Scabies

What is scabies?

The Sarcoptes scabiei mite causes scabies. These little bugs make tunnels (burrow) under your skin to live, feed and lay eggs. Your skin reacts to the mite by developing an itchy rash. Scabies spreads easily from person to person, especially among people who live close together. If one family member has scabies, a healthcare provider should check and treat other family members and close contacts at the same time.

Scabies is a worldwide problem but happens most often in crowded, tropical areas, particularly in under-resourced countries. But it can affect people of all ages, races or economic status. It has nothing to do with how clean or hygienic you are. Healthcare providers treat scabies with medicated creams you apply to your skin or medication you take by mouth.

Are there different types of scabies?

Yes, there are different forms in addition to the classic form. Other types include:

• Crusted (Norwegian): This type often happens in people with weak immune systems. It tends to form crusted areas covering a large area of skin. If you have crusted scabies, you might have millions of mites instead of the 10 to 15 mites common with classic or typical scabies.
• Nodular: This type is more common among children and affects their genitals, groin or armpits. The raised bumps can still be there long after the mites are gone.

How common is scabies?

Scabies affects more than 400 million people each year worldwide. It’s generally more common in tropical countries that lack medical resources, but it can still occur anywhere. Scabies outbreaks in the U.S. and similar countries tend to occur in places where people share living space like nursing homes, dorms or correctional facilities.

What are the symptoms of scabies?

Scabies causes an extremely itchy rash on your skin. It can take up to six weeks for this rash to develop if you’ve never had scabies, though. If you’ve had scabies before, you tend to get a rash within a few days.

The rash spreads slowly over weeks or months. In addition to the rash, signs and symptoms of scabies include:

• Intense itching, which is worse at night and could make it hard to sleep.
• Sores or painful bumps that sometimes become infected because of scratching.
• Burrowing tracks or bumps that appear as raised, skin-colored lines.

Children with scabies may have itching all over their bodies and might be cranky or tired from lack of sleep due to itching at night.

Where do scabies mites live on your body?

The mites live in the folds and cracks of your skin. Common mite sites include:

• Folds in between your fingers and toes.
• Folds in your thighs and genital area.
• Bends at your wrists and knees.
• The area around your waist.
• Under fingernails.
• Under rings, watch bands and bracelets.
• The area around your nipples.

Can I see the mite?

The scabies mite is very small, about the size of the tip of a needle, and very difficult to see. It’s white to creamy white. It has eight legs and a round body, which you can see if the mite is under a microscope.

What does scabies rash look like?

The skin rash can appear in different colors depending on your skin tone. For example, it can look red, brown or gray. The rash can look like hives, insect bites or pimples. It can even appear in a line across your skin.

What causes scabies?

Scabies is a mite infestation. These tiny mites burrow under your skin to live, eat, poop and lay eggs. Your skin reacts to this by swelling and itching, much like your skin reacts to an allergy.

How does scabies spread?

Scabies mites spread from person to person. Direct contact with a person’s skin is the easiest way to spread scabies. Less commonly, you can also get it through sharing bedding, clothes or towels with someone who has the disease.

Can my pet give me scabies?

No. The mites that affect your pet can’t live on humans.

What are the risk factors for scabies?

Anyone can get scabies. It’s not a disease you get from poor hygiene. Some people are more likely to get scabies, including:

• People who live in close, crowded conditions.
• Infants and children. (Children have a lot of close physical contact with their caregivers, friends, family members and classmates.)
• People who are elderly, especially those living in nursing homes.
• Healthcare workers who care for people who aren’t aware they have scabies.
• People who are sexually active.
• People with weak immune systems.

What are the complications of scabies?

Scabies can cause complications like:

• Painful skin sores.
• Septicemia (infection in your blood).
• Heart disease.
• Kidney disease.

How is scabies diagnosed?

Make an appointment with your healthcare provider if you think you (or your child) have scabies. Your provider can often diagnose scabies by just looking at your skin.

Your healthcare provider may also apply mineral oil to the rash and use a scalpel to get a small sample of skin (scraping). They examine the sample under a microscope to look for mites and mite eggs.

How do you get rid of scabies?

Scabies treatment may involve medication you apply directly to your skin or medication you swallow. The goal of treatment is to kill the mites, although you can still itch for weeks afterward. Medication can’t kill mite eggs, so you may need to repeat treatment if your symptoms continue.

Recent sexual partners and anyone who lives with you also need treatment.

