Scabies

What is scabies?

Scabies is a skin condition caused by a mite (Sarcoptes scabiei var. hominis). The microscopic scabies mites burrow into the skin and lay eggs. This is referred to as an ‘infestation’ and commonly causes intense itching and a pimple-like rash.

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 childcare centers. Other high-risk locations for spread are homeless shelters and encampments.

How is scabies spread?

Scabies mites are spread from one person to another during direct skin-to-skin contact. The mites do not jump from one person to another. Less commonly, it is spread by sharing clothing, towels, or bedding with an infected 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 two to six weeks after exposure. If a person has had scabies before, symptoms appear much faster, usually within one to four days of exposure.

How is scabies diagnosed?

A healthcare provider may diagnose scabies based on a physical exam and history but will likely try to confirm 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 is treated with prescription creams, lotions, or pills that kill scabies mites. Medications should be used exactly as prescribed by a healthcare provider. Fingernails should be trimmed and cleaned to remove any mites or eggs. People 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 two to four 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.

Do people who have been in contact with someone with scabies need to be tested and treated?

Those who have been identified as having close skin to skin contact, particularly household contacts, are encouraged to seek treatment. Household members should be treated at the same time to prevent reinfestation. People who have shared clothing, bedding, or towels should also be treated.

How can scabies be prevented?

Avoid direct physical contact with a person who has scabies and their belongings, especially clothing and bedding, until after treatment has been completed. To prevent further spread, persons with scabies should not attend school, daycare, or be at their workplace, until at least 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. You can find your local health department at vdh.virginia.gov/health-department-locator/.
• Visit the CDC page on scabies at cdc.gov/scabies/about/index.html for more information.