What is scabies?
Scabies is an infestation of a highly contagious, microscopic skin parasite. It can spread between anyone through skin-to-skin contact and through sharing clothes, towels, or other materials that touch the skin. Scabies usually isn’t serious, but it can be harmful for people with certain health conditions. It can also lead to dangerous infections without proper treatment. You can get rid of scabies with a doctor’s help.
Symptoms of scabies
If you’ve gotten scabies for the first time, you might not notice any symptoms for up to six weeks. Then, an intensely itchy rash will appear on your skin. The itching may be severe enough that it affects your sleep. Rashes usually form a line of small red bumps, which can look like acne, hives, eczema, or other skin conditions. Scratching these rashes may lead to infections due to bacteria and dirt on your fingers getting into open sores.
Causes of scabies
Sarcoptes scabiei is the mite, or microscopic bug, that causes scabies. Female scabies mites burrow into your skin, where they lay eggs that hatch and reproduce with each other, maintaining the infestation. They can burrow anywhere on your body, but common areas for rashes to develop are your wrists, knees, genitalia, breasts and nipples, underarms, and between your fingers.
A severe and more contagious type of scabies is called crusted scabies or Norwegian scabies, which is more common in elderly people and those with weakened immune systems. With crusted scabies, a much higher number of mites live on the skin, and can make it look crusty in certain places. Crusted scabies spreads through clothing, towels, and other objects that touch the skin more often than regular scabies, which usually spreads through skin-to-skin contact.
Who gets scabies?
Scabies spreads through close contact between people, especially through skin-to-skin contact, and can take as little as 15 to 20 minutes to be transmitted. Sexual partners, nursing home residents and employees, children and workers at child care facilities, and people living in close quarters are common examples of who gets scabies, but anyone can get it if they are exposed.
Diagnosis of scabies
A doctor will be able to provide a scabies diagnosis. They will ask about your symptoms and who you've been in contact with. The doctor will also need to examine your skin, and may painlessly take a small sample of your skin to inspect it under a microscope for scabies mites and eggs.
Treatments for scabies
A doctor needs to officially diagnose you with scabies to prescribe proper treatment. All effective scabies treatments require a doctor’s prescription — no scabies medication is sold over the counter.
The only proven way to treat scabies is with scabicide, a type of medication that kills scabies mites and eggs. Most scabicides are creams or lotions that you apply all over the skin from head to toe, usually before bed, and wash off in the morning. These topical medications typically contain one of the following ingredients:
Scabicides sometimes take more than one application to work. If itching and other symptoms continue more than four weeks after initial treatment, contact your doctor — you may need additional treatment. If these medications still don’t work, or if you aren’t able to use the above products due to pregnancy, allergy, health conditions, or other reasons, a doctor may prescribe a pill containing the ingredient ivermectin.
Everyone who has been in close contact with a person with scabies, including sexual partners and household members, needs treatment even if they don’t show symptoms. Contacts should receive treatment as close to the same time as possible to prevent reinfestation.
Home care by itself won’t get rid of scabies, but it can help prevent future infestations by killing all existing mites.
Wash bedding, clothing, towels, and other fabrics that touch the skin with hot water and, if possible, dry on a hot cycle or get them dry-cleaned. For whatever objects can’t be washed, don’t touch them for at least 72 hours. If possible, seal these objects in a closed plastic bag for at least three days. When they’re not inside the skin, scabies mites will die within that time frame.
No alternative therapies have yet proven to be effective in preventing or treating scabies. Surgery usually is not necessary.
Risks and side effects of scabies treatment
Scabies could be misdiagnosed, as it shares symptoms with other drug interactions and skin conditions. Using scabicide more often than directed could worsen your rash and itching. Make sure to follow your doctor’s instructions and follow up with any questions or concerns.
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American Academy of Dermatology Association: "Scabies: Signs and Symptoms."
British Medical Journal: "Scabies: diagnosis and treatment."
Centers for Disease Control and Prevention: "Parasites: Scabies."
Centers for Disease Control and Prevention: "Scabies: Medications."
Centers for Disease Control and Prevention: "Scabies: Prevention & Control."
Centers for Disease Control and Prevention: "Scabies: Treatment."
Harvard Health Publishing: "Scabies."
Johns Hopkins Medicine: "'Scratch' the Confusion Away: Hopkins Researchers."
National Center for Advancing Translational Sciences: "Crusted scabies."