STI Guide

The term STIs stands for sexually transmitted infections, that is, those that can be transmitted primarily (but not only!) through sexual contact. These include, for example, chlamydia, gonorrhoea, syphilis and HIV. Many STIs initially run their course without symptoms but, if left untreated, can have health consequences.

The term STDs stands for sexually transmitted diseases. The term is often used synonymously with STIs, but it refers more to the disease that can develop from an infection. So while an infection can be present without any complaints, we speak of a "disease" when symptoms occur.

Today the term STI is increasingly used because it's more precise: not every infection automatically leads to a disease. In German, the term "Geschlechtskrankheit" (venereal disease) is still common, but it's imprecise and can be stigmatising. With STI we emphasise the medically correct and more neutral expression.

Chlamydia is caused by bacteria (Chlamydia trachomatis) and is one of the most common sexually transmitted infections. It often runs its course without symptoms but, if left untreated, can lead to serious secondary damage, such as infertility.

Lymphogranuloma venereum (LGV) is an aggressive special form of chlamydia (L1–L3) that affects the lymphatic system and manifests through severe anal complaints, fever and swollen inguinal lymph nodes. A reliable diagnosis is made using a two-step PCR laboratory test; treatment requires a 21-day course of antibiotics to prevent chronic tissue damage.

• Young people between 15 and 25 years of age.
• Gay and bisexual men of all ages.
• The special form LGV (lymphogranuloma venereum) occurs in Germany almost exclusively in men who have sex with men.

• Vaginally, anally or orally through mucous membrane contact.
• Transmission via contaminated hands or objects is also possible during sex: pathogens can pass from one person to another, or to other sites on your own body, via the hands or shared sex toys.

• Condoms significantly reduce the risk.
• Early detection: for women up to 25, statutory health insurance covers a chlamydia test free of charge once a year. It's best to ask your health insurer whether you're entitled to it.

Often none, which is why many infections go unnoticed. If they do occur, then for example:

• Women: discharge (watery or purulent), itching, burning when urinating.
• Men: clear discharge from the urethra, burning when urinating.
• Rectal: discharge, itching, sometimes pain.
• Throat: usually no complaints.
• LGV: severe pain, swollen lymph nodes in the groin, bleeding, problems with bowel movements.

• Urine sample and swabs from the urethra, cervix, rectum and/or throat.
• For LGV: a special examination to distinguish it from other forms of chlamydia using a two-step PCR laboratory test.

• Usually antibiotics for at least one week (three weeks for LGV).
• Sexual partners from the last few weeks are generally treated as well, even without a separate test, to avoid ping-pong infections.

• Chlamydia is very treatable.
• Detected early, long-term consequences can be avoided.
• Regular testing is especially important if you have changing partners.
• A single chlamydia infection doesn't lead to immunity; you can become infected again straight after successful treatment.

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. If left untreated, it can attack various organs and cause serious long-term consequences, but it's readily curable with antibiotics.

• In Germany there are around 7,000–8,000 new cases each year.
• Most commonly affected: men who have sex with men (MSM).
• More common in large cities.
• Notifiable: cases are reported anonymously to the public health authority.

• Above all through close mucous membrane contact during vaginal, anal or oral sex.
• Infection occurs via small wounds or direct contact with ulcers or moist warts (condylomata lata).
• Less commonly: from mother to child during pregnancy, via blood, or through needlestick injuries.

• Condoms significantly reduce the risk (by around 95%) but don't offer complete protection, as wounds can also be located outside the area covered by the condom.
• Regular testing after higher-risk contacts – particularly recommended for MSM with changing partners (every 3–6 months).
• Pregnant people are tested as standard in Germany.

Syphilis progresses in several stages:

• Early stage (after about 3 weeks): a painless ulcer at the site of entry (genitals, anal area, mouth) plus swollen lymph nodes.
• Second stage: skin rash (often on the palms and soles), flu-like symptoms, moist warts in skin folds, hair loss.
• Symptom-free stage (latency): the symptoms disappear, but the pathogens are only dormant. The disease remains detectable in the laboratory and can enter the dangerous late stage at any time.
• Late stage (rare): severe damage to the brain, heart, nerves and other organs.

• Blood test (antibody detection).
• In early stages, also direct detection of the pathogen from the wound.
• If involvement of the nervous system is suspected: examination of the cerebrospinal fluid.

