Scabies is an infestation of the skin caused by a microscopic bug called the human itch mite. This tiny mite burrows into the outer layers of skin where it lays eggs. The body develops an allergic reaction to the mites, causing an extremely itchy rash. The mites can travel from one person to another infecting many people at a time. Nursing homes, schools, and childcare centers are common areas where people can get infected. This is a highly contagious skin condition that affects millions of people each year.
Intense itching is the most common symptom of scabies. The itching is so severe that it can keep you awake at night. Another symptom of scabies is a rash that has the appearance of tiny red bumps. These itchy bumps often form a line on the skin and may look like pimples or hives. Frequent scratching of the itchy rash can cause sores to develop. As the condition progresses, scales or crusts can form on the skin.
Scabies can develop anywhere on the body, although there are certain areas where the mites are more likely to burrow. If you have scabies, these are the most common parts of the body where you’re most likely to develop an itchy rash:
In children, scabies symptoms can appear on most areas of the body, but they typically can be seen on a child’s scalp, palms or soles of the feet. Babies often have a rash on the soles of their feet and palms.
Seeing a dermatologist is the first step toward diagnosing scabies. Your doctor will carefully examine your skin from head to toe. To confirm a diagnosis of scabies, your dermatologist may also remove a small amount of skin for examination under a microscope. If scabies mites or their eggs are detected in the skin sample, your dermatologist will develop a personalized treatment plan.
Most people can achieve a scabies cure by using a topical prescription medicine on their skin. These creams and lotions are applied from the neck down to the soles of your feet. For young children and infants who have scabies, these topical treatments are applied to the forehead and scalp. The cream or lotion is left on the body for a recommended period of time, usually 8–14 hours, before washing it off.
A 5% permethrin cream is the most common treatment for scabies. Like other prescription topical treatments for scabies, permethrin cream works by killing the scabies mites and their eggs. Other topical treatments for scabies include 10% crotamiton cream, 25% benzyl benzoate lotion, sulfur (5%–10%) ointment, or 1% lindane lotion. Most patients only need a single treatment to successfully eliminate scabies mites, but occasionally two applications are needed.
If you have a resistant infection that doesn’t respond well to topical treatment, you may be prescribed Ivermectin, an oral antiparasitic drug. With only one dose, Ivermectin is an effective treatment for resistant scabies infections.
If you’re diagnosed with scabies, anyone who is in close contact with you also requires treatment as it is highly contagious. This includes everyone who lives in the same household and recent sexual partners. Treating everyone you’ve been in close contact with is the only way to prevent new outbreaks of scabies.
The most effective method for scabies prevention is avoiding physical contact with an infected person and their personal items, especially bedding and clothing. Scabies mites can survive for several days without being on human skin. If any mites survive, it’s possible to get scabies again. To prevent a scabies infestation from happening again, it’s important to wash all of your bedding, clothes, washcloths, and towels on the same day you begin treatment.
It’s important to use the hottest water possible when washing these items, and you should also ensure that you’re using the hottest setting on your dryer. If an item can’t be washed or dried, you should seal it inside a plastic bag for a minimum of one week or take it to a dry cleaner. You should also vacuum your entire home.
If you have scabies symptoms, it’s important to see your dermatologist as soon as possible. Our dermatologists are experienced in diagnosing scabies and will create a treatment plan that works best for you.
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