Scabies, a highly contagious skin condition, affects an estimated 200 million people worldwide at any given time. This itchy rash results from tiny mites, called Sarcoptes scabiei, burrowing into the skin. Experts emphasize that anyone can get scabies, and quick, comprehensive treatment for all close contacts is crucial to prevent its rapid spread.[nhs+2]
What is Scabies and How Does it Spread?
Scabies starts when microscopic mites, too small to be easily seen, burrow into the top layer of human skin. Female mites then lay two to four eggs each day, continuing this for their one to two-month lifespan. These eggs hatch in two to five days, and the young mites mature into adults within about three weeks, restarting the cycle.[who+3]
The primary way scabies spreads is through prolonged, direct skin-to-skin contact. This often includes intimate contact or sharing a bed. Brief interactions, like a quick handshake or hug, usually do not transmit the mites. However, the condition can spread easily within families, childcare groups, schools, or nursing homes due to close living conditions.Unlike some animal skin conditions, human scabies mites do not live on pets.[nhs+6]
Recognizing the Signs: Common Scabies Symptoms
The most noticeable symptoms of scabies are intense itching and a pimple-like rash. The itching often gets worse at night, sometimes making it hard to sleep. The rash may look red on lighter skin tones or appear as darker spots or tiny bumps on brown or black skin.[nhs+4]
Tiny burrow tracks, which are wavy, raised lines about 1 centimeter or less, can sometimes be seen on the skin. These burrows may have a tiny dark dot at one end, indicating the mite's location. Common areas for the rash and burrows include the skin between the fingers, around the wrists, under the arms, and on the waist, groin, and buttocks. In young children and older adults, the rash might also appear on the head, neck, palms of the hands, and soles of the feet.[nhs+6]
If a person has never had scabies before, symptoms can take four to eight weeks to appear. However, if someone has had scabies previously, symptoms might show up much faster, sometimes within 24 hours. Constant scratching can break the skin, leading to bacterial infections.[medicalnewstoday+3]
A more severe form, called crusted scabies or Norwegian scabies, can develop in people with weakened immune systems. This type features thick, crusted, flaky skin that contains millions of mites, making it extremely contagious even through brief contact or contaminated items like bedding.[nhs+4]
Getting a Diagnosis and Effective Treatment
Doctors diagnose scabies by examining the skin for typical rashes and burrows. They might also take a small skin scraping to look for mites, eggs, or mite waste under a microscope, which helps confirm the diagnosis.[mayoclinic+2]
Treatment for scabies requires prescription medication, as no effective over-the-counter options exist. These medications, called scabicides, kill the mites and their eggs. Topical creams, such as permethrin cream, are commonly prescribed. Patients apply these creams to their entire body, typically from the neck down for adults. For infants and young children, the cream must also cover the head and neck.[who+4]
Often, a second application of the cream is necessary seven days after the first to ensure all newly hatched mites are killed. Other topical treatments include sulfur cream, crotamiton cream or lotion, and benzyl benzoate lotion.[who+3]
In more severe cases, or when topical treatments are not effective, doctors may prescribe oral medication like ivermectin. This pill is often used for crusted scabies or for individuals with compromised immune systems. However, ivermectin is not recommended for pregnant or nursing women, or for children weighing less than 15 kilograms (33 pounds).[who+2]
It is important to remember that itching can continue for several weeks after successful treatment, even though all mites are dead. This is a normal part of the healing process as the body reacts to the remaining mite particles in the skin.[nhs+2]
Preventing Spread and Future Infestations
A critical part of scabies treatment and prevention is ensuring that all household members and other close contacts, including sexual partners, receive treatment at the same time. This is necessary even if they do not show symptoms, as scabies can spread before symptoms appear and untreated contacts can easily re-infest others.[nhs+5]
Beyond medication, thorough cleaning helps prevent re-infestation. All bedding, clothing, and towels used by an infested person should be washed in hot water, at least 60 degrees Celsius (140 degrees Fahrenheit), and then dried in a hot dryer cycle. Items that cannot be washed, such as stuffed animals or certain clothing, should be sealed in plastic bags for at least three to eight days. This starves the mites, as they typically die within two to three days away from a human host. Vacuuming carpets and upholstered furniture is also recommended.[nhs+5]
Avoiding direct skin-to-skin contact with someone who has scabies, especially if they have an active rash, is the best way to prevent getting the condition. By following treatment guidelines and taking preventative measures, communities can effectively manage and reduce the spread of scabies.[who]
