Everything You Need to Know About Scabies (2024)

Scabies is a mite infestation that results from direct skin-to-skin contact with someone who has scabies. Treatment usually involves topical prescription medications.

Scabies is a skin infestation caused by a mite known as Sarcoptes scabiei. It causes an itchy rash on your skin.

Untreated, these microscopic mites can live on your skin for months. They reproduce on the surface of your skin and burrow into it to lay eggs.

Read on to learn more about scabies symptoms, causes, and treatment.

There are approximately 200 million cases of scabies worldwide at any given time. It’s highly contagious and spreads through direct skin contact.

Recognizing scabies bites and the distinctive rash can help you find treatment faster. Depending on your skin tone, the raised rash may be skin-colored, red, brown, or violet. General inflammation caused by the mites may appear red on lighter skin tones and gray on darker skin tones.

After the initial exposure to scabies, symptoms can take 2 to 8 weeks to appear. However, symptoms usually develop more quickly in people who’ve had scabies before, often as soon as 1 to 4 days after exposure.

The hallmark symptoms of scabies include a rash and intense itching that worsens at night.

The rash itself can consist of:

  • tiny bites
  • hives
  • bumps under the skin

Common sites for scabies include the:

  • wrist
  • elbow
  • armpit
  • nipple
  • penis
  • waist
  • buttocks
  • the area between the fingers

You can sometimes see the mite’s burrow tracks on the skin. They may appear as tiny raised or discolored lines.

Scabies is caused by an infestation of tiny, eight-legged mites. The mites burrow into the top layer of your skin to live and feed. Female mites lay eggs. Your skin reacts to the mites and their waste, and you develop an itchy rash.

These mites pass easily between people. Direct skin-to-skin contact is the most common way the infestation is spread. The mites can also be spread through infested:

  • furniture
  • clothes
  • bedding

Scabies outbreaks are more common in crowded areas where there is skin-to-skin contact. This can include:

  • nursing homes and extended care facilities
  • detention facilities
  • child care facilities
  • encampments of unhoused people

Can you get scabies from animals?

Animals do not spread the type of scabies that commonly affects people. A different type of scabies mite can affect pets, causing a condition called mange, which can also potentially affect people.

The type of mite that causes a scabies infestation in humans can cause several kinds of infestations:

  • Typical scabies: This infestation is the most common and causes an itchy rash on the hands, wrists, and other common spots.
  • Nodular scabies: This type of scabies may develop as itchy, raised bumps or lumps, especially around your genitals, armpits, or groin.
  • Norwegian scabies: Some people with scabies may develop another form of infestation known as Norwegian scabies or crusted scabies. This is a more severe and extremely contagious type of scabies. People with crusted scabies develop thick skin crusts that contain thousands of mites and eggs. This condition is life threatening.

Crusted scabies usually develops in people with weakened immune systems. This includes people who are:

  • living with HIV
  • using steroids or certain medications (such as some for rheumatoid arthritis)
  • living with certain cancers
  • undergoing chemotherapy

Scabies is highly contagious and can easily lead to a community outbreak. In rare cases, bacterial infections of scabies sores can cause serious complications like:

  • chronic kidney disease
  • septicemia, a bacterial infection of your bloodstream
  • heart disease

Persistent itching from scabies can cause insomnia.

A doctor can likely diagnose scabies by performing a physical exam and inspecting the affected area of the skin. They may also want to confirm the diagnosis by removing a mite from the skin with a needle.

Doctors may use other tests to diagnose scabies, including tissue biopsies and ink tests to highlight burrow paths.

Treatment for scabies usually involves getting rid of the infestation with prescription ointments, creams, and lotions applied directly to the skin. Doctors may also recommend oral medications.

Ointments, creams, and lotions for scabies

A doctor will probably instruct you to apply topical medications at night when the mites are most active. You may need to treat all of your skin from the neck down. You can wash off the medication the following morning.

Common medications for treating scabies include:

  • 5% permethrin cream
  • 25% benzyl benzoate lotion
  • 10% sulfur ointment
  • 10% crotamiton cream
  • 1% Lindane lotion

Medications for scabies itch

A doctor may also prescribe additional medications to help relieve some of the bothersome symptoms associated with scabies. These medications include:

  • antihistamines, such as diphenhydramine (Benadryl) or pramoxine lotion, to help control the itching
  • antibiotics to kill any infections that develop from scratching your skin
  • steroid creams to relieve swelling and itching

You may need more aggressive treatment for severe or widespread scabies. Doctors may prescribe an oral tablet called ivermectin (Stromectol) to people who:

  • don’t see an improvement in symptoms after initial treatment
  • have crusted scabies
  • have scabies that covers most of the body

Some traditional scabies treatments can cause unwanted side effects, such as:

  • a burning sensation on the skin
  • redness or irritation
  • swelling
  • numbness or tingling

While these side effects are typically temporary, they may be uncomfortable.

Common natural treatments for scabies include:

  • tea tree oil
  • aloe vera
  • capsaicin cream
  • essential oils
  • soaps

Scabies is highly contagious. It can spread in the following ways:

  • prolonged skin-to-skin contact, such as holding hands
  • intimate personal contact, such as having sexual intercourse
  • sharing clothing, bedding, or towels used by someone with a scabies infection

Since scabies mainly spreads through direct physical contact, the infestation can easily pass on to family members, friends, and sexual partners. The infestation may also spread quickly in settings where many people are in close contact for long periods, such as schools.

While no medication can prevent a scabies infection, you may be able to avoid getting scabies by avoiding direct skin-to-skin contact with a person who has it.

It’s also best to avoid unwashed clothing or bedding used by someone with scabies.

Scabies mites can live for 2 to 3 days after falling off your body, so certain precautions may help prevent another infestation. Make sure to wash all of the following in hot water that reaches 122°F (50°C):

  • clothing
  • bedding
  • towels
  • pillows

How does a person get scabies?

Anyone can get scabies from skin-to-skin contact with someone who has it, and it has nothing to do with your level of personal hygiene. However, you may have an increased risk of scabies if you live in close, crowded environments, like college dormitories.

Can you see scabies mites?

Scabies mites aren’t visible to the human eye and reach a maximum length of about 0.45 millimeters (1/56th of an inch), or about the size of a pin tip.

How long does scabies last?

Scabies mites can live on a person for 1 to 2 months.

Scabies vs. bedbugs

Scabies and bedbugs feed off the human body. One does it from outside your body (bedbugs), while the other does it from inside (scabies).

Scabies are microscopic mites that burrow into your skin to live and lay eggs. When bedbugs bite, you often see clusters of bites. Each cluster usually contains three to five bites in a zigzag pattern.

Will scabies go away on its own?

Scabies does not go away on its own and needs medical treatment with prescription medication.

How can you identify scabies?

If you have scabies, your itching spots or rash may appear red, brown, or black, depending on your skin tone. It will likely itch more at night and spread across your body in most cases. It can be hard to tell scabies from other conditions with similar symptoms, so seeing a doctor for a diagnosis is a good idea.

Scabies is a skin infestation from tiny mites that can cause skin discoloration, swelling, and severe itching.

The mites spread through direct contact with scabies sores or through communal surfaces, meaning scabies is often more common in close-knit living quarters such as dorm rooms and nursing facilities.

Topical ointments and oral anti-inflammatories can often treat scabies and its symptoms.

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Everything You Need to Know About Scabies (2024)

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