What are the symptoms of scabies?

The most common symptom is intense itching, which is often worse at night.

The rash may include:

Small itchy bumps
Thin, crooked burrow lines
Tiny blisters
Crusted or scratched areas
Eczema-like patches
Sores caused by scratching

Common locations include:

Between the fingers
Wrists
Elbows
Underarms
Waist
Buttocks
Genital area
Around the nipples
Shoulder blades

Infants, young children, older adults and immunocompromised patients may also have involvement of the scalp, face, neck, palms or soles.

Symptoms can take several weeks to develop after a first exposure, but an infected person may spread scabies before itching begins.

How does scabies spread?

Scabies usually spreads through prolonged skin-to-skin contact. It may also spread through recently used clothing, towels or bedding.

Brief contact such as a quick handshake is less likely to spread typical scabies. Household members, intimate partners and caregivers have a greater risk because of repeated close contact.

Human scabies does not come from household pets.

How is scabies diagnosed?

A dermatology provider will examine the distribution of the rash and look for burrows. Magnification or dermoscopy may help identify a mite.

A small skin scraping may be examined under a microscope. A negative scraping does not always exclude scabies because a person with ordinary scabies may have relatively few mites.

The pattern of symptoms among household members can also support the diagnosis.

How is scabies treated?

Prescription treatment may include:

Permethrin cream
Oral ivermectin for selected patients
Another prescription scabicide
Medication to reduce itching or inflammation
Antibiotic treatment when scratching has caused a bacterial infection

The medication must be applied exactly as directed. Treatment may need to be repeated approximately one week later.

Household members and other close contacts are often treated at the same time, even when they do not yet have symptoms.

How should clothing and bedding be handled?

On the day treatment begins, wash recently used clothing, towels and bedding in hot water and dry them using high heat when the items allow.

Items that cannot be washed can generally be sealed in a plastic bag for the period recommended by your healthcare provider.

Vacuum upholstered furniture and carpeting. Extensive pesticide spraying or fumigation is not generally required.

Itching may continue for several weeks after successful treatment because the allergic reaction takes time to settle. New burrows or new bumps may indicate ongoing infestation and should be evaluated.

Schedule a scabies consultation

Persistent nighttime itching or a rash affecting several household members should be examined. The Dermatology Clinic can confirm the diagnosis, prescribe treatment and explain how to treat contacts and household items to prevent reinfestation. Contact us today to get scheduled.