Scabies: Causes, Risk Factors, Symptoms, Treatment


Scabies is a highly contagious skin infestation caused by the Sarcoptes scabiei mite. It spreads through close personal contact and manifests as intense itching, particularly at night. The mites burrow into the skin to lay eggs, leading to redness, rash, and small raised bumps. Commonly affected areas include between fingers, wrists, elbows, and genitals. Treatment involves prescription creams or lotions to kill the mites and relieve symptoms. Prompt treatment is essential to prevent spreading the infestation to others.

Symptoms of Scabies

If you suspect you or someone else is experiencing Scabies, it is crucial to seek immediate medical attention by calling emergency services or consult with a Dermatologist.


Sarcoptes scabiei: Infestation by the microscopic mite, Sarcoptes scabiei, which burrows into the skin to live and lay eggs.
Direct Skin-to-Skin Contact: The primary mode of transmission is direct, prolonged skin-to-skin contact with an infected person. This allows the mites to move from one person to another.
Sexual Contact: Scabies can spread through sexual contact, as the mites can move easily between partners during intimate contact.
Close Personal Contact: Sharing of bedding, towels, or clothing with an infected individual can facilitate transmission of the mites.
Crowded Living Conditions: Scabies outbreaks are more common in crowded environments such as nursing homes, childcare facilities, and prisons, where close contact is frequent.
Prolonged Contact: Mites can survive for a short period away from human skin, so prolonged contact with contaminated objects like furniture or bedding can also lead to transmission.
Poor Hygiene: While scabies is not directly caused by poor hygiene, overcrowded and unsanitary living conditions can contribute to its spread.

Risk Factors

  • Close Contact: Direct, prolonged skin-to-skin contact with an infected person is the primary risk factor.
  • Crowded Environments: Living in or frequenting crowded places such as nursing homes, prisons, or childcare facilities increases the risk.
  • Sexual Contact: Transmission through sexual activity, especially in sexually active individuals.
  • Sharing Personal Items: Sharing clothing, towels, bedding, or other personal items with an infected person.
  • Weakened Immune System: Conditions such as HIV/AIDS, leukemia, or undergoing immunosuppressive therapy increase susceptibility.
  • Age: Infants and elderly individuals may be at higher risk due to weaker immune responses and close living conditions.
  • Poor Hygiene: Although scabies can affect anyone regardless of hygiene, poor hygiene may contribute to easier transmission.
  • Healthcare Settings: Healthcare workers and patients in hospitals may be at increased risk due to close contact and compromised immunity.
  • Migrant Workers: People living in migrant worker camps or temporary housing where there is close living and working proximity.


  • Intense Itching: One of the hallmark symptoms of scabies is severe itching, especially at night. The itching is often more intense in areas where the mites have burrowed under the skin.
  • Skin Rash: Scabies can cause a rash that appears as small red bumps or blisters on the skin. These bumps may be accompanied by thin, irregular burrow tracks made by the mites.
  • Burrows: Mites create tiny, thread-like burrows in the skin where they lay eggs. These burrows are often difficult to see but may appear as fine, wavy lines.
  • Sores: Constant scratching due to itching can lead to open sores or secondary bacterial infections on the skin.
  • Common Areas: Scabies typically affects warm areas of the body such as the folds of the skin, between fingers, wrists, elbows, armpits, waistline, genitals, and buttocks. In children and infants, the scalp, face, neck, palms, and soles of the feet may also be affected.
  • Transmission: It spreads through direct, prolonged skin-to-skin contact with an infected person. Sharing bedding, towels, or clothing with someone who has scabies can also spread the infestation.
  • Symptoms Duration: Symptoms may take several weeks to develop after initial exposure, and a person can spread scabies even before symptoms appear.

