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Scabies: Signs, Symptoms, Causes and Treatment


Mites cause this common skin condition. This is called the eight-legged mite, and it's so small you can't see it on the skin. People get scabies when the mites penetrate the top layer of the skin to live and feed. When the skin reacts to the mites, a very itchy rash develops. This mite can be transmitted from one infected person to another.


Most people get scabies from direct skin-to-skin contact. Often, people pick up mites from infested items such as bedding, clothing, and furniture. The mite can survive for three to four days without being on a human. Worldwide, there are millions of cases of scabies every year.

What are the signs and symptoms of scabies?

After the mites penetrate the skin, it takes some time for signs and symptoms to appear. If you've had scabies before, the itching usually begins within one to four days. When a person does not have scabies, the body needs time to develop a reaction to the mites. It may take two to six weeks for symptoms to appear.

Scabies signs and symptoms include:

  • Itching, especially at night: Itching is the most common symptom. The itching can be so severe that a person stays awake at night.
  • Rashes: Many people develop rashes caused by scabies. This rash causes small bumps that often form a streak. The bumps can look like hives, small bites, nodes under the skin, or blisters. Some people develop scaly patches that resemble eczema.
  • Sores: Scratching an itchy rash can cause sores. Infections can develop in sores.
  • Thick scales on the skin: Crusts form when a person has a severe type of scabies called crusted scabies. Another name for crusted scabies is Norwegian scabies. With so many mites in the skin, the rash and itching become severe. You'll find more information about crusted scabies below.

Severe itching can lead to constant scratching. With constant scratching, an infection can develop. Incessant scratching can lead to sepsis, a sometimes life-threatening condition that develops when an infection enters the blood.

Scabies can develop anywhere on the skin. However, mites prefer to hide in certain parts of the body. The most common places for itching and rashes to develop are:

  • Hands: Mites like to burrow into the skin between the fingers and around the nails.
  • Arms: mites such as elbows and wrists.
  • The skin is usually covered by clothing or jewelry: it is likely to dig into the buttocks, belt line, penis, and the skin around the nipples. Moths also like to hide in the leather covered on a bracelet, watch band, or ring.

In adults, mites rarely penetrate the skin over the neck.

Scabies in children

Some children develop scabies on a large scale. A scabies rash can cover most of the body. Even a child's palms, soles and scalp can be infested with mites.

Scabies in children

In children, the rash often appears on the palms and soles. Children with scabies are very nervous and often do not want to eat or sleep. Children are also often very nervous. The itch can keep them awake at night.

Crusted scabies

Also known as Norwegian scabies, crusted scabies is a severe form of scabies. People with crusty scabies have 100 or even 1,000 mites on their skin. By comparison, most people who get scabies have 15 to 20 mites on their skin.

crusted scabies

Crusted scabies develops in people who have a weakened immune system due to a medical condition, the elderly, and people who live in institutions. Scaly scabies develops when a person's body cannot develop any resistance to the mites. Without resistance, mites multiply rapidly.

A common sign of crusted scabies is the presence of scales on the skin. These scales tend to be thick and crumble easily to the touch and look gray. Scales sometimes appear on one or a few areas of the body, such as the scalp, back, or feet.

Who gets scabies?

Anyone can get scabies. Since skin-to-skin contact is the most common way to get scabies, the following people are especially vulnerable:

  • Children
  • Mothers of young children
  • Sexually active youth
  • Residents of nursing homes, assisted living housing, and extended care facilities
  • Hospital patients

A weakened immune system also increases the risk of developing scabies. Older adults and people who have a weakened immune system due to a disease such as HIV/AIDS, lymphoma, or leukemia have an increased risk. People who have had an organ transplant also have a higher risk.

Scaly scabies is particularly contagious. Moth-filled crust can fall off. The shed shell can provide food and protection for the moths, allowing them to live for up to one week without human contact.

Interpersonal scabies in nursing homes and extended care facilities has become a common problem in the United States. Residents often need help with daily tasks, so there is frequent skin-to-skin contact. 

Scabies can be spread to nursing staff. The staff can then pass the scabies on to other residents. This can happen quickly.

Scabies can spread when people have no signs or symptoms. A person who has never had scabies often has no signs or symptoms for two to six weeks.

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What causes scabies?

The human itch mite causes scabies. People get scabies when the mites burrow into the skin. You can get mites on your skin by:

  • Skin-to-skin contact
  • Contact with an infected object such as a towel, bedding, or upholstered furniture

You cannot get scabies from an animal infected with mites. Only humans get this type of scabies.

Most people will not get scabies from a handshake or hug. Skin-to-skin contact should be longer so that the mites can crawl from one person to another. Adults often get scabies through sexual contact.

Who needs treatment?

A person with scabies and everyone who has been in close contact with that person needs treatment. Even people who do not have any signs or symptoms should receive treatment.