• Standard therapy: a penicillin injection (single dose or over several weeks, depending on the stage).
• Alternative for penicillin allergy: other antibiotics (e.g. doxycycline).
• Important: sexual partners from the last few weeks or months should also be treated to avoid renewed infections.

• Syphilis leaves no immunity; you can become infected again at any time.
• Early detection protects against serious long-term consequences.
• Testing is especially important with new or changing partners.

Gonorrhoea, colloquially also known as "the clap", is a sexually transmitted infection caused by bacteria (Neisseria gonorrhoeae). It can affect the genitals, rectum and throat, often without you noticing anything.

• In Germany, an estimated 25,000–30,000 new cases per year.
• The second most common bacterial STI after chlamydia.
• Particularly affected: men who have sex with men (MSM) and young adults with changing partners.

• Vaginal, anal and oral sex.
• Transmission is also possible through finger or sex-toy contact if no condoms or protective barriers are used.
• Mother-to-child transmission during birth is possible.
• No transmission via toilets, towels or swimming pools.

• Condoms and dental dams significantly reduce the risk.
• Regular testing with frequently changing partners; recommended every 3–6 months for MSM.
• Tests can check for chlamydia and gonorrhoea at the same time.

Often none, especially in the throat or rectum. If they do occur, then for example:

• Women: increased discharge, spotting between periods, lower abdominal pain.
• Men: yellow, purulent discharge from the urethra, burning when urinating.
• Rectal: itching, discharge, sometimes bleeding.
• Throat: usually symptom-free, sometimes a sore throat.
• If left untreated, gonorrhoea can lead to inflammation, infertility and chronic pain.

• Urine sample and swabs from the urethra, cervix, throat or rectum.
• Modern tests (PCR) are very reliable and also detect symptom-free infections.

• Standard: a single antibiotic injection (ceftriaxone).
• If resistance is suspected: antibiotics based on testing.
• Important: sexual partners from the last 60 days should also be treated, even without their own test, to prevent renewed infection.

• No lasting immunity; renewed infection is possible at any time.
• Resistant gonorrhoea strains (super-gonorrhoea) are increasing worldwide, so timely and correct treatment is important.
• A test of cure is recommended, especially for throat infections or during pregnancy.

Hepatitis C is a viral infection that mainly affects the liver. If left untreated, it can lead to liver inflammation, cirrhosis of the liver and liver cancer, but with modern medicines it's now curable in almost all cases.

• Worldwide: around 50 million people.
• Germany: an estimated 189,000 chronic infections.
• Many of those affected are unaware of their illness, as it often causes no symptoms.

• Above all through blood-to-blood contact, e.g. shared syringes or equipment during drug use, non-sterile tattoos or piercings, or needlestick injuries in medical settings.
• Sexual transmission is rare in everyday life. However, the risk rises significantly if other sexually transmitted infections are already present, as inflammation or small wounds serve as an entry point for the virus.
• Mother-to-child transmission during birth is possible.
• No transmission through shaking hands, kissing or sharing dishes.

• Don't share needles, syringes or equipment.
• Ensure sterile conditions for piercings and tattoos.
• Condoms for higher-risk contacts.
• Hygiene in medical and private settings (your own razors, toothbrushes).
• Regular testing if risk factors are present.

Often no symptoms, or only non-specific complaints such as fatigue, muscle pain or problems with concentration. Possible signs of an acute infection, on the other hand, include:

• Yellowing of the skin or eyes (jaundice).
• Dark urine, pale stool.
• Pain in the upper right abdomen.

If left untreated, hepatitis C can lead to cirrhosis or liver cancer over many years.

• Blood test for antibodies against hepatitis C.
• If the result is positive: detection of the virus in the blood (HCV RNA test).
• Liver examinations to assess damage (e.g. ultrasound, elastography).

• Modern tablet therapies (DAAs) over 8 to 12 weeks.
• Cure rates over 95%.
• In Germany, treatment is covered by health insurers.
• No vaccination is available.
• After being cured, renewed infection is possible.

• Early diagnosis prevents serious long-term consequences.
• Test regularly if there's an ongoing risk.
• Treatment today is short, well tolerated and very successful.

HIV (human immunodeficiency virus) attacks the immune system. If left untreated, it can lead to AIDS. Thanks to modern medicines, people with HIV who are treated in good time can today live almost as long as people without HIV.

• Around 40.8 million people worldwide are living with HIV.
• In Germany, around 96,700 people are living with HIV, and about 8% are unaware of their infection.
• The number of new infections in Germany has been stable for years.

