What is scabies?

Scabies are tiny mites on the skin. They cause small, red bumps and severe itching. Scabies is very contagious. It is spread by direct skin contact. It is easily spread by:

Close physical contact
Sharing bed linens and towels
Shared clothing
Sexual contact

What causes scabies?

Scabies mites burrow under the skin. They don’t jump or fly. They lay eggs in the skin. The eggs hatch and grow into adults. They then create new burrows over the next 1 to 2 weeks. The mites die in about 4 to 6 weeks. The rash and itching are caused by an allergic reaction to the mites’ saliva or feces.

Scabies mites are very contagious. They often spread from person to person while they are sleeping in the same bed, or during other close contact. Scabies should be treated quickly to keep the mites from spreading.

Who is at risk for scabies?

Scabies can affect people of all ages and social groups. It is common all over the world. Scabies happens mostly in children and young adults. It’s also more likely if you live in close quarters with other people, such as in a college dormitory or nursing home.

You are more at risk if you are in contact for at least 15 to 20 minutes with someone who has scabies. Scabies mites can pass from person to person through close physical contact. They can also be passed through shared clothing, towels, and bedding.

What are the symptoms of scabies?

It may take 2 to 6 weeks to develop symptoms of scabies after contact with an infected person. If you have had scabies before, the rash can appear in 1 to 4 days.

Symptoms can occur a bit differently in each person. They can include:

Itching, usually severe and worse at night
Rash with small pimples or red bumps
Tiny lines on the skin surface, which are the mites’ burrows
Sores on the body caused by scratching
Scaly or crusty skin in severe cases

In adults, the rash appears on the hands, between the fingers, wrists, belt line, thighs, belly button, in the groin area, around the breasts, and in the armpits.

The symptoms of scabies can be like other health conditions. Make sure to see your healthcare provider for a diagnosis.

How is scabies diagnosed?

Your healthcare provider will ask about your symptoms and health history. They will give you a physical exam. The physical exam will include closely checking your skin. You may also have a skin scraping. The provider scrapes a small sample of your skin and looks at it with a microscope to check for mites. You may also need a skin biopsy. This test takes a small sample of skin to look at with a microscope.

How is scabies treated?

Everyone living in your house and all sexual partners should be treated at the same time. After the first treatment, you will no longer be contagious. You may return to work or school.

Scabies infection is most often treated with a prescription cream or lotion that has 5% permethrin. This kills the mites. When using prescription lotion or cream:

Follow instructions from your healthcare provider and pharmacist. Ask about safety steps for using this medicine.
Use the cream or lotion on your body when your skin is cool and dry. Don’t use it after a hot shower or bath.
Apply the cream or lotion to your entire body from the chin down. This includes the neck, palms of your hands, soles of your feet, groin, and under your fingernails.
Don’t use more than prescribed.
Leave the cream or lotion on for the advised amount of time. This is usually 8 to 14 hours. Don’t leave it on your skin longer than directed.
Wear only clean clothes after the treatment.
Reapply the cream or lotion to your hands after you wash them.
If you are breastfeeding, wash off your nipples before feeding. Then reapply the cream or lotion after breastfeeding.
If advised, repeat the application of cream or lotion 1 week later.

Other treatments include:

Ivermectin. This is an oral medicine for severe cases. It may also be used if you can’t apply cream or lotion. This can be used before other treatments, but it usually costs more than skin cream medicines.
Antihistamine medicine. Itching may cause the most discomfort. If large areas of your skin are affected, over-the-counter antihistamines may be used to reduce itching. Or you may be given a prescription antihistamine.
Antibiotics. This medicine may be used to treat infected sores from scratching. It is important to finish taking all of the antibiotics even if the sores look better. This is to make sure the infection has fully gone away.

Medicines work quickly to kill the mites, but the itchy rash may last for several weeks after treatment. Marks on the skin from scabies usually go away in 1 to 2 weeks, but sometimes take a few months to go away.

Talk with your healthcare providers about the risks, benefits, and possible side effects of all treatments.

What are possible complications of scabies?

Scratching the rash can cause sores, which may become infected with bacteria.

Can scabies be prevented?

To prevent reinfection and the spread of scabies to others:

Machine wash in hot water all sheets, towels, pillowcases, underwear, pajamas, and clothing.
Dry them in the hot cycle of a dryer.
Seal anything that is hard to wash in a plastic bag for 1 week. This includes coats, jackets, blankets, and bedspreads, pillows, and soft toys.
Vacuum floors and furniture. Throw the vacuum bag away afterward.

When should I call my healthcare provider?

Call the healthcare provider if you have:

New rashes or lines in the skin after treatment
Sores that do not heal
Signs of infection in sores, such as crusts, fluid leaking, swelling, pain, or red streaks
Fever of 100.4°F (38ºC) or higher, or as directed by your healthcare provider

Key points about scabies

Scabies are tiny mites on the skin. They cause small, red bumps and severe itching.
Scabies mites are very contagious. They often spread from person to person while they are sleeping in the same bed, or during other close contact. Scabies should be treated quickly to keep the mites from spreading.
It may take 2 to 6 weeks to develop symptoms of scabies after contact with an infected person. If you have had scabies before, the rash can appear in 1 to 4 days.
Everyone living in your house and all sexual partners should be treated at the same time.
Scabies infection is most often treated with a prescription cream or lotion that kills the mites. The itchy rash may last for several weeks after treatment.
To prevent reinfection and the spread of scabies to others, make sure to wash in hot water all bedding, clothing, pillows, and soft toys.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells you.
At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that visit.
Know how you can contact your healthcare provider if you have questions, especially after office hours or on weekends.