What is scabies?

Scabies is a skin infestation caused by a tiny mite called Sarcoptes scabiei. The mites burrow into the upper layer of skin where they live and lay eggs, causing intense itching and a pimple-like rash.

Scabies is highly contagious and spreads quickly through close physical contact, making it common among sexual partners, household members, and in crowded living conditions. Similar to pubic lice (crabs), scabies is a parasitic infestation rather than a bacterial or viral infection.

Signs and symptoms of scabies

Scabies symptoms typically appear 4 to 8 weeks after initial infestation. However, if you’ve had scabies before, symptoms can develop within 1 to 4 days.

Common symptoms include:

Intense itching - Often worse at night
Pimple-like rash - Small red bumps or blisters
Thin, irregular burrow tracks - Tiny raised lines on the skin, often greyish-white
Sores from scratching - Can become infected with bacteria

Common locations:

Scabies mites tend to burrow in specific areas:

Between fingers and toes
Wrists and elbows
Armpits
Waist and belt line
Genital area
Buttocks
Around the nipples (in women)

In adults, scabies rarely affects the face, scalp, or neck, though infants and young children may have infestations in these areas.

How do you get scabies?

Scabies spreads through prolonged skin-to-skin contact with an infested person. This includes:

Sexual contact - The most common way scabies spreads among adults
Close physical contact - Hugging, holding hands, or sleeping in the same bed
Sharing personal items - Bedding, towels, or clothing (less common)

A quick handshake or hug is usually not enough for transmission. The mites need extended contact to crawl from one person to another.

Scabies can spread easily between sexual partners and household members. If one person in a household has scabies, everyone living there should be treated at the same time.

Testing for scabies

Scabies is usually diagnosed through a physical examination. A healthcare provider may:

Visual inspection - Look for characteristic burrows and rash
Skin scraping - Gently scrape a small area of skin to examine under a microscope for mites, eggs, or faecal matter
Ink test - Apply ink to the skin and wipe it off; ink remaining in burrow tracks confirms scabies

Because scabies can look similar to other skin conditions like eczema or dermatitis, proper diagnosis is important.

Treatment for scabies

Scabies is treated with prescription medications called scabicides that kill the mites and their eggs. Common treatments include:

Permethrin cream (5%) - Applied to the entire body from the neck down and left on for 8-14 hours before washing off
Ivermectin - An oral medication, sometimes used for severe cases or when cream treatments haven’t worked
Other topical treatments - Sulfur ointment or crotamiton may be prescribed in some cases

Important treatment steps:

Apply medication to clean, dry skin
Treat the entire body, not just areas with visible rash
All household members and sexual partners should be treated at the same time
Wash all bedding, clothing, and towels in hot water and dry on high heat
Items that can’t be washed should be sealed in a plastic bag for at least 72 hours

Itching may continue for 2 to 4 weeks after treatment, even if the mites are dead. This is a reaction to the mites and their waste in the skin and doesn’t mean treatment has failed.

Preventing scabies

To prevent scabies:

Avoid prolonged skin contact with anyone who has scabies
Treat all contacts - Sexual partners and household members should be treated simultaneously
Wash bedding and clothing in hot water if exposed
Avoid sharing personal items like towels and bedding with an infested person

Telling your partner about scabies

If you have scabies, it’s important to inform your sexual partners and anyone you’ve had close physical contact with. They need to be treated at the same time as you to prevent reinfection.

Notify your partners anonymously about scabies with TellYourPartner.com. This ensures they receive the information they need to get treated without revealing your identity.