Creams, lotions or ointments

Healthcare providers may prescribe a cream, lotion or ointment to treat scabies. You put the medication on your whole body from your neck downward, including your hands, palms and feet. Children with scabies may need medication on their faces and scalps.

Follow the instructions on the package or from your healthcare provider. Most creams need to stay on your skin for eight to 14 hours. In most cases, you’ll apply the medication at bedtime and wash it off in the morning.

Your provider may prescribe the following topical medications:

• Permethrin cream.
• Crotamiton cream or lotion.
• Benzyl benzoate lotion.
• Sulfur ointment.

Medications

Medications you swallow by mouth are another option. Your provider may recommend oral medication if you need a stronger medication or if you can’t use topical medications.

Ivermectin is the most common medication to treat scabies. This is an antiparasitic pill given in a single dose, followed by a second dose one to two weeks later. Children less than 35 pounds (15 kilograms) and women who are pregnant or nursing can’t take this medication.

Other medications your provider may recommend include:

• Antihistamines (to help with itching).
• Antibiotics (if you have an infection).
• Steroid creams (for redness and swelling).

How soon does the scabies rash go away?

The red bumps on your skin should go away within four weeks after treatment.

How soon are the mites killed?

One treatment with a topical cream or pill kills the mites that cause scabies. You may still have a rash or itch for up to two weeks, but the mites usually die after one dose of medication.

How soon does the itching stop?

The itching may take two to four weeks to go away (even when all the mites are dead).

Will scabies go away on its own?

No, scabies won’t go away on its own. Only prescription medication can treat it. If you don’t treat it, you’ll probably continue to spread the disease to other people. In addition, the constant itching will probably lead to constant scratching and a skin infection.

Is scabies hard to get rid of?

Scabies is treatable but can be hard to get rid of completely. Certain forms of scabies are harder to treat, such as the crusted form. In addition, you might need more than one round of treatment to make sure all the mites are gone.

How can I prevent spreading scabies?

You can prevent spreading scabies by:

• Washing bed linens, towels and clothing in hot water and putting them in a dryer.
• Making sure family members and others in close contact with you get checked for scabies.
• Limiting close contact with others if you receive a scabies diagnosis.

Place unwashable items like stuffed animals, large pillows and toys in large garbage bags. Place the bags in a garage or basement for about seven days. Mites on these surfaces will die within a few days without human skin. You can then remove the items from the bags and wash them off by hand.

Can you prevent getting scabies?

There’s no vaccine to prevent scabies. The only way to prevent getting scabies is to avoid people or places with known scabies outbreaks. The disease spreads easily among people who live in the same household or share a room.

What is the outlook for someone with scabies?

While scabies can be frustrating and uncomfortable for several weeks, your healthcare provider can prescribe medication to get rid of the mites and help ease your symptoms. It may take up to two months for your skin to heal.

Talk to your healthcare provider if you don’t see your symptoms improve with medication or if you still have a rash after four weeks. You may need repeat treatment to get rid of any remaining mites.

Be sure to wash your bedding, clothing and towels and clean the floors in your home. While mites can’t live on these surfaces for more than a few days, you should still eliminate the mites that lurk outside of your body.

If my child has scabies, how soon can they return to school?

In most cases, your child can return to school the day after treatment begins. If you’re an adult, you can go back to work after you begin treatment. Check with your healthcare provider to be sure.

Can a person get scabies more than once?

Yes. You can get scabies any time you come into close contact with an infected person.

When should I see my healthcare provider?

Call your healthcare provider if you have scabies and you:

• Still have symptoms or skin issues after a month.
• Develop signs of a bacterial infection, like redness or sores with pus. These types of infections can lead to more severe medical issues.
• Have some type of side effect from the medication or the condition that’s worrying you.

What questions should I ask my healthcare provider?

If you find out you have scabies, it’s normal to have questions. Some questions to ask your provider are:

• Do people who live with me need treatment?
• Can I go back to work or school after I start medication?
• Am I still contagious?
• Will I get scabies again?
• What side effects should I watch for?
• When will my symptoms get better?

Can you feel scabies crawling on you?

No, you can’t feel the mites crawling on you because they’re tiny and crawl slowly. The only thing you can feel is the itchiness or inflammation they cause to your skin.

Can scabies mites live in a mattress?

Mites may temporarily live on or in a mattress, but they need human skin to survive. Mites can appear on virtually anything — furniture, clothes or surfaces — but they’ll die after a few days.

Can dirty sheets cause scabies?

Dirty sheets don’t cause scabies because the disease isn’t related to hygiene or cleanliness. But scabies can spread from person to person through bedsheets.