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Clinical Examination: A healthcare provider examines the skin, looking for characteristic signs such as burrows, rash, and intense itching, especially in typical areas like between fingers, wrists, elbows, armpits, waistline, genital area, and buttocks.
Patient History: Gathering information about symptoms, duration of itching, and any recent contacts with individuals who have similar symptoms is crucial. It helps in understanding the likelihood of scabies transmission.
Skin Scraping: A skin scraping may be performed where a scalpel blade or a glass slide is used to gently scrape the skin to collect samples of skin tissue and mites for microscopic examination.
Microscopic Examination: The collected skin scrapings are examined under a microscope to identify the presence of scabies mites, eggs, or fecal matter (scybala).
Dermoscopy: Dermoscopy, using a handheld device with magnification and light, can aid in visualizing characteristic features of scabies mites or burrows on the skin.
Biopsy (Rarely): In cases where diagnosis is unclear, a skin biopsy may be performed to examine skin tissue under a microscope for confirmation.
Response to Treatment: Sometimes, diagnosis is confirmed if symptoms improve significantly after treatment with scabicidal medications, suggesting the presence of scabies.


Topical Medications: Prescription creams or lotions containing permethrin (5%) are commonly used. These are applied over the entire body from the neck down and washed off after a specified period.
Oral Medications: In cases where topical treatments are ineffective or impractical, oral medications such as ivermectin may be prescribed.
Antihistamines: These help reduce itching and discomfort caused by scabies.
Steroid Creams: In some cases, steroid creams may be prescribed to reduce inflammation and itching.
Treating Close Contacts: It's crucial to treat all household members and close contacts simultaneously to prevent re-infestation.
Environmental Measures: Washing bedding, clothing, and towels in hot water and vacuuming carpets and furniture can help eliminate mites from the environment.
Follow-Up: Follow-up with a healthcare provider is essential to ensure treatment success and monitor for any complications or recurrence.

Preventive Measures

Maintain Personal Hygiene: Regularly wash hands with soap and water, especially after direct contact with an infected person.
Avoid Direct Skin-to-Skin Contact: Minimize close contact with individuals known to have scabies.
Clean Bedding and Clothing: Launder bedding, towels, and clothes in hot water and dry on high heat to kill mites.
Isolate Infected Individuals: Encourage infected persons to avoid close contact until treatment is complete.
Treat Close Contacts: Proactively treat household members and close contacts to prevent spread.
Avoid Sharing Personal Items: Refrain from sharing clothing, towels, or bedding with others.
Environmental Cleaning: Thoroughly clean and vacuum living spaces, focusing on areas where infested individuals have spent time.

Do's & Don’t's

Do's Don't
Do seek medical attention Don't ignore symptoms or delay treatment
Do follow the doctor's treatment plan Don't use over-the-counter treatments without consulting a healthcare professional
Do wash all bedding, clothing, and towels in hot water Don't share clothing, towels, or bedding with others
Do vacuum carpets and furniture regularly Don't scratch affected areas excessively
Do inform close contacts about the condition Don't engage in close physical contact until treatment is completed
Do trim fingernails to reduce scratching Don't use scented lotions or perfumes on affected areas
Do maintain good hygiene practices Don't assume the condition will go away on its own

If you suspect you or someone else is experiencing Scabies, it is crucial to seek immediate medical attention by calling emergency services or consult with a Dermatologist.

Frequently Asked Questions
Scabies typically presents with intense itching, especially at night. Other common symptoms include a rash consisting of small red bumps or blisters, and the presence of burrows on the skin.
Scabies is highly contagious and can spread through close physical contact with an infected person. It can also be transmitted through sharing personal items such as clothing, bedding, or towels.
Symptoms of scabies may take anywhere from 2-6 weeks to appear after initial exposure to the mites. However, if a person has had scabies before, symptoms may develop much sooner (within a few days).
Yes, scabies can be effectively treated with prescription medications such as topical creams or oral medications. It is important to follow your healthcare provider's instructions carefully and complete the full course of treatment to ensure eradication of the mites.
While it may not always be possible to prevent getting scabies, there are certain precautions that can reduce your risk of infection. Avoid close contact with individuals who have active infestations and refrain from sharing personal items.
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