Scabies

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KEY POINTS

• Scabies is a skin infection caused by very small bugs called mites that cause an itchy rash. Scabies mites easily spread from person to person through direct skin to skin contact or from clothing and bedding.
• Your healthcare provider will prescribe a skin cream that will kill the mites. Be sure you understand and follow the instructions that come with your medicine.
• To keep from getting infected again or spreading scabies, everyone living in your home may need to be treated at the same time.

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What is scabies?

Scabies is a skin infection caused by very small bugs called mites. The mites burrow into the skin, causing an itchy rash.

What is the cause?

Scabies mites easily spread from person to person through direct skin to skin contact or from clothing and bedding.

What are the symptoms?

Symptoms may include:

• A very itchy rash
• Tiny blisters or bumps, usually in a thin line, which break easily when scratched

Although the rash can start anywhere, it often starts on the hands, between the fingers or in a crease of the wrist. Other common areas for the mites are the nipples, waistline, and genital area. After the rash begins, it can spread to the whole body within a few days.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Your healthcare provider will ask if you have been exposed to someone who has scabies. Your provider may get a scraping from your skin to look for mites under the microscope.

How is it treated?

Your healthcare provider will prescribe a skin cream that will kill the mites. Be sure you understand and follow the instructions that come with your medicine.

If you are pregnant, ask your healthcare provider what treatment you should use.

Your healthcare provider may prescribe an antihistamine medicine that you take by mouth to help relieve the itching. Keep taking antihistamines as long as you have itching. You can also soothe itching by putting 1% hydrocortisone cream or calamine lotion on your skin.

You will keep having itching and a rash while the medicine is killing the mites. The itching and rash can last at least 2 to 4 weeks after treatment with the cream prescribed by your healthcare provider. This does not mean that the treatment didn't work or that it needs to be repeated. The symptoms will not go away until your body sheds the layers of skin that contain the bodies of the mites, their eggs, and their droppings.

Scabies is very contagious. The treatment will not be successful unless everyone infected in your home is treated. All household items that may have mites on them must also be disinfected. Scabies mites don’t survive more than 2 or 3 days away from human skin.

You may need a second treatment if:

• You have symptoms 4 weeks or more after your treatment with the cream.
• Your symptoms get much worse after your first treatment.

If your rash gets worse, with more redness, more tenderness, or a yellow crust, see your healthcare provider.

How can I help prevent scabies?

• To keep from getting infected again or spreading scabies, everyone living in your home may need to be treated at the same time.
• Vacuum everything carefully, including cracks and crevices. Make sure that you dispose of the contents of the vacuum cleaner container or the bag right away. Put the contents or bag in a sealed plastic bag to keep the bugs from getting out of the bag.
• When you start treatment, wash all the clothing, bedding, and towels that you have used in the past week in hot water (at least 120°F, or 49°C). Dry the clothes and other items in a clothes dryer on the high heat setting for 20 minutes. This should kill the mites. You can also put pillows and stuffed toys in the dryer, even if you can't wash them first.
• Put items that can't be washed into plastic bags. Keep them in the bags for at least 72 hours to kill the mites.