This is the only way to prevent an outbreak of scabies after weeks. People to treat are:

  • Everyone who lives with this person
  • Modern sexual partners

Most people can be treated with medication that they apply to their skin. These drugs are often applied to all types of skin from the neck down.

Babies and young children often need a scalp and facial treatment as well. Your dermatologist will provide specific instructions to follow.

Most medications are applied at bedtime. Then the medicine is washed off when the patient wakes up. You may need to repeat this process after one week.

It is important to follow your dermatologist's instructions. Treating the skin more than instructed can worsen the rash and itching.

Medicines that may be prescribed include:

Permethrin 5% cream: This is the most common treatment for scabies. It is used to treat patients 2 months of age and older and pregnant women.

  • 10% Crotamiton Cream
  • 25% benzyl benzoate solution
  • Sulfur (5% - 10%) Ointment
  • 1% lindane lotion

Treating disseminated scabies

Scabies that cover a large part of the body and crusted scabies often require stronger medication. A patient with this type of scabies may receive a prescription for ivermectin.

This drug can be prescribed to children and patients with HIV. Some patients only need one dose, but many need two or three doses to treat scabies. The pills are usually taken once every two weeks.

When scabies infects many people in a nursing home, extended-care facility, and other institutions, ivermectin may be prescribed to anyone at risk of developing scabies.

Other signs and symptoms of scabies

Some patients need other treatment as well. Your dermatologist may prescribe the following:

  • Antihistamines: to control itching and help you sleep.
  • Pramoxine Lotion: To control itching.
  • Antibiotic: to eliminate infection.
  • Steroid cream: To relieve redness, swelling and itching.

Treatment can get rid of the mites, eliminate symptoms such as itching, and treat an infection that has developed. For the first few days to a week, the rash and itching can worsen during treatment. Your skin should heal within four weeks.

If your skin has not healed within 4 weeks, you may still have mites. Some people need treatment two or three times to get rid of the mites.

Be sure to check with your dermatologist for treatment. You should never use scabicide used to treat crops or livestock.

People with crusted scabies, also known as Norwegian scabies, often need repeat treatments to get rid of the mites.

To get rid of mites and prevent scabies infestation again, you need to do more than treat the skin or take birth control pills. You will need to wash clothes, bedding, and towels to get rid of mites that may have fallen off your skin. You should also clean your entire house.

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What to do if you suffer from scabies

Scabies is a common skin disease caused by human itch mites. People get scabies when mites penetrate the top layer of their skin to survive and feed. When the skin reacts to the mites, a very itchy rash develops.

If you suspect you have scabies, follow these dermatologist-certified tips to help you get rid of the mites. The mite that causes scabies is strong. These tips can help you get rid of mites.

1. If you think you have scabies, don't be shy about visiting a dermatologist.

Some people do not seek medical help because they feel this reflects poorly on them. this is not true.

People who are very clean and elegant can get scabies. People of all ages, genders, and income levels get scabies.

2. Everyone you have been in close contact with needs treatment.

Scabies is highly contagious. If you get treatment and the people you live with or have close contact with have not received any treatment, you can get mites again.

The signs and symptoms of scabies do not have to appear on their skin. A person who has never had scabies may not have any symptoms for two to six weeks.

3. If your dermatologist prescribes a medication that you apply to your skin, be sure to shower before applying the medication.

You should then massage the medicine onto clean, dry skin. The medicine should remain on the skin for 8 to 14 hours.

You will wash off the medicine afterwards. For this reason, most people use the medicine at bedtime and wash it off in the morning.

4. Apply the medicine from your neck to your toes.

This includes all the skin between your neck and your toes, the skin around your nails, the crease between your buttocks, and the skin between your toes.

Babies, children and the elderly often need treatment for the scalp, temples and forehead. The medicine should never be applied to the nose, lips, eyelids, or around the eyes or mouth.

5. If you wash your hands after applying the medicine, be sure to put the medicine back on your hands.

Mites like to hide on the hands, so it is important to treat the hands. Be sure to apply the medication to the skin between your fingers.

6. On the day you start the treatment, wash your clothes, linen, and towels.

Mites can live for a few days without human skin. If the mite survives, you can get scabies again.

To prevent this, clothes, sheets, quilts, blankets, towels and other items should be washed. Be sure to follow these instructions when washing:

  • Wash all items in the washing machine using the highest temperature water possible.
  • After washing, dry everything in a dryer using the hot setting.
  •  If you can't wash something in the washing machine and then dry it in a dryer, take it to a dry cleaner or seal it in a plastic bag for at least a week.
  •  Items that have not touched your skin for more than a week generally do not need to be washed. If you're not sure if you've worn an item or used an item in the past week, be sure to wash and dry it.

7. Sweep your entire home the day you start the treatment.

Vacuum carpets, rugs, and all upholstered furniture.

8. Do not treat your pets.

The human itch mite cannot live on animals. Pets do not need treatment.

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