Scabies is a skin condition that can cause itching and a rash. It is caused by a microscopic mite. It can occur at any age and spreads through physical contact. Topical medications, such as permethrin cream, can treat it.
Scabies is contagious and can spread very easily from person to person through close physical contact. This makes outbreaks likely in close settings, such as the family home, a childcare group, a school class, or a nursing home.
However, it can affect people of all ages, whatever their living situation and socioeconomic status. If an individual has scabies, they and anyone they have close contact with should all receive treatment at the same time.
In this article, learn about what scabies looks like, its symptoms, its causes, and some of its treatment options.
Scabies affects around
Scabies is highly contagious, spreading easily through close physical contact and by sharing bedding, clothing, and furniture items infested with mites.
Scabies most often occurs in children and young adults, with outbreaks common in childcare facilities and schools.
Photography by DermNet New Zealand
Photography courtesy of Gzzz/Wikimedia
The onset of scabies symptoms varies depending on whether or not a person has previously had exposure to mites. The first time a person has exposure to the scabies mite, it can take
This timeframe is significantly shorter in subsequent infestations, as the body’s immune system is quicker to react. This is typically within 1–4 days.
Some symptoms of scabies include:
- Itching: This is often worse at night, and it can be severe and intense. Itching is one of the most common scabies symptoms.
- Rash: When the mite burrows into the skin, it forms burrow tracks, or lines, which are most commonly present in skin folds. The rash may look like hives, bites, knots, pimples, or patches of scaly skin. Blisters may also be present.
- Sores: These occur in infested areas where a person has scratched the skin. Open sores can lead to impetigo, which is commonly caused by a secondary infection with Staphylococcus aureus.
- Thick crusts: Crusted scabies is a form of severe scabies in which hundreds to thousands of mites and mite eggs are present within skin crusts. This causes severe skin symptoms.
Most often, people with crusted scabies exhibit widespread gray, thick, and crumbling crusts. Mites living in the detached crusts can live for more than a week without needing human contact due to the food provided by the crusts themselves.
The most common sites of infestation in adults and older children include:
- between the fingers
- around the fingernails
- the armpits
- the waistline
- the inner parts of the wrists
- the inner elbow
- the soles of the feet
- the breasts, particularly the areas around the nipples
- the male genitalia
- the buttocks
- the knees
- the shoulder blades
Infants and young children tend to experience infestations in other areas of the body, including the:
- scalp
- face
- neck
- palms of the hands
- soles of the feet
At times, children can present with a widespread infestation that covers the majority of the body.
Infants with scabies tend to exhibit symptoms of irritability as well as sleeping and eating difficulties.
How long does scabies last?
Scabies mites can live for 1–2 months on children and adults. When they are not on people, mites only survive for up to
Treatment with prescribed medications generally kills mites quickly. The itching and rash that scabies causes may initially become worse, but the skin should heal within 4 weeks.
If the symptoms persist beyond 4 weeks, scabies mites may still be present. To get rid of the mites thoroughly, some people may need to receive treatment two or three times.
Scabies is an infestation with the Sarcoptes scabiei var. hominis mite, which is also known as the human itch mite.
After burrowing under the skin, the female mite lays its eggs in the tunnel it has created. Once hatched, the larvae move to the surface of the skin and spread across the body or to another host through close physical contact.
Humans are not the only species that mites affect. Mites can also affect dogs and cats. However, each species hosts a different species of mite, and while humans may experience a mild, transient skin reaction to contact with animal mites, a full-scale human infection with animal mites is rare.
Scabies is highly contagious and spreads through direct skin-to-skin contact or by using a towel, piece of bedding, or furniture item infested with the mites. Because of this, some of the most likely people to experience an infestation include:
- children attending daycare or school
- parents or caregivers of young children
- sexually active young adults
- people with multiple sexual partners
- residents of extended care facilities
- older adults
- people with weakened immune systems, including those with HIV, transplant recipients, and others taking immunosuppressant medications
Scabies is highly contagious, so anyone living with someone who has the condition will most likely need to receive treatment for scabies even if they do not have any symptoms. This includes anyone with whom the person has had recent intimate contact.
