Scabies is an itchy rash that develops with infestation of the skin by a microscopic mite called the human itch mite. This eight-legged mite burrows in the very top layer of the skin, feeds there, and lays eggs giving rise to increasing numbers of mites if left untreated. The mite can be transferred to other people and is spread by direct skin-to-skin contact. Rarely, mites can be picked up from infested bedding, clothing, or furniture, but the mites only survive up to 3-4 days off of a human. Anyone can get scabies. If it is the first time for someone to get this infestation, it may take 2-6 weeks for the itchy rash to develop. If someone has had it before, itching may develop within 1-4 days of a new infestation.
Sign and symptoms of scabies infestation include:
- Rash: little red bumps, and sometimes little burrow lines in finger webspaces
- Itching: This is the most common symptom and is usually worst at night.
- Sores: Intense scratching can lead to sores from breaking open the skin.
- Thick dry crusts: A severe type called crusted scabies or Norwegian scabies can cause thick, dry, crusty buildup on the skin. This most often affects elderly in nursing homes or people who are immunosuppressed. This is a highly contagious form of the disease.
Scabies can cause a rash in the scalp of infants and young children, but in adults the mites rarely cause rash above the neck. Hands, arms, groin and genitalia, and the lower back and lower abdomen are very common places for the rash to appear.
A dermatologist will likely suspect the diagnosis of scabies upon visual inspection and gathering of information through questions, but a skin scraping of some of the lesions of the rash will help to make the definitive diagnosis using a microscope in the office. Your dermatologist will treat scabies with either a prescription cream, lotion, or pill medication. The person diagnosed along with everyone who has had close contact with that patient will all require treatment, even people without any signs or symptoms. Scabies can be transmitted back and forth in a household if everyone is not appropriately treated at the same time. Your dermatologist will give you specific instructions for how to take the medication and when everyone should be treated. Along with treatment for clearing the infestation, other medications may be used to calm the symptoms, which include antihistamines, pramoxine or menthol lotion, or a corticosteroid cream. Lastly, it is important to wash all bedding, towels, and clothing with very hot water and to vacuum your entire home on the day of treatment. All of this should be repeated with treatment is repeated according to your dermatologist’s instructions.