What is scabies?
Scabies is a skin condition caused by mites (little bugs) that burrow under the skin and produce small red bumps and severe itching. The mites easily spread from person to person, especially among people who share close living spaces. If one family member has scabies, other family members and close contacts must be checked and treated at the same time.
The mites live in the folds and narrow cracks of the skin. Common mite sites include:
- Folds in between the fingers and toes.
- Bends at the wrists.
- Area around the belt line.
- Bends at the knees.
- Under fingernails.
- Folds in thighs.
- Under rings, watch bands, and bracelets.
- Folds in genitals.
- Area around the nipples (in women).
Who gets scabies?
Anyone can get scabies. Poor hygiene does not lead to scabies. People who are more likely to get scabies include:
- People who live in close, crowded conditions.
- Infants and children. (Children have a lot of close, physical contact with others, including their mothers, parents, friends, family members, and classmates.)
- The elderly, especially those living in nursing homes.
- Healthcare workers who care for people not aware they have scabies.
Symptoms and Causes
What are the symptoms of scabies?
The symptoms of scabies include:
- Intense itching.
- Skin rash of tiny red bumps that look like bites or pimples. (These spread slowly over a period of weeks or months.)
- An intense itch that leads to loss of sleep.
- Bumps that sometimes become infected as a result of scratching.
Children with scabies may have itching all over their bodies and may be cranky or tired from lack of sleep due to itching at night.
A person can be infected with scabies for four to six weeks before having symptoms. It's important that you get rechecked up to six weeks after you think you may have been exposed or any time symptoms occur, even if you were already screened for scabies.
Diagnosis and Tests
How can I know if I or my child has scabies?
Visit your healthcare provider. Most cases of scabies can be confirmed just by looking closely at the skin. Your healthcare provider may also apply mineral oil to the rash and use a scalpel to get a small sample of skin. The sample is placed under a microscope and examined for mites and mite eggs.
Can I see the mite?
The mite is very small, about the size of a needle point, and very difficult to see. It is white to creamy white in color. When magnified, its eight legs and round body are visible.
Management and Treatment
How is scabies treated?
Scabies is treated with a cream that contains a medicine called permethrin. This cream must be ordered by your healthcare provider.
The cream is applied to the whole body below the head, including the hands, palms, and soles of the feet. In children with scabies, the cream may need to be applied to the scalp. Be sure that the skin is clean, cool and dry before applying the cream.
Permethrin cream is left on the skin for eight to 14 hours and then washed off. (The cream is most often applied at night and washed off in the morning.)
Ivermectin is another option for treating scabies. This is an antiparasitic pill given in a single dose, followed by a second dose one to two weeks later. Ivermectin shouldn’t be used by pregnant or lactating women or children who weigh less than 35 pounds (15 kg).
Antihistamines, medicine taken by the mouth and in creams, may also be ordered to relieve itching. Any infections that are present will also be treated.
How soon are the mites killed?
The mites are killed after one treatment. The treatment does not need to be repeated unless the infection does not go away or comes back.
How soon does the itching stop?
The itching may take two to four weeks to go away, even though the mites have been killed.
How soon does the rash go away?
Red bumps on the skin should go away within four weeks after treatment.
How can I prevent spreading scabies?
You can prevent spreading scabies by:
- Washing bed linens, towels, and clothing in hot water and machine dry.
- Making sure family members and others in close contact with the infected person get checked for scabies.
Outlook / Prognosis
If my child has scabies, how soon can they return to school?
Your child can return to school the day after treatment.
Can a person get scabies more than once?
Yes. You can get scabies any time that you come into close contact with an infected person.