What is Scabies?
Scabies is a highly contagious skin condition caused by tiny mites called Sarcoptes scabiei. These microscopic mites burrow into the upper layer of the skin where they live and lay eggs, triggering intense itching and a rash.
Scabies spreads through close physical contact, including skin-to-skin contact or sharing clothing, bedding, or towels with someone who is infected. Though uncomfortable, scabies is treatable with prescription medications.
What Are the Symptoms of Scabies?
Symptoms may not appear until several weeks after initial exposure, especially in people with no prior infection. The main symptom is intense itching, which tends to be worse at night.
Common Symptoms
- Severe itching: Especially at night.
- Red rash: Often with small bumps, blisters, or sores.
- Thin burrow tracks: Wavy, raised lines on the skin where mites have burrowed.
- Sores from scratching: These can lead to skin infections.
Where Do Symptoms Usually Appear?
- Between fingers and toes
- Wrists and elbows
- Waistline and buttocks
- Under breasts
- Genital area
- In infants and elderly individuals, it may affect the head, neck, palms, and soles
How is Scabies Spread?
Scabies spreads through prolonged skin-to-skin contact with an infected person. Brief contact (like a handshake) usually isn’t enough to transmit it unless the person has a severe form known as crusted scabies.
Common Ways It Spreads
- Close physical contact (e.g., family members, sexual partners)
- Sharing bedding or clothing
- Crowded environments (e.g., nursing homes, dormitories, prisons)
What Causes Scabies?
Scabies is caused by the Sarcoptes scabiei mite. After the mite enters the skin, it lays eggs, which hatch and continue the cycle. The itching and rash result from the body’s allergic reaction to the mites, their eggs, and waste.
How is Scabies Diagnosed?
Scabies is typically diagnosed based on symptoms and physical examination. In some cases, further tests may be needed to confirm the diagnosis.
Common Diagnostic Methods
- Skin exam: Doctor looks for burrows and rash patterns.
- Ink test: Ink is applied to the skin to highlight burrow tracks.
- Skin scraping: A sample of skin is examined under a microscope to detect mites, eggs, or waste.
How is Scabies Treated?
Treatment focuses on eliminating the mites and relieving symptoms. Everyone in close contact with the infected person should be treated at the same time, even if they don’t show symptoms.
First-Line Treatments
- Prescription creams and lotions:
- Permethrin cream: Applied from neck to toes (or full body in infants).
- Benzyl benzoate or sulfur ointment: Alternatives for certain individuals.
- Oral medication:
- Ivermectin: Often used for crusted scabies or severe cases.
Additional Steps
- Treat all contacts: Family members and close contacts must be treated simultaneously.
- Wash clothing and bedding: Use hot water and dry on high heat.
- Seal unwashable items: Place in plastic bags for at least 3 days.
- Manage itching: Use antihistamines or soothing lotions as recommended.
What Are the Complications of Scabies?
If not properly treated, scabies can lead to:
- Skin infections: Scratching can break the skin and allow bacteria to enter, leading to impetigo or cellulitis.
- Crusted scabies (Norwegian scabies): A severe form that occurs mostly in people with weakened immune systems. It causes thick crusts filled with thousands of mites and is highly contagious.
- Widespread outbreaks: Especially in institutional settings like nursing homes.
How Can Scabies Be Prevented?
Prevention focuses on avoiding close contact and promptly treating infected individuals.
Tips to Prevent Scabies
- Avoid skin-to-skin contact with infected individuals.
- Don’t share personal items like towels, clothing, or bedding.
- Follow treatment instructions carefully if exposed.
- Inform close contacts to get checked and treated if necessary.
- Clean living spaces thoroughly during outbreaks.
How Long Does It Take to Recover from Scabies?
With proper treatment, itching may begin to improve within a few days but can last for several weeks as the skin heals. The rash may also linger, even after the mites are gone.
Most people are no longer contagious within 24–48 hours after treatment begins, but full recovery depends on avoiding re-infestation and treating all contacts.