Scabies

Topic Overview

What is scabies?

Scabies is a condition of very itchy skin caused by tiny mites that burrow into your skin. The itching is caused by an allergic reaction to the mites.

Scabies spreads very easily from person to person. It can affect people of all ages and from all incomes, social levels, and living situations.

With treatment, the scabies mites die and the itching goes away over a period of days to weeks. Without treatment, the mites continue to reproduce under the skin, causing more sores and itching.

How is scabies spread?

Scabies mites spread from person to person by close contact, such as sleeping in the same bed or touching someone's skin. The mites can also be spread by sharing towels, clothing, and other personal items.

Scabies often affects several household members at the same time. You can spread it to another person before you have symptoms.

What are the symptoms?

Scabies has two main symptoms:

  • Severe itching that is usually worse at night. Small children and older adults tend to have the worst itching.
  • A rash with tiny blisters or sores. Children tend to have worse skin reactions than adults.

Symptoms are more likely to occur:

  • Between the fingers and on the palm side of the wrists.
  • On the outside surfaces of the elbows and in the armpits.
  • Around the waistline and navel.
  • On the buttocks.
  • Around the nipples, the bra line, and the sides of the breasts (in women).
  • On the genitals (in men).

In babies and small children, itching and skin irritation may also occur on the scalp, neck, and face and on the palms of the hands and soles of the feet.

If you have many scaly, crusted sores, you may have a rare form of scabies called crusted scabies or Norwegian scabies.

If this is the first time you have had scabies, it may be several weeks before you have itching and skin sores. But if you have had it before, symptoms will probably start in a few days.

How is scabies diagnosed?

Usually a doctor can diagnose scabies based on your symptoms. Scabies is especially likely if you have had close contact with other people who have had the same symptoms.

Sometimes you may have a test to confirm that you have scabies. For example, the doctor may gently scrape some dry skin from an affected area and look at it under a microscope for signs of mites.

How is it treated?

Scabies won't go away on its own. To get rid of it, and to keep from spreading it to others, you need to use a special cream or lotion that a doctor prescribes. These products contain permethrin or another medicine. In severe cases, your doctor may also give you pills to take.

Most creams or lotions are applied to the entire body from the neck down. The medicine may also be applied to the scalp, face, and neck, taking care to avoid the area around the mouth and eyes. In most cases, you leave the medicine on for 8 to 14 hours and then wash it off.

Children can usually return to day care or school after treatment is completed.

Some scabies medicines aren't safe for children, older adults, and women who are pregnant or breast-feeding. To avoid dangerous side effects, be sure to follow your doctor's instructions carefully.

If you have scabies, you and anyone you have close contact with must all be treated at the same time. This keeps the mites from being passed back and forth from person to person. Until scabies has cleared up, you should avoid close contact with anyone and make sure not to share any personal items.

To make sure that all the mites are killed:

  • Immediately after treatment starts, clean all of your (or the affected person's) bedding, towels, and the clothing that was worn during the past 2 to 3 days (48 to 72 hours).1 Wash all items in hot water, and dry them in a hot dryer. Or they can be dry-cleaned.
  • Place any items that cannot be washed or dry-cleaned in a closed plastic bag for at least 7 days.
  • Clean and carefully vacuum the room or rooms used by the person who had scabies.

After treatment, the itching usually lasts another 2 to 4 weeks. It will take your body that long to get over the allergic reaction caused by the mites. Antihistamines (such as Benadryl), steroid creams, or, in severe cases, steroid pills can help relieve itching. Before you use these medicines, talk with your doctor about what is best for you (or your child).

If you still have symptoms after 4 weeks, you may need another treatment.

Other Places To Get Help

Organizations

American Academy of Dermatology
P.O. Box 4014
Schaumburg, IL  60168
Phone: 1-866-503-SKIN (1-866-503-7546) toll-free
(847) 240-1280
Fax: (847) 240-1859
Email: MRC@aad.org
Web Address: www.aad.org
 

The American Academy of Dermatology (AAD) provides information about the care of skin. You can locate a dermatologist in your area by using their "Find a Dermatologist" tool. Or you can read the latest news in dermatology. "SPOT Skin Cancer" is the AAD's program to reduce deaths from melanoma. There is also a link called "Skin Conditions" that has information about many common skin problems.


American Social Health Association
P.O. Box 13827
Research Triangle Park, NC  27709
Phone: (919) 361-8400
Fax: (919) 361-8425
Web Address: www.ashastd.org
 

The mission of the American Social Health Association is to improve the health of individuals, families, and communities, with a focus on sexual health and preventing sexually transmitted diseases.


Centers for Disease Control and Prevention (CDC): Parasites
1600 Clifton Road
Atlanta, GA  30333
Phone: 1-800-CDC-INFO (1-800-232-4636)
TDD: 1-888-232-6348
Email: cdcinfo@cdc.gov
Web Address: www.cdc.gov/parasites
 

The U.S. Centers for Disease Control and Prevention (CDC)'s website on parasites offers information on diseases caused by parasites. It provides information on topics such as malaria, neglected tropical diseases, and parasitic infections in the United States. There are also links to related information, such as a glossary and a site on healthy water, and other references and resources, such as statistics on parasitic diseases.


KidsHealth for Parents, Children, and Teens
Nemours Home Office
10140 Centurion Parkway
Jacksonville, FL 32256
Phone: (904) 697-4100
Web Address: www.kidshealth.org
 

This website is sponsored by the Nemours Foundation. It has a wide range of information about children's health—from allergies and diseases to normal growth and development (birth to adolescence). This website offers separate areas for kids, teens, and parents, each providing age-appropriate information that the child or parent can understand. You can sign up to get weekly emails about your area of interest.


References

Citations

  1. Chosidow O (2006). Scabies. New England Journal of Medicine, 354(16): 1718–1727.

Other Works Consulted

  • Tucker WFG (2010). Scabies. In MG Lebwohl et al., eds., Treatment of Skin Disease: Comprehensive Therapeutic Strategies, 3rd ed., pp. 682–684. Philadelphia: Mosby Elsevier.
  • Wolff K, Johnson RA (2009). Scabies. In Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 6th ed., pp. 868–876. New York: McGraw-Hill.

Credits

By Healthwise Staff
Primary Medical Reviewer Adam Husney, MD - Family Medicine
Specialist Medical Reviewer John Pope, MD - Pediatrics
Last Revised January 23, 2013

Last Revised: January 23, 2013

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

© 1995-2013 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

Decision Points

Our interactive Decision Points guide you through making key health decisions by combining medical information with your personal information.

You'll find Decision Points to help you answer questions about:

Interactive Tools

Get started learning more about your health!

Our Interactive Tools can help you make smart decisions for a healthier life. You'll find personal calculators and tools for health and fitness, lifestyle checkups, and pregnancy.

Symptom Checker

Feeling under the weather?

Use our interactive symptom checker to evaluate your symptoms and determine appropriate action or treatment.

Symptom Checker