Scabies is a contagious skin condition where mites burrow into the skin causing itchy rashes. Eczema is a noncontagious, life-long skin condition that flares up at different times, sometimes without warning.

Both conditions cause itchy rashes to appear on the skin. Scabies is treatable with medications that kill the mites that cause it. Eczema, on the other hand, requires lifelong management.

This article will discuss the differences between scabies and eczema, treatment options for each condition, and when to contact a doctor.

According to the American Academy of Dermatology Association (AAD), scabies and eczema both cause:

Rashes can occur anywhere on the body, but scabies rashes tend to be more prevalent on the arms and hands.

Scabies

Scabies symptoms can take 4 to 6 weeks to present. The main symptom is constant itching with small, pimple-like rashes.

If a person suddenly develops an itchy rash between the fingers, around the belly button, or on their genitals, it could be scabies rather than eczema.

According to the AAD, a person with scabies typically has 15 to 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 hundreds or thousands of mites in their skin.

Eczema

Symptoms of eczema often present at different times, sometimes without warning.

Rashes

Eczema rashes present more in areas that flex, such as the following:

  • wrists
  • neck
  • inner elbow
  • hands
  • feet

Other symptoms

Accompanying symptoms vary depending on the type of eczema a person has. However, if a person has a history of allergies, such as hay fever, this can help a 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 a small, itchy rash that develops 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 in nummular eczema 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: Problems with 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.
  • Neurodermatitis: Also known as lichen simplex chronicus, neurodermatitis occurs in 12% of the population and causes intense, chronic itching. Most commonly, this occurs on the:
    • feet
    • ankles
    • hands
    • wrists
    • elbows
    • shoulders
    • neck
    • scalp

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 lifelong skin condition with no obvious causes.

Scabies

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. The mites can also spread via fabrics that come into contact with the skin, such as a towel or bedding.

The mites that cause scabies are called Sarcoptes scabiei var hominis and they only burrow into the skin of humans.

Eczema

Eczema is not contagious. Although researchers do not know the exact cause of eczema, the National Eczema Association notes 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,” where the skin barrier cannot contain moisture properly, leading to constantly dry skin.

Treatment for scabies and eczema includes creams and ointments. People with severe scabies may also need to take ivermectin tablets.

Scabies

Permethrin cream is a 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
  • spinosad liquid
  • sulfur ointment
  • lindane lotion

These medicines aim to get rid of the mites that cause scabies, rather than addressing the symptoms.

Treatment to alleviate symptoms, such as infection, itching, and swelling, may include:

Eczema

Although there is no cure for eczema, people can use several treatment options to manage the symptoms, depending on the type and severity of their eczema.

Medications and therapies for treating eczema include:

A doctor may suggest a person use corticosteroid cream when they experience moderate to severe symptom flare-ups.

Treatment may also involve reducing exposure to triggers. For example, a person may manage their eczema by avoiding certain irritants.

Doctors diagnose scabies and eczema by visually inspecting the rashes to check for signs of mites or skin irritation. A doctor will also ask when the symptoms started.

According to the AAD, a doctor may take a small skin sample and view it under a microscope to check for mites or eggs.

Scabies is highly contagious, so a person must contact a doctor when they are showing symptoms.

Once a person has a diagnosis of scabies, they need to inform everyone they have come into close contact with, so those people can consult 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 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 can manage eczema symptoms by:

How do I know if my rash is scabies?

To determine if a rash is scabies, a person can look for these signs:

  • intense itching, especially at night
  • thick crusts on the skin
  • a rash made up of small, pimple-like bumps or blisters on the hands, wrists, elbows, armpits, waist, or groin

How do you rule out scabies?

To rule out scabies, doctors may use some of the following techniques to check for the presence of mites, eggs, or burrows:

  • using a dermatoscope
  • skin scraping, which involves taking a sample from the skin to look at under a microscope
  • applying adhesive tape to the skin, pulling it off, and examining the tape under a microscope

What is mistaken for scabies?

Conditions often mistaken for scabies include:

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 lifelong 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.