Scabies

What is scabies?

Scabies is a disease of the skin caused by a mite (Sarcoptes scabiei var. hominis). These scabies mites burrow into the skin, producing intense itching and a pimple-like rash. This is referred to as an ‘infestation.’

Who gets scabies?

Anyone can have a scabies infestation. Scabies can affect people of any age, sex, race, or level of cleanliness. Even if a person has had a scabies infestation before, a person can be infested again if they are exposed to mites. Outbreaks of scabies often occur in nursing homes, institutions, schools, and child care centers.

How is scabies spread?

Scabies mites are spread from one person to another during direct skin-to-skin contact, including sexual contact. The mites do not jump from one person to another. Indirect transfer of mites in undergarments, sheets, or blankets can occur if these articles have been contaminated by an infested person immediately before use by another person. Killing mites and their eggs through treatment stops the spread of scabies.

What are the symptoms of scabies?

The most common symptoms of scabies are intense itching, especially at night, and a pimple-like itchy rash. The areas of the skin most often affected include the webbing between the fingers, wrists, elbows, armpits, waist, buttocks, genitals, nipples, and shoulder blades. People with scabies can also develop skin infections from scratching the rash. Signs of skin infection include redness, warmth, pain, tenderness, swelling, and pus at the site of infection.

How soon after exposure do symptoms appear?

The first time a person gets scabies, symptoms appear from 2–6 weeks after exposure. If a person has had scabies before, symptoms appear much more quickly, usually within 1–4 days of exposure.

How is scabies diagnosed?

A healthcare provider can diagnose scabies by looking at skin scrapings under a microscope. Applying ink to the skin also helps the healthcare provider identify scabies burrows.

What is the treatment for scabies?

Scabies can be treated with topical creams that can kill the mites. These topical creams contain permethrin, lindane, or crotamiton and are available by prescription from your healthcare provider. Medications should be used exactly as prescribed by your healthcare provider. Fingernails should be trimmed and cleaned to remove any mites or eggs. Persons who have had direct skin contact with an infested person (including family members, roommates, and sexual contacts) should be treated at the same time as the infested person to prevent reinfestation. Retreatment might be necessary if itching continues more than 2–4 weeks after treatment or if new burrows appear. Antihistamine or steroid medicines might be used to reduce the itching. Skin infections might require antibiotics.

Bedding, clothing, and towels used by an infested person should be decontaminated by machine-washing in hot water and drying using the hot cycle or by dry-cleaning. Items that cannot be washed or dry-cleaned can be placed in a sealed plastic bag for at least 72 hours.

How can scabies be prevented?

Avoid direct physical contact with infested people and their belongings, especially clothing and bedding, until 24 hours after treatment. To prevent further spread, persons with scabies should not attend school or daycare, or be at their workplace, until 24 hours after treatment.

How can I get more information about scabies?

• If you have concerns about scabies, contact your healthcare provider.
• Call your local health department. A directory of local health departments is located at the VDH Local Health Districts page.
• Visit the Centers for Disease Control and Prevention website at the CDC page on scabies.

September 2018