• Sexually: above all through unprotected anal or vaginal sex (highest risk with receptive anal sex).
• Blood contact: shared syringes or needles, blood transfusions (extremely rare in Germany).
• Mother-to-child transmission: during pregnancy, birth or breastfeeding, virtually ruled out in Germany thanks to treatment.
• Not transmissible through: shaking hands, hugging, kissing, sharing dishes.

• Condoms: significantly reduce the risk.
• PrEP (pre-exposure prophylaxis): preventive medicines that, when taken correctly, can be almost 100% effective.
• PEP (post-exposure prophylaxis): emergency medication that must be started within 72 hours of a possible exposure. The efficacy of HIV PEP (post-exposure prophylaxis) is very high, ranging from over 80% to more than 90%, provided it's started in time and taken without error. For ethical reasons, there are no exact percentages from controlled human studies, but observational data and modelling show clear trends.
• Regular testing: detected early, HIV is very treatable.

• Initially often no noticeable complaints.
• In the first weeks after infection: flu-like symptoms such as fever, night sweats, sore throat and aching limbs.
• Skin rash, swollen lymph nodes, fatigue.
• Nausea, diarrhoea or weight loss.
• Later in the course (without treatment): increasing immunodeficiency, frequent infections, opportunistic diseases (serious infections or cancers that a healthy immune system would fend off easily, but which exploit the immunodeficiency as a 'favourable opportunity').

One of these samples is tested:

• Blood sample (venous blood).
• Blood from the finger (capillary blood).
• Swab from the oral mucosa / saliva.
• Plasma / serum for highly sensitive laboratory tests.

• Antiretroviral therapy (ART): daily tablets or long-acting injections keep the viral load so low that HIV is no longer detectable.
• "U = U": when HIV remains below the detection limit, it's not transmitted during sex.
• Treatment should begin immediately after diagnosis.

• With good treatment, people with HIV can today lead an almost normal life.
• Modern therapies are very well tolerated and often available as a single tablet.
• The earlier the diagnosis, the better the prognosis.

Herpes is an infection caused by herpes simplex viruses that typically appears as painful blisters on the lips, genitals or other parts of the body. The viruses remain permanently in the body and can flare up again and again when the immune system is weakened or under stress. The two herpes types are called HSV-1 and HSV-2, with HSV-1 classically causing cold sores and HSV-2 being mainly responsible for genital herpes, although both types can now occur at both sites.

• In Germany, around 75 to 95% of adults are affected by HSV-1; however, the initial infection is completely symptom-free in over 90% of those affected, which is why many people carry the virus unnoticed. When it flares up, it usually appears on the lip, but from there it can also reach the genitals or anal mucosa of a partner.
• Around 20% of the population is affected by HSV-2; the infection usually appears on the genitals and is painful there. Heterosexual people are more frequently affected. Once infected, symptomatic phases are possible at any time. The frequency varies greatly from person to person.

• Genital, rectal, oral: mucous membrane–to–mucous membrane contact.
• Indirect (smear) infection: contact with infectious fluid from the blisters.

• Condoms reduce the likelihood of transmission only a little. HSV is also transmitted "around the condom": through kissing, oral sex and touch (via the fingers).
• Avoid contact with blisters or ulcers.
• If blisters form on the genitals or lip, avoid (oral) sex and kissing as far as possible until they heal, after about 1–2 weeks.

• Genital, rectal, oral: burning, painful, itching blisters.
• The lesions (the blisters) always heal again, with or without treatment. However, the herpes viruses remain "hidden" in the nerves and can therefore reappear at the same spot, especially during stress, strong sun exposure (lips) or other concurrent infectious illnesses.
• In cases of immunodeficiency, severe courses with organ involvement and brain involvement are possible.

• Medical examination based on the typical blisters and symptoms.
• A swab of the blister fluid for direct detection of the virus in the laboratory.
• A blood test for antibodies if the infection is unclear or runs its course without visible symptoms.

• For a mild course: local therapy with an ointment.
• For a severe course: antivirals (medicines that inhibit viral replication) as a tablet or intravenously.

• Herpes viruses remain in the body for life after an infection.
• Herpes isn't curable, but outbreaks can be treated and well controlled.
• Stress, sun or a weakened immune system can trigger an outbreak.
• The blisters are contagious, especially with direct skin or mucous membrane contact.

