Scabies is a skin infestation caused by tiny, microscopic mites called Sarcoptes scabiei. These mites burrow into the upper layer of your skin to live and lay eggs, leading to an allergic reaction that causes intense itching.
If you suspect you have scabies, it is important to see a healthcare provider, as it will not go away on its own and is highly contagious.
Key Symptoms
Intense Itching: This is the most common sign. It is often severe and typically worse at night.
The Rash: Look for small, pimple-like bumps or blisters. They often appear in “tracks” or thin, wavy lines (burrows) where the mite has traveled.
Common Areas: Mites prefer skin folds and tight areas, including:
Between the fingers and on the wrists.
Elbows and armpits.
Around the waistline and buttocks.
Around the nipples (in women) or the penis (in men).
How It Spreads
Scabies is usually passed through direct, prolonged skin-to-skin contact (e.g., holding hands, living in the same house, or sexual contact).
Brief contact like a handshake or a quick hug usually isn’t enough to spread it.
Indirect contact through shared bedding, towels, or clothing is possible but less common, as the mites can only survive about 48–72 hours away from human skin.
Treatment & Management
Because it is a parasitic infestation, over-the-counter (OTC) creams generally do not work. You need a prescription scabicide.
1. Medical Treatment
Permethrin Cream (5%): The most common treatment. It is applied from the neck down, left on for 8–14 hours (usually overnight), and then washed off.
Ivermectin: An oral medication sometimes prescribed for difficult cases or for those who cannot use topical creams.
Repeat Treatment: A second dose is almost always required 7 days after the first to kill any mites that hatched from eggs after the initial treatment.
2. Household Decontamination
To prevent re-infestation, you must treat your environment on the same day you start your medication:
Wash: All clothing, bedding, and towels used in the last 3 days should be washed in hot water (60°C / 140°F) and dried on a high-heat cycle.
Seal: Items that cannot be washed should be sealed in a plastic bag for at least 3 to 7 days. The mites will starve without human contact.
Treat Everyone: All household members and sexual partners should be treated at the same time, even if they have no symptoms.
What to Expect
Itching persists: It is normal to keep itching for 2–4 weeks after the mites are dead. This is because your body is still reacting to the mite debris left in the skin. Your doctor may suggest antihistamines or hydrocortisone to help.
Return to work/school: Most people can return 24 hours after their first full treatment.