Scabies

Common symptoms of scabies include:

• Intense itching, often worse at night
• Small red bumps, blisters, or pimples
• Thin, raised lines or burrows on the skin
• Skin irritation or sores from scratching

Symptoms may appear weeks after first exposure in people who have never had scabies before.

Scabies is caused by the mite Sarcoptes scabiei, which goes through four stages:

• Egg – Female mites burrow into the skin and lay several eggs daily
• Larva – Eggs hatch into larvae that move to the skin’s surface
• Nymph – Larvae mature into nymphs with four pairs of legs
• Adult – Adult mites continue the cycle by burrowing and reproducing

In first-time infestations, symptoms can take up to 4–6 weeks to appear. Repeat infestations usually cause symptoms within days.

In severe cases, crusted (Norwegian) scabies may develop, involving thousands of mites. This form is most common in people with weakened immune systems.

Scabies is caused by direct infestation with Sarcoptes scabiei mites. The mites burrow into the skin to live and lay eggs. The body’s allergic reaction to the mites, eggs, and waste causes the intense itching and rash.

Scabies does not resolve on its own. With proper treatment, mites are killed quickly, but itching and rash may persist for 2–4 weeks as the skin heals.

Re-infestation can occur if the environment or close contacts are not treated properly.

No. Prescription treatment is required to eliminate scabies mites completely.

Scabies mites prefer warm skin folds and tight spaces, including:

• Between fingers and toes
• Wrists, elbows, and knees
• Waistline and buttocks
• Thighs and groin
• Under fingernails
• Beneath rings, watches, or bracelets
• Around the nipples

In infants and older adults, scabies may also affect the scalp, face, palms, or soles.

Yes. Scabies spreads easily through:

• Prolonged skin-to-skin contact
• Sharing bedding, clothing, or towels
• Close household or sexual contact

Because of how contagious it is, close contacts often need treatment at the same time.

Scabies can resemble eczema, hives, bed bug bites, or lice. Features that suggest scabies include:

• Severe itching that worsens at night
• Visible burrows or thin, wavy lines in the skin
• Rash in typical scabies locations (hands, wrists, waist, groin)

A medical provider can help confirm the diagnosis.

You can reduce the risk of spreading scabies by:

• Washing bedding, towels, and clothing in hot water
• Drying items on high heat
• Treating all close contacts simultaneously
• Avoiding close physical contact until treatment is complete
• Completing the full course of prescribed medication

Scabies must be treated with prescription medication. Common topical treatments include:

• Permethrin cream
• Crotamiton cream or lotion
• Benzyl benzoate lotion

Providers may also prescribe medications to relieve itching, inflammation, or secondary infections.

While prescription medication is required to kill the mites, home care can help relieve symptoms:

• Cool compresses or ice packs
• Oatmeal baths
• Fragrance-free moisturizers
• Calamine or menthol lotions
• Topical products containing pramoxine

These do not replace medical treatment.

Scabies treatment may include:

• Topical permethrin or crotamiton
• Oral ivermectin (in certain cases)
• Antihistamines for itching
• Antibiotics if infection develops from scratching

Your provider will recommend the most appropriate option.

Most treatments kill mites after the first application. However, itching and rash may continue for several weeks, even after successful treatment.

Untreated scabies can lead to serious complications, including:

• Severe skin infections
• Bloodstream infections
• Kidney disease
• Increased risk of spreading scabies to others

Early treatment is important.

With proper treatment, scabies usually stops being contagious within 24 hours after medication is started.

Yes. You can complete a quick online assessment and consult with a licensed medical provider. If appropriate, prescription scabies treatment can be sent discreetly to your home or local pharmacy.