HPV (human papillomaviruses) are very common viruses that can affect the skin and mucous membranes. There are over 200 types; some cause harmless warts, others can trigger cancer.

• More than 80% of all sexually active people become infected at some point.
• The infection usually clears up on its own within 1–2 years.
• Anyone can be affected.

• Mainly through sexual contact (vaginal, anal, oral), even without penetration.
• Less commonly from mother to child during birth.
• Condoms reduce the risk but don't provide complete protection.

• Vaccination: protects very reliably against the most common dangerous HPV types.
• Recommended for all children and adolescents between 9 and 14 years of age (catch-up vaccination up to 17 years).
• Cost coverage: many health insurers pay for the HPV vaccination in full up to a certain age. Be sure to ask your health insurer up to what age they pay.
• Condoms: reduce the risk and additionally protect against other STIs.
• Early detection: regular screening examinations, e.g. a Pap test at the gynaecologist.

• Low-risk types: genital warts (unpleasant but not dangerous).
• High-risk types: changes to cells that can lead to cancer, e.g. cervical, anal or throat cancer.

• A swab from the cervix (Pap test) for the early detection of cell changes.
• An HPV DNA test for direct detection of the virus, often combined with the Pap test.
• Visible warts in the genital or anal area can be diagnosed clinically.
• In men there are no routine screenings; testing is usually symptom-driven.

• In many cases, an HPV infection clears up on its own, without treatment.
• Visible changes such as genital warts can be removed with creams, freezing, laser or surgically.
• Cell changes on the cervix are monitored and removed depending on the findings.
• There's currently no causal treatment against the virus itself.

• Most HPV infections disappear on their own.
• Only a few become chronic and can cause cancer. Regular check-ups are therefore important.
• HPV can affect anyone, regardless of gender.

Trichomonads are single-celled parasites (Trichomonas vaginalis). Infection with them is one of the most common curable sexually transmitted infections worldwide. Very often it runs its course entirely without symptoms.

• According to the World Health Organization, one of the four most common curable STIs, together with chlamydia, gonorrhoea and syphilis.
• In Germany there's no reporting requirement, so exact figures aren't known.
• Women are more frequently affected and show complaints more often than men.

• During sex through contact with infected mucous membranes and secretions, above all vaginally.
• Via shared, moist sex toys.
• The parasites need a moist environment and can't survive for long outside the body.

• Condoms and internal condoms significantly reduce the risk.
• Clean sex toys before sharing them, or put a fresh condom over them.

Often none, which is why many infections go unnoticed. If they do occur, then for example:

• Women: yellowish-green, unpleasant-smelling discharge, itching, burning, pain during sex or when urinating.
• Men: usually no complaints; rarely burning, discharge or irritation of the urethra.

• A swab from the vagina or urethra.
• Laboratory examination, for example by nucleic acid test or under the microscope.

• Usually a highly effective antibiotic (typically metronidazole) as a tablet.
• Sexual partners are generally treated as well to avoid ping-pong infections.

• Trichomoniasis is very curable.
• If left untreated, it can promote inflammation and increase the risk of other infections such as HIV.
• During pregnancy, treatment is especially important, as an untreated infection significantly increases the risk of premature rupture of the membranes, preterm birth or a too-low birth weight for the baby.

Mycoplasmas are very small bacteria without a solid cell wall. As a sexually transmitted pathogen, Mycoplasma genitalium is particularly relevant; it can affect the urinary tract and the sexual organs. An infection often runs its course entirely without symptoms.

• Mycoplasma genitalium is increasingly recognised as a sexually transmitted infection in its own right.
• Exact figures aren't known, as there's no reporting requirement in Germany.
• All sexually active people can be affected.

• During sex through contact with infected mucous membranes, vaginally and anally, less commonly orally.
• Transmission is also possible via shared sex toys.

• Condoms reduce the risk.
• If you have symptoms, get tested specifically rather than taking antibiotics as a precaution, in order to avoid resistance.

Often none. If they do occur, then for example:

• Men: burning when urinating, discharge from the urethra.
• Women: discharge, burning, spotting between periods, lower abdominal pain.
• Rectal: usually no complaints.

• Urine sample or swab, detection by nucleic acid test in the laboratory.
• For Mycoplasma genitalium, testing for antibiotic resistance is also carried out.

• Treatment is targeted, using antibiotics, above all when there are symptoms or a confirmed Mycoplasma genitalium.
• Because resistance is increasing, the choice of agent is guided by the result of the resistance test.
• Sexual partners are usually treated as well.

