Jane Mundye was at her breaking point when she called her general practitioner in tears, desperate for relief from a relentless itch. Initially, she visited her doctor in August last year, convinced she was dealing with insect bites. The diagnosis given was an allergy, and she was prescribed antihistamines.

However, when the medication provided no relief after several weeks, Jane, aged 77, pleaded with her GP for a reevaluation. “I was consumed by my need to scratch,” she recounted. “I called in tears, but he simply asked, ‘What do you want me to do?’

It wasn’t until Jane sought help from her local pharmacist out of sheer desperation that she received an accurate diagnosis.

Jane was suffering from scabies, a highly itchy rash caused by microscopic mites that burrow into the skin to lay eggs. This condition is transmitted through close contact with an infected person and is often referred to as a Victorian-era disease. Recent statistics indicate a resurgence of scabies in the UK this winter, continuing a trend observed over the past few years.

According to the UK Health Security Agency, general practitioners have noted a 20% increase in scabies cases compared to the same period last year, with a notable rise since 2023.

Jane, who resides in Dorset, remains uncertain about how she contracted the mites. “I still don’t know how I got it,” she admitted. “No one wants to admit to having it. It’s been a significant ordeal, but I’m just thankful it’s finally over.”

Last week, The Mail on Sunday’s GP columnist, Dr Ellie Cannon, wrote of concerns that the main treatment being given – a cream called permethrin – no longer worked because the bugs had become resistant to it.

When Mail on Sunday columnist Dr Ellie Cannon wrote about concerns over the cream permethrin last week, it prompted dozens of readers to write in about their own experiences with scabies

Experts say the main problem with permethrin, which has been the first line treatment for decades, is it must be applied correctly to work – and doing so is onerous

Many scabies sufferers are repeatedly misdiagnosed with other problems such as allergies or skin conditions such as eczema or psoriasis

It prompted dozens of readers to write in about their own experiences with the parasitic infection. And it gave an intriguing insight into what might be driving the wave of infections.

In some cases, readers such as Jane are being repeatedly misdiagnosed with other problems such as allergies or skin conditions such as eczema or psoriasis, and only finally diagnosed with scabies weeks or months later – after the problem has worsened and potentially spread to others.

One man revealed that he suffered from itchy skin for three years and was repeatedly told it was ‘allergies’ until he was diagnosed with scabies by a dermatologist.

But, tellingly, others have also revealed that permethrin had failed to get rid of the problem.

So what is going on? Experts say the main problem with permethrin, which has been the first line treatment for decades, is it must be applied correctly to work – and doing so is onerous.

It must be slathered all over the body, left on for 12 hours, and repeated a week later to catch any new eggs. Entire households must also be treated at the same time, even if they have no symptoms, to avoid reinfection.

Professor Michael Marks from the London School of Hygiene and Tropical Medicine, an expert in infectious diseases, said: ‘It’s incredibly hard to apply it properly – to get it into your armpits, under your nails and belly button, and then keep it on.

‘It remains unclear whether or not it really doesn’t work, or it isn’t used correctly, which we call “pseudo-resistance”.’ But as Dr Ellie has noted, there are also ‘plausible reports’ that suggest scabies may be developing some resistance to permethrin.

One 2023 review of the evidence found permethrin treatment failure is increasing by 0.58 per cent a year – double the figure for other treatments. And a 2024 review concluded ‘permethrin-resistant scabies is an escalating threat’.

Professor Tess McPherson, from the British Association of Dermatologists, said: ‘We’re possibly seeing some issues with permethrin as a first-line treatment, and we have to be open to the idea that there might be some resistance.

‘I still think we feel it works for the majority of cases, as long as it’s left on long enough and it’s repeated.

‘But I think if people have had multiple courses of permethrin, other treatments should be recommended.’

The letters to the Mail suggest this often isn’t happening.

An alternative to permethrin, a tablet called ivermectin, is easier to use but is not routinely prescribed. Studies found it can kill the bug and its eggs, and may stop them returning for up to two years.

But it is expensive for the NHS, and many GPs – who may rarely see scabies infections – are not yet aware of a 2024 update which means it can be given as a first-line treatment.

There are several other options, including benzyl benzoate or malathion cream, which can be used if neither permethrin or ivermectin work.

Diagnosing scabies, which are invisible to the human eye, can be tricky because the tell-tale red rash, which typically appears in folds of the skin inside the elbow, knee, buttocks and between fingers and toes, can take months to appear.

Professor McPherson said it was ‘not surprising’ that scabies was ­misdiagnosed but GPs and patients should be aware it is a possibility given the current outbreak.