Scabies is an infection caused by very tiny mites that burrow into the skin. The mites are called Sarcoptes scabiei. They cause severe itching. Though children are most commonly infected, anyone can get scabies. Scabies mites can pass from person to person through close physical contact. They can also be passed through shared clothing, towels, and bedding. Scabies infection is not usually dangerous, but it is uncomfortable. Because it is so contagious, scabies should be treated immediately to keep the infection from spreading.
Symptoms of scabies appear about 2 to 6 weeks after infection in a child or adult who has never had scabies before. A child or adult who has been infected before will experience symptoms much sooner, in 1 to 4 days. Signs of scabies infection may include:
Intense itching, especially at night or after a hot bath
Skin irritations that look like hives, insect bites, pimples, or blisters, especially on warmer areas of the body (such as between the fingers, in the armpits, and in the creases of the wrists, elbows, and knees)
Sores on the body caused by scratching (the sores may become infected)
Burrows created by mites traveling under the skin, which look like lines on the skin’s surface
Treating scabies infection
Scabies infections are usually treated with a prescription lotion that kills the mites. The lotion must be applied to the entire body from the neck down. This includes the palms of the hands, soles of the feet, groin, and under the fingernails. The lotion must be left on for 8 to 14 hours. In some cases, a second application of lotion is needed a week after the first. Medicines work quickly, but most children and adults continue to have an itchy rash for several weeks after treatment. Marks on the skin from scabies usually go away in 1 to 2 weeks, but sometimes take a few months to clear.
Preventing spread of the infection
To prevent reinfection and the spread of scabies to others, follow these instructions:
Wash the infected person’s clothing, towels, bed linens, cloth toys, and other personal items in very hot, soapy water. Dry them thoroughly. Do not share among family members.
Seal items that can’t be washed in plastic bags for 2 weeks.
Vacuum floors and furniture. Throw the vacuum bag away afterward.
Notify an infected child’s school and caregivers so that other children can be checked and treated.
Keep an infected child home from daycare or school until the morning after treatment for scabies.
Warn children not to share items such as clothing and towels with other children.
You may need to treat all household members who may have been exposed to scabies, whether they show symptoms or not. Talk with your healthcare provider.
Do not spray your house with chemicals or pesticides. These can be dangerous to your family’s health.
When to call your healthcare provider
Call your healthcare provider right away if any of the following occur:
The infected person has a fever, red streaks, pain, or swelling of the skin.
Sores get worse or do not heal.
New rashes appear or itching continues for more than 2 weeks after treatment.
March 24, 2018
Bass, Pat F. III, MD, MPH,Image reviewed by StayWell medical illustration team.,MMI board-certified, academically affiliated clinician