• Not every bacterial detection means that treatment is necessary.
• Unnecessary antibiotics promote resistance.
• For persistent complaints without a clear cause, a targeted test can be useful.

Ureaplasmas are very small bacteria without a solid cell wall. They belong to the same family as mycoplasmas and naturally colonise the urinary tract and sexual organs in many people. In most cases they're harmless, but under certain circumstances they can cause complaints.

• Ureaplasmas aren't considered a classic sexually transmitted infection.
• They can be detected in many healthy, sexually active people without any complaints.
• They can be passed on during sex but usually don't cause disease. However, they can be medically relevant in certain situations, for example if they multiply massively and cause persistent inflammation of the urethra or the prostate.

• Ureaplasmas are very common and are part of the normal colonisation in many people.
• They occur in all sexually active people, but more frequently in women.
• In Germany there's no reporting requirement, so exact figures aren't known.

• During sex through contact with mucous membranes, vaginally and anally, less commonly orally.
• From the pregnant person to the child during pregnancy or birth.

• In the vast majority of cases they cause no complaints.
• In some cases they're associated with inflammation of the urethra, for example with burning when urinating or discharge.
• A possible involvement in inflammation in the genital area is also discussed, but the scientific assessment here is inconsistent.
• If you have complaints, the classic pathogens such as chlamydia, gonorrhoea, Mycoplasma genitalium or trichomonads should be investigated first.

• During pregnancy, ureaplasmas can play a role in individual cases, for instance in premature labour or preterm birth.
• They can be transmitted to the newborn during birth and, in rare cases, contribute to infections in the child.
• Whether testing or treatment is carried out is decided individually by the medical team.

• Without complaints, targeted testing is generally not recommended.
• A positive finding alone usually doesn't mean action is needed.
• A test can be useful for persistent complaints with no other cause, or in certain situations during pregnancy.

• Without complaints, ureaplasmas are generally not treated.
• If complaints are present and no other cause can be found, targeted treatment with antibiotics can be useful.
• Because ureaplasmas have no cell wall, certain antibiotics don't work; the appropriate choice is made by the medical team.
• Unnecessary antibiotics promote resistance, so treatment isn't given as a precaution.

• A positive ureaplasma finding is in most cases no cause for concern.
• For persistent complaints or during pregnancy, a conversation with a doctor helps.
• Sexual partners are only treated as well if treatment is actually necessary.

Hepatitis A is an inflammation of the liver caused by the hepatitis A virus. It almost always runs an acute course, usually heals on its own and doesn't become chronic. There's an effective vaccination against hepatitis A.

• Widespread worldwide, especially in regions with lower hygiene standards.
• Rather rare in Germany, but outbreaks occur again and again, among others in men who have sex with men.

• Via tiny traces of stool that get into the mouth (faecal–oral transmission).
• During sex, above all through oral–anal contact.
• Via contaminated food or contaminated water, especially when travelling.

• Vaccination: the most effective protection, particularly recommended for people at increased risk and before travelling.
• Dental dams or gloves for oral–anal contact.
• Thorough hand-washing, especially after using the toilet and before eating.

• Often mild or entirely without complaints, especially in children.
• Fatigue, nausea, loss of appetite, a feeling of pressure in the upper abdomen.
• Yellowing of the skin and eyes (jaundice), dark urine, pale stool.

• A blood test for antibodies against the hepatitis A virus.
• The test also shows whether protection already exists from a previous infection or a vaccination.

• There's no specific antiviral treatment; the infection usually heals on its own.
• Rest and avoiding alcohol are important, to relieve the liver.
• For more severe complaints, a medical team monitors the course.

• After a past infection or vaccination, you're usually protected for life.
• Vaccination is particularly worthwhile if there's an increased risk or before long-distance travel.

Hepatitis B is an inflammation of the liver caused by the hepatitis B virus. It can run an acute course and heal, or become chronic. There's a very effective vaccination against hepatitis B.

• Worldwide, one of the most common viral infections of the liver.
• Declining in Germany thanks to vaccination.
• If the virus is transmitted in infancy, it particularly often becomes chronic.

• Via blood and bodily fluids such as semen and vaginal secretions; the virus is highly contagious.
• During sex through mucous membrane contact.
• Via shared needles or syringes.
• From mother to child during birth.

