Scabies is a contagious skin condition where mites burrow into the skin causing itchy rashes. Eczema is a noncontagious and life-long skin condition that flares up at different times, sometimes without warning.
Both conditions cause dark, itchy rashes to appear on the skin. Scabies is treatable with medications that kill the mites that cause it. Eczema, on the other hand, is a skin condition that requires life-long management.
This article will discuss the differences between scabies and eczema, treatment options for each condition, and when to see a doctor.
According to the American Academy of Dermatology Association (AAD), scabies and eczema both cause:
- itchy rashes
- small bumps of darker skin
Rashes can occur anywhere on the body, but scabies rashes tend to be more prevalent on the arms and hands.
If a person suddenly develops an itchy rash between the fingers (finger webs), around the belly-button, or on their genitals, it could be scabies rather than eczema.
According to the AAD, typically, when a person has scabies, they have 15-20 mites living in their skin.
However, people with more severe types of scabies, such as crusted or Norwegian scabies, where crusts form on the skin, might have 100s or 1000s of mites living in their skin.
The symptoms of eczema often present at different times, sometimes without warning. Eczema rashes present more in areas that flex, such as the wrists, neck, inner elbow, hands, and feet.
Accompanying symptoms vary depending on the type of eczema a person has. However, if a person has a history of allergies, such as hayfever, this can help the doctor diagnose eczema as the cause of their rash.
Different types of eczema include:
- Atopic dermatitis: This is the most common form of eczema, with the primary symptom being itchy skin. This type of eczema has a genetic link and tends to run in families.
- Contact dermatitis: People with contact dermatitis experience flare-ups from touching irritants, such as cosmetics or scented soaps.
- Dyshidrotic eczema: The first symptom of dyshidrotic eczema is small itchy rashes that develop into blisters on the feet or hands. This type of eczema tends to run in families.
- Nummular eczema: This type of eczema can appear on the legs and torso. The rashes tend to ooze and crust more than other types of eczema.
- Seborrheic dermatitis: Symptoms of seborrheic dermatitis present around the scalp and behind the ears. The skin’s appearance is scaly with the scales forming as greasy patches.
- Stasis dermatitis: Poor circulation in the legs causes stasis dermatitis, with symptoms presenting on the ankles, feet, and legs. The skin appears scaly and darker in affected areas, and a person may experience swelling in the ankles.
Scabies and eczema have very different causes. Scabies is a highly contagious infection where mites burrow into the skin and lay eggs. Eczema is a life-long skin condition with no obvious causes.
According to the Centers for Disease Control and Prevention (CDC), scabies mites move easily from one person to another through prolonged and direct skin-to-skin contact. They can also spread via fabrics that come into contact with the skin, such as a towel or bedding.
The Sarcoptes scabiei var. hominis mites that cause scabies only burrow in humans.
Eczema is not contagious. Although researchers do not know the exact cause of eczema, the National Eczema Association note that some eczema types run in families, which implies the condition may have a genetic link.
According to the American Academy of Allergy, Asthma & Immunology, one possible cause of eczema is ‘leaky skin.’ This is where the skin barrier is unable to contain moisture properly, leading to constantly dry skin.
Treatment for scabies and eczema includes creams and ointments. But people with severe scabies may also need to take ivermectin tablets.
Permethrin cream is the most common form of treatment for scabies. A doctor will suggest applying this cream directly to the skin.
Other forms of treatment for scabies include:
- crotamiton cream
- benzyl benzoate lotion
- sulfur ointment
- lindane lotion
These medicines aim to treat the mites that cause scabies, rather than addressing the symptoms.
Treatment to alleviate symptoms, such as itching and swelling, may include:
- pramoxine lotion
- steroid cream
There is no cure for eczema, but people can use several treatment options to manage their symptoms, depending on the type and severity of their eczema.
Medications and therapies for treating eczema include:
- crisaborole ointment
- pimecrolimus cream or tacrolimus ointment
- coal tar
A doctor may suggest a person uses corticosteroid cream when they experience moderate-to-severe symptom flare-ups.
Treatment may also involve managing triggers. For example, a person may control their eczema by avoiding certain irritants.
A doctor will diagnose both scabies and eczema by visually inspecting the rashes to check for signs of mites or skin irritation. They will also ask when the symptoms started.
According to the AAD, a doctor may take a small skin sample. They can then use a microscope to check for mites or eggs.
Scabies is highly contagious, so a person must see a doctor when they are showing symptoms.
Once a person has a diagnosis of scabies, they need to inform everyone they have come into contact with, so those people can see a doctor for diagnosis and treatment.
A person who experiences eczema flare-ups should speak with their doctor if their skin is drying out or they are experiencing increasing inflammation. The doctor can then prepare a treatment plan and advise on treatment options.
If a person knows somebody with scabies, they should avoid close contact until the infection has cleared. This includes not sharing towels, bedding, or anything else that might come into contact with the skin.
It is not possible to prevent eczema, but it is sometimes possible to prevent the onset of a flare-up. According to the National Eczema Association, people could manage their symptoms of eczema by:
- avoiding irritants
- managing stress
- keeping cool
- maintaining a good skincare regime
Scabies and eczema both cause scaly and itchy patches on the skin.
Scabies is a contagious condition that requires medication. Treatment for scabies can take up to 4 weeks to take effect. A person may find the rashes and itching worsen in the first week of treatment, but this is completely normal.
Eczema is a life-long chronic condition that may require ongoing treatment, such as corticosteroids. Flare-ups may occur without warning, and a person should contact their doctor if their current treatment plan is not working, or their eczema is getting worse.