Scabies Basics

General information about scabies, including symptoms, complications, treatment, and prevention.

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What is scabies?

Scabies is an itchy skin rash caused by mites that spread from person to person. The mites can only be seen using a microscope and burrow into the skin to lay eggs.
Crusted scabies, commonly known as Norwegian scabies, is a rare and severe form of scabies. People affected by crusted scabies have crusted areas of skin with large numbers of scabies mites. This form of scabies is very contagious.

Who can get scabies?

Scabies can affect anyone regardless of gender, race, or socioeconomic status. Crusted scabies typically occurs in those with immune system problems, the disabled, or in elderly persons.

How does a scabies infestation occur?

Scabies is usually spread through direct skin-to-skin contact with an infected person such as sexual partners or household members. Scabies can also be spread by an infected person sharing items like clothing or bedding. Infestations can affect facilities where close body contact often occurs such as nursing homes, prisons, and childcare facilities.

What are the signs of a scabies infestation?

The most common signs of scabies are intense itching and a pimple-like rash, which can occur two to six weeks after becoming infested. Symptoms can occur anywhere on the body; however, commonly affected sites include wrists, between fingers, elbows, armpits, waist, and buttocks.
Tiny burrows can sometimes be seen on the skin. The burrows appear as tiny, thin lines on the skin. These are made from the female mites creating tunnels to lay their eggs.

How do you diagnose scabies?

Scabies is typically suspected based on the appearance of a rash and the presence of burrows. A diagnosis should be confirmed by a health care provider performing a skin scraping to look for mites, eggs, or their fecal matter.

How do you treat scabies?

Topical medications called scabicides are used to treat scabies in people by killing the mites. Scabicides must be prescribed by a doctor and are not available over the counter (OTC). OTC products have not been approved for human use and OTC anti-itch products do not kill the mites.
Always follow the exact instructions for applying the medication. Typically, a lotion or cream is applied from the neck down on adults and all over the body on children. It should be left on for the recommended amount of time. Itching may continue for two to four weeks following treatment even if all the mites are gone. Anti-itch medications may be useful to help control symptoms after treatment.

Who should be treated for scabies?

Anyone diagnosed with scabies should be treated. Additionally, sexual partners, household members, or other contacts who have had prolonged skin-to-skin contact with the person with scabies should be treated. If someone in a household has scabies, all persons in the household should be treated at the same time.

How should you clean the environment?

Scabies mites do not survive off the human body more than two or three days and they do not reproduce off the body. Items like bedding, clothing, and towels used by an infested person can be cleaned by washing with hot water and drying on high heat. For items that cannot be washed, store in a sealed plastic bag for at least 72 hours to kill any mites. Vacuum and clean rooms and furniture used by the person with scabies. This is especially recommended in the case of crusted scabies. The use of insecticides is not recommended for environmental control.

How do you prevent the spread of scabies?

Avoid direct skin-to-skin contact with a person with scabies. Also, avoid contact with items used by the infested person such as clothing and bedding. All infested items should be decontaminated by hot washing and drying cycles. Thoroughly clean and vacuum rooms and furniture if the person has crusted scabies. If a member of a household has scabies, all persons living in the household should be treated at the same time to prevent re-infestation.

Outbreaks that occur in health care settings can affect patients, visitors, and workers. For guidance on controlling scabies in a healthcare setting in Minnesota, call 651-201-5414.