• Vaccination: the best protection; it's recommended for all children and is also possible for adults.
• Condoms significantly reduce the risk.

• Often no noticeable complaints.
• Fatigue, nausea, loss of appetite, joint pain.
• Jaundice, dark urine.
• A chronic infection often goes unnoticed for a long time and can damage the liver.

• A blood test that detects an acute or chronic infection.
• The blood also reveals whether vaccine protection already exists.

• An acute infection usually heals on its own and is mainly managed symptomatically.
• A chronic infection can be well controlled with antiviral medicines.
• Medical monitoring helps to keep an eye on the liver in the long term.

• Vaccination is the most reliable protection.
• After a possible exposure, prompt vaccination, sometimes together with antibodies, can still protect.
• Detected early, long-term consequences for the liver can be avoided.

Mpox (formerly known as monkeypox) is a viral disease that can be transmitted, among other ways, during sex through close skin and mucous membrane contact. The course is usually mild but unpleasant. There's a vaccination against mpox.

• Since 2022, cases have increased worldwide.
• Affected above all are networks of men who have sex with men.
• In Germany, cases occur individually or in smaller outbreaks.

• Through close body and skin contact, above all with the typical skin changes.
• During sex through contact with blisters or mucous membranes.
• Via droplets during very close contact, as well as via contaminated objects, towels or laundry.

• Vaccination: recommended for people at increased risk.
• Avoid close contact when symptoms or skin changes are present.
• Condoms reduce the risk but can't rule it out because of skin contact.

• A skin rash with blisters and pustules, often in the genital and anal area, on the face or on the hands.
• Fever, muscle pain and headache.
• Swollen lymph nodes, a general feeling of illness.

• A swab from a skin change such as a blister or a pustule.
• The sample is examined for the virus in the laboratory by PCR.

• In most cases mpox heals on its own; the focus is on relieving the symptoms.
• In more severe cases, antiviral medicines can be used.
• If mpox is suspected, a medical assessment helps.

• Vaccination offers good protection.
• If mpox is suspected, it makes sense to inform close contacts and seek medical advice.
• After having had the illness, there's usually long-lasting immunity; rare renewed infections are possible but then usually run a much milder course.

Pubic lice (also known as crab lice) are small parasites that nest mainly in the pubic hair and suck blood there. They're harmless but annoying, and they can be treated well.

• Widespread worldwide.
• They can affect all sexually active people, regardless of age.

• Through close body contact, above all during sex.
• Less commonly via shared towels, bed linen or clothing.

• Condoms don't protect, as transmission occurs through skin contact.
• In the event of an infestation, avoid close contact until treatment is complete.
• Wash towels, bed linen and clothing at a high temperature.

• Itching in the intimate area, often stronger at night.
• Lice and their eggs (nits) visible to the naked eye or with a magnifying glass.
• Small bluish spots or scratch marks on the skin.

• Usually a visual diagnosis, as lice and their eggs (nits) are often visible to the naked eye.
• If in doubt, a magnifying glass helps to confirm the creatures and nits in the hair.

• Special products from the pharmacy, for example creams or solutions containing permethrin.
• Removing the hair can also help.
• Wash towels, bed linen and clothing, and treat partners as well.

• Pubic lice don't transmit any other diseases.
• They can be treated well.
• In the event of an infestation, it's worth testing for other sexually transmitted infections.

Scabies is a skin condition caused by scabies mites that dig fine tunnels into the top layer of the skin. It causes severe itching but can be treated well.

• Widespread worldwide.
• Scabies isn't only transmitted during sex, but close skin contact during sex is one possible route.

• Through prolonged, close skin-to-skin contact, including outside of sex.
• Less commonly via shared textiles such as bed linen or clothing.

• Condoms don't protect, as transmission occurs through skin contact.
• In the event of an infestation, avoid close body contact until treatment is complete.
• Wash bed linen, towels and clothing.

• Severe itching, often especially at night.
• Fine tunnels, small blisters or nodules on the skin.
• Typical sites are the hands, genital area, armpits and the inner elbows.

• Examination of the skin for the typical tunnels and skin changes.
• If needed, mites or tunnels are made visible with a dermatoscope.

• Creams to apply, for example containing permethrin, or tablets.
• Wash bed linen, towels and clothing.
• Close contacts and partners are usually treated as well.

• The itching can persist for a while even after successful treatment.
• Scabies is very curable.
• In the event of an infestation, it's worth testing for other sexually transmitted infections.