Scabies 

Scabies is a skin infection. It's caused by a tiny parasitic mite that's too small to see directly. It can be seen under a microscope, but it's usually recognized only by the rash and symptoms it causes. This can make it hard to diagnose since the signs and symptoms can be similar to other diseases.

The scabies mite tunnels under the skin. It creates a small burrow, where it leaves its eggs. These 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 scabies saliva or feces.

Scabies is highly contagious. It's spread by direct skin contact. It's easily spread by close personal contact, sexual contact, or by sharing bed linens or clothing used by an infected person.

It may take 4 to 6 weeks for symptoms to appear after being exposed. Everyone living in the house with you, as well as your sexual partners, should be treated at the same time. After the first treatment, you will no longer be contagious. You may return to work, school or daycare.

Home care

  • Machine wash in hot water all sheets, towels, pillowcases, underwear, pajamas, and any other clothing you have worn lately. Use the hot cycle of a dryer. If an item can't be laundered, dry clean the item.

  • Seal anything that is hard to wash in a plastic trash bag for at least 3 days, and possibly up to a week. This includes coats, jackets, blankets, and bedspreads. (The insects die after 3 days off the human body.)

Medicines

Scabicides

Medicines used to treat scabies are called scabicides. These are creams that kill the scabies mites. A prescription is needed. When using these medicines:

  • Always follow instructions provided by your healthcare provider and pharmacist. Also follow the printed instructions that come with the medicine.

  • Talk with your provider about precautions to take when using these medicines.

  • Use the cream on your body when your skin is cool and dry. Don’t use it after a hot shower or bath.

  • Follow your healthcare provider's instructions for applying the medicine. Usually the cream is put on your whole body. This means from your chin all the way down to your toes. Scabies doesn't usually affect an adult’s head. So cream is not needed there. For children, discuss how to apply the medicine with your child’s provider.

  • Leave the cream or lotion on for the recommended amount of time. This is usually 8 to 12 hours.

  • Don’t leave cream or lotion on your skin longer than directed. Don’t use more than recommended.

  • Wear clean clothes after the treatment.

  • If you wash your hands after using the cream, reapply the cream to your hands.

  • If you are breastfeeding, wash off your nipples before feeding. Then reapply the cream after breastfeeding.

  • For babies or infants, put mittens on their hands. This will stop them from licking the cream or lotion. It will also stop them from scratching themselves because of the itching.

Other medicines

  • An oral medicine called ivermectin may be prescribed for severe cases that don't respond to topical creams. It may also be used if you can’t apply creams.

  • 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. Some of these medicines may make you sleepy. They are best used at bedtime. Antihistamines that don’t make you sleepy can be used during the day. Note: Don’t use medicine that has diphenhydramine if you have glaucoma, or if you are a man who has trouble urinating due to an enlarged prostate.

  • If you were given antibiotics due to a bacterial infection, take them until they are finished. It's important to finish the antibiotics even if the wound looks better. This is to make sure the infection has cleared.

Follow-up care

Follow up with your healthcare provider, or as advised. Call your provider if your symptoms don’t improve after 1 week, or if new burrows or rashes appear.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

  • Yellow-brown crusts or drainage from the sores

  • Other signs of infection, including increasing redness, swelling, pain, or pus

  • Fever of 100.4°F (38ºC) or higher, or as directed by your provider

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