Scabies is not an infection, but an infestation. Tiny mites called Sarcoptes scabiei set up shop in the outer layers of the human skin. The skind does not take kindly to the invasion. As the mites burrow and lay eggs inside the skin, the infestation leads to relentless itching and an angry rash.
When a person is infested with scabies for the first time, it can take four to six weeks for the skin to react. The most common symptoms are:
- Intense itching, especially at night
- A pimple-like rash
- Scales or blisters
- Sores caused by scratching
Scabies or Something Else?In its early stages, scabies may be mistaken for other skin conditions because the rash looks similar. This image compares acne, mosquito bites, and scabies. What sets scabies apart is the relentless itch. Itching is usually most severe in children and the elderly.
Where Do Scabies Mites Live? Scabies mites can live anywhere on the body, but some of their favorite spots include:
- Between the fingers
- The folds of the wrist, elbow, or knee
- Around the waistline and navel
- On the breasts or genitals
- The head, neck, face, palms, and soles in very young children
Can Scabies Mites Be Seen? Most people with scabies only carry 10 to 15 mites at any given time, and each mite is less than half a millimeter long. This makes them very difficult to spot. To the naked eye, they may look like tiny black dots on the skin. A microscope can identify mites, eggs, or fecal matter from a skin scraping
How Does Scabies Spread? Scabies typically spreads through prolonged, skin-to-skin contact that gives the mites time to crawl from one person to another. Shared personal items, such as bedding or towels, may occasionally be to blame. Scabies can be passed easily between family members or sexual partners. It is not likely to spread through a quick handshake or hug. The scabies mite can jump or fly, and it crawls very slowly.
In most cases, a doctor can identify scabies based on the appearance of the rash and your description of the itch. Sometimes a skin scraping is used to confirm the diagnosis. This involves collecting skin from the affected area and using a microscope to check the sample for mites, eggs, or fecal matter.
Treating Scabies: Rx Creams
Scabies will not go away on its own. It can only be cured with prescription medications that kill the mites. Treatment is a cream or lotion that is applied to the entire body from the neck down in most cases. It is left on for 8 to 14 hours and then washed off. In some cases, a doctor may prescribe pills to treat scabies. Treatment takes up to three days, depending on the medication used.
Treating Scabies: Itch Relief
While prescriptions can kill scabies mites and their eggs, they don't provide any immediate itch relief. To control itching, especially at night, antihistamine pills can help. Hydrocortisone cream may also help, but it can change the appearance of the scabies rash, making the condition harder to diagnose. It's best to use this cream only after your doctor has confirmed the diagnosis.
How Soon Will Scabies Go Away?
Scabies medications can kill the mites and eggs quickly, and patients can usually return to school or work 24 hours after starting treatment. However, the itch may persist for a few weeks. This is the result of an ongoing allergic reaction in the skin. If the itching continues for more than four weeks or a new rash appears, see your doctor. It may be necessary to reapply scabies medication.