Doctors generally treat scabies with topical medications such as 5% permethrin cream, crotamiton cream, or lindane lotion. In some cases, a 25% benzyl benzoate lotion or 10% sulfur ointment may be necessary.
For most topical preparations, people should apply them at night, leave them on during sleep, wash them off in the morning.
In the meantime, if they can, the person should wash all sheets, towels, and clothing they have recently used. If it is impossible to wash a particular item, the person should put it in a sealed bag and leave it out for 3–5 days.
Ivermectin, which is an oral medication, may be a good option for people with weakened immune systems, those with crusted scabies, or those who do not respond to topical therapy.
People should not use ivermectin during pregnancy or while breastfeeding. Children weighing under 33 pounds (15 kilograms) should also avoid this medication.
A doctor might prescribe other medications — including antihistamines, anti-itching lotions such as pramoxine lotion, antibiotics, and steroid creams — to offer relief from symptoms.
Tests and diagnosis
A person can sometimes mistake scabies for dermatitis or eczema, as these skin conditions also cause itching and bumps on the skin. Anyone who is unsure about the cause of a skin condition should contact a doctor, as over-the-counter remedies cannot eradicate scabies.
A doctor can diagnose scabies by examining the skin or looking at skin scrapings under a microscope.
Some scabies infestations can resolve without treatment, whereas some may require medical treatment.
If a person wants to try a home remedy for scabies, they should contact a doctor first. Many home remedies are not scientifically proven to treat scabies effectively.
The following are some common home remedies for scabies:
- Tea tree oil: This essential oil may help relieve itching and destroy mites, according to a
preliminary research study . However, further research is necessary to determine its effectiveness. - Oatmeal bath: Taking a bath with colloidal oatmeal may soothe itching from a variety of skin conditions.
- Moisturizer: Moisturizing the skin with a gentle, fragrance-free product may help relieve some of the symptoms of scabies.
- Loose-fitting clothing: Wearing loose clothing can help prevent a person from irritating any affected skin on their body.
- Reducing stress and anxiety: Stress and anxiety can worsen a person’s itching, so it may be worth finding some techniques to reduce these. Options to try include yoga, meditation, and daily exercise.
Sarcoptes scabiei var. hominis most commonly affects humans. The sections below look at some different mite species and some types of scabies infestations.
Species of mites
The scabies mite that affects humans belongs to the Sarcoptidae family, which contains three subfamilies: Sarcoptinae, Teinocoptinae, and Diabolicoptinae.
Altogether, the entire scabies mite family includes
Types of scabies infestations
The human scabies mite can affect people in different ways, as follows:
- Typical scabies: The most common type, this infestation causes itchiness on the hands, wrists, and other areas, but not on the face or scalp.
- Nodular scabies: This causes itchy, raised bumps that
usually develop in the armpits or around the genital area. - Crusted scabies: People with typical scabies who have weakened immune systems may develop this type. It produces thick, gray crusts of skin that contain thousands of scabies mites. It is extremely contagious.
If a person scratches or rubs their skin to relieve the intense itching of a scabies infestation, it may create skin sores.
Should these open sores become infected with bacteria on the skin, such as S. aureus, it could lead to serious conditions, such as heart disease, kidney disease, or blood poisoning.
People can prevent scabies infestations by limiting contact with the skin of someone who already has one and items such as their bedding or clothing.
However, this may be difficult when it comes to members of the same household or people who are in close proximity to someone with an infestation, as that person can sometimes be symptom-free for as long as
To prevent subsequent infestations and spreading, a person should wash or dry-clean all clothes, towels, and linens. When doing so, they should use hot, soapy water and dry on a high heat. People should place any items that they cannot wash into a sealed plastic bag for at least 3 days to starve the mites.
People should also vacuum the entire home — including carpets, rugs, and upholstery — on the day that treatment is initiated and either discard the bag or thoroughly clean the vacuum’s canister.
If a person has any concerns that they may have or may be at risk of experiencing scabies, they should speak with a doctor.