Bruce P.Robinson, MD


Scabies is an infestation of the skin by the human itch mite. The tiny mites burrow into the upper layer of the skin where it lives and lays its eggs. It has infested humans for at least 2,500 years. It is often hard to detect, and causes a fiercely itchy skin condition. Dermatologists estimate that more than 300 million cases of scabies occur worldwide every year. The condition can strike anyone of any race or age, regardless of personal hygiene. The good news is that with better detection methods and treatments, scabies does not need to cause more than temporary distress.

How Scabies Develops

The microscopic mite that causes scabies can barely be seen by the human eye. Being a tiny, eight-legged creature with a round body, the mite burrows in the skin. Within several weeks, the patient develops an allergic reaction causing severe itching; often intense enough to keep sufferers awake all night.

Human scabies is almost always caught from another person by close contact. It could be a child, a friend, or another family member. Everyone is susceptible. Scabies is not a condition only of low-income families and neglected children, although, it is more often seen in crowded living conditions with poor hygiene.

Attracted to warmth and odor, the female mite burrows into the skin, lays eggs, and produces toxins that cause allergic reactions. Larvae, or newly hatched mites, travel to the skin surface, lying in shallow pockets where they will develop into adult mites. If the mite is scratched off the skin, it can live in bedding for up to 24 hours or more. It may take up to a month before a person will notice the itching, especially in people with good hygiene and who bathe regularly.

What to Look For ...

The earliest and most common symptom of scabies is intense itching, especially at night. Little red bumps like hives, tiny bites, or pimples appear. In more advanced cases, a rash can spread slowly over a period of weeks or months and the skin may be crusty or scaly.

Scabies skin mite is about 0.4mm, just visible to the human eye

The scabies mite is very small, about the size of the tip of a needle and very difficult to see. It’s white to creamy-white in color. It has eight legs and a round body, which you can see if the mite is magnified. Scabies prefers warmer sites on the skin such as skin folds, where clothing is tight, between the fingers or under the nails, on the elbows or wrists, the buttocks or belt line, around the nipples, and on the penis. Mites also tend to hide in, or on, bracelets and watchbands, or the skin under rings. In children, the infestation may involve the entire body including the palms, soles, and scalp. The child may be tired and irritable because of loss of sleep from itching or scratching all night.

Bacterial infection may occur due to scratching. In many cases, children are treated because of infected skin lesions rather than for the scabies itself. Although treatment of bacterial infections may provide relief, recurrence is almost certain if the scabies infection itself is not treated.

How is Scabies Treated?

Your healthcare provider must order a cream that contains a medicine called permethrin to treat scabies. The cream is applied to your whole body below your head, including the hands, palms, and soles of the feet.

In children with scabies, the cream may need to be applied to the scalp. Be sure that skin is clean, cool and dry before applying the cream.

Permethrin cream is left on the skin for eight to 14 hours and then washed off. (The cream is most often applied at night and washed off in the morning.)

Ivermectin is another option for treating scabies. This is an antiparasitic pill given in a single dose, followed by a second dose one to two weeks later.

If you’re pregnant or lactating, you shouldn’t use ivermectin. If your child weighs less than 35 pounds (15 kilograms), they shouldn’t use ivermectin.

Your provider might also suggest antihistamines, which can be taken by mouth and as a cream, to relieve itching. Your provider will also treat any type of infection that may be present.

How soon are the mites killed?

The mites that cause scabies are killed after one treatment. The treatment doesn’t need to be repeated unless the infection doesn’t go away or comes back.

How soon does the itching stop?

The itching may take two to four weeks to go away, even though the mites have been killed.

How soon does the scabies rash go away?

Red bumps on the skin should go away within four weeks after treatment.

How can I prevent spreading scabies?

You can prevent spreading scabies by:

  • Washing bed linens, towels and clothing in hot water and machine dry.
  • Making sure family members and others in close contact with the infected person get checked for scabies.
  • Limiting close contact with others if you know you’ve got scabies.

Can a person get scabies more than once?

Yes. You can get scabies any time that you come into close contact with an infected person.

Will scabies go away on its own?

No, scabies won’t go away on its own. If you don’t treat it, you’ll probably continue to spread the disease to other people. In addition, the constant itching will probably lead to constant scratching and will cause some type of bacterial infection of the skin.

Is scabies hard to get rid of?

Scabies is treatable, but they can be hard to get rid of completely. Certain forms of scabies are harder to treat, such as the crusted form. In addition, you might need more than one round of treatment to make sure all of the mites are gone.

If you have a rash and it’s so itchy that you can’t sleep, make sure you contact your healthcare provider. You may have scabies, which is an infectious disease. You and other people close to you should be tested and treated. You’ll want to schedule an appointment with Dr. Robinson if you have any kind of skin rash that doesn’t go away and that causes problems for you. Scabies, like many other types of red itchy rashes, can be treated successfully.

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