Pharmacists have highlighted the cost to patients of treating scabies, as the Royal College of General Practitioners (RCGP) has reported 'regional spikes' in cases.

In a statement issued on Friday (25 October), RCGP chair Professor Kamila Hawthorne said GPs were seeing scabies presentations at a rate 'above the five-year average and rising', with 'the north of England seeing a spike in scabies cases', although she said incidences were 'still infrequent'.

Scabies cases in the north of England (the purple line in the graph below) are higher than the national average (red line), and cases in all regions are well above the 5-year average (dark blue line), the RCGP has reported.

'We recognise that patients may be apprehensive to seek treatment given the social stigma that surrounds the condition, but it is important that they don’t ignore their symptoms as this could lead to them getting worse and risks transmitting the condition to other people – particularly if they are living in close proximity to others such as on a university campus,' Professor Hawthorne said.

Community pharmacist Shadi Freige, based in Cockerton Pharmacy in Newcastle-upon-Tyne, told The Pharmacist that he had seen a 'massive uptick' in scabies presentations over the last month.

Speaking to The Pharmacist on Friday, Mr Freige said he had dealt with 'six or seven' scabies cases that day already - more than he usually would at this time of year.

Around half of those had been referred to the pharmacy by their GP through the Pharmacy First minor ailments pathway, while others had come directly to the pharmacy to ask about their symptoms.

Patients came from 'all age groups', with a rise in the number of children presenting with scabies since the start of the school term, Mr Freige said.

And he suggested that schools could help raise awareness of the condition, how to check for symptoms, how it is spread and how to treat it.

Scabies can be treated with a medicated cream or lotion to kill the mites, such as permethrin cream, and can require more than one course of treatment and treatment for the entire household, including those without symptoms. Permethrin cream is available over-the-counter and can currently cost between £15 and £20 or more per tube, The Pharmacist understands, although children under two years old must always see a GP to treat scabies.

Last autumn, the British Association of Dermatologists (BAD) warned that ongoing shortages of scabies treatments were posing a ‘significant threat’ to public health. However, Mr Freige told The Pharmacist that he was not experiencing any supply issues this year.

He also said that in his local area of Newcastle-upon-Tyne, most patients were able to access the treatment free of charge through a local minor ailments scheme which funds over-the-counter treatments for those entitled to free prescriptions.

But in other areas where such schemes do not exist, some patients are visiting their GP to get the medication on prescription to avoid the high cost of the cream, The Pharmacist has learned.

Community pharmacist Ansam Aljeraisi, based at Longboon and Wise Pharmacy in Manchester, told The Pharmacist that although many  patients would prefer to visit the pharmacy to 'buy it straight away', once they had found out that the cream was 'a bit expensive', they would 'rather go to the doctors' to get a prescription for it.

And highlighting the regional nature of the spikes, Ms Aljeraisi said her pharmacy was seeing around six or seven cases of scabies each month, with no notable increase in recent weeks.

In a statement to The Pharmacist,  Dr Will Welfare, director of regions at the UK Health Security Agency, highlighted that 'anyone can get scabies', which is spread through close skin contact, and advised those who think they have the condition to 'speak to a pharmacist'.

Professor Claire Anderson, president of the Royal Pharmaceutical Society (RPS), said that pharmacy teams across Great Britain 'routinely support people with scabies, providing advice on effective treatments and preventing its spread.'

'Through services like Pharmacy First and the Common Ailment Service, busy community pharmacies continue to play a vital role in the health of the nation, making it easier for patients to access timely care and easing pressure on other healthcare services.'

Scabies can lead to complications such as impetigo, which is one of the seven conditions treatable under the Pharmacy First clinical pathways.

Last year, scabies was one condition that Nottingham GP Dr Hussain Gandhi told our sister title Pulse that he had seen a 'significant rise' in patients contacting their GP for treatment about, following the termination of a minor ailments scheme in the area.

He warned this contributed to block GP access for other patients, joining calls for access to prescription items through a funded minor ailments scheme in community pharmacy.