live off the human body for more than two or three days, so avoiding potential exposure from items like furniture that can't be washed or put in a dryer is a possible way to avoid getting infected," she told Fox News Digital. "Avoid communal areas and surfaces for at least three to five days."

Geanau agreed that it's vital to follow treatment protocols precisely. 

"As scabies is highly contagious, and spreads via skin-to-skin contact, if even one person in a group is still infected after completing a treatment plan, they can easily reinfect the rest of the group as well," she warned. 

"Reinfection is a quite common outcome, as treatments have to be followed to the letter, and everyone must be treated simultaneously."

Drug shortages a factor in outbreak

The two main treatments for scabies are permethrin 5% cream and malathion liquid, both of which are in limited supply in the U.K.

In September 2023, BAD issued a press release urging manufacturers to ramp up production, warning that the shortages "pose a significant threat to public health" in light of the "highly contagious nature" of scabies.

"The shortage of treatments for scabies is a major public health concern," said professor Mabs Chowdhury, president of BAD, in the release.

"This is a common condition, which is highly contagious," he went on. "The ease with which it spreads highlights the urgency of maintaining an adequate supply of effective treatments."

Chowdhury urged manufacturers of permethrin and malathion to do "everything in their power" to increase production. 

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"We also call on regulators, such as the MHRA (Medicines and Healthcare products Regulatory Agency) and the government, to give the necessary support to manufacturers and suppliers to enable them to rapidly resolve the issue."

BAD has been advised that more supplies of permethrin and malathion will become available early this year, Geanau noted. In the meantime, ivermectin has recently been licensed for the treatment of scabies, which is expected to help.

"We must ensure that an adequate supply of effective treatments is maintained," Geanau added.  

When contacted by Fox News Digital, the Association of the British Pharmaceutical Industry said it cannot comment on the shortage of permethrin and malathion, as it represents only the "newer, branded end of the U.K. medicines market," which does not include "long-running generic medicines like permethrin and malathion."

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Fox News Digital also reached out to the U.K. ​​Department of Health & Social Care requesting comment on the outbreak and shortages.

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