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  • Dr. Kaplan – Scabies


    Scabies is a common skin condition that is caused by a human mite that is so small it cannot be seen with naked eye. When your skin reacts to the mite, a very itchy rash develops.


    Scabies are contracted by skin-to-skin contact. The longer the contact, the more likely the mites can get on your skin. A quick handshake or brief hug does not spread mites. It can be contracted through sexual contact, or when sharing a towel, bedding or clothing with a person who have scabies.


    Scabies can affect anyone of all ages, sex, races, and income levels. Even people who are very clean and neat can get scabies.The following people have much greater risk, because of their frequent skin-to-skin contact with others or they have weak immune system:

    • Children
    • Mothers
    • Sexually active adults
    • Presidents of nursing homes, assisted-living residences, and extended care facilities
    • People with weak immune systems due to disease or immunosuppressive drugs
    • People who have had organ transplant
    • People often don’t know they have scabies for weeks, leaving many more people at risk of being exposed to the mites.


    Common signs and symptoms are:

    • Itching, especially at night
    • A rash that looks like red bumps, pimples or hives
    • Scratching, which can cause sores that may get infected
    • Bruising caused by intense scratching

    The symptoms do not appear for 2-6 weeks after being exposed to scabies. But if a person had previously had scabies, the itching usually begins within 1-4 days.

    The most common places on the body to find scabies are:

    • Hands, especially between the fingers and around the nails
    • Skin covered by jewelry, such as under a bracelet, watchband, or ring
    • Skin covered by clothing, such as on the elbows, buttocks, belt line, groin, penis, or around the nipples

    In children scabies and affect the entire body, including the palms, sols, and scalp. Children including babies who have scabies may be tired and irritable from lack of sleep because of itching that keeps them awake at night.


    A more severe form of scabies is known as the crusted, or Norwegian, scabies. These involve 100s to 1000s of mites in the skin, whereas a normal scabies have 10 to 15.Crusted scabies occurs mostly among those with weak immune system, and it is very contagious.

    With crusted scabies, the skin forms thick crusts that often cover large areas of the body. It also is possible to have it only on certain areas of the body such as the hands and feet. The crusts tend to crumble easily when touched and look gray in color.


    To diagnose scabies, a dermatologist will examine you from head to toe, scraping off a tiny bit of skin and looking at it under a microscope. If he sees scabies mites or their eggs, you have scabies.


    Treatment is essential for scabies. It should begin as soon as possible.Everyone with whom you have close contact should receive treatment at the same time, even if they do have any symptoms. Scabies can be passed to others before they are discovered. This includes:

    • Everyone in your household
    • Sexual partners
    • Residents and staff at nursing homes or assisted-living facilities
    • Day care or school classmates, teachers and other staff

    Medicine for scabies can only be obtained by prescription. Most medicines are topical, and include:

    • 5% permethrin cream is the most common treatment
    • 25% benzoyl benzoate lotion
    • 10% sulfur ointment used only on young children and pregnant women

    The above medicine is usually applied at bedtime. The same treatment will be repeated in exactly one week to treat any additional mites. Use exactly as directed by doctor, including washing yourself before application.

    Some people need additional treatment, and that may include:

    • An antihistamine, to control the itch and help you sleep
    • Pramoxine lotion, to control the itch
    • An antibiotic, to eliminate an infection
    • A steroid cream, to ease the redness, swelling, and itch


    • See a dermatologist as soon as you have symptoms or are told you have been around someone with scabies
    • Make sure that everyone with whom you have had close contact receives treatment. It can take 2-6 weeks for symptoms to appear.
    • If your treatment includes a medicine that is applied to the skin, apply to clean, dry skin. Be sure to apply it from your neck to your toes
    • If you wash your hands after applying, be sure to reapply the medicine to your hands
    • When starting treatment, wash all bedding, clothes, and towels you have touched during the past 6 weeks.
    • Use hottest water possible and dry everything in hot dryer.
    • Any items that cannot go in a washing machine should be dry cleaned or sealed in a plastic bag for at least 1 week.
    • Vacuum entire home, and throw away the vacuum bag, or if there is no bag, empty the canister and wash it with hot soapy water. If you cannot remove the canister, wipe it clean with a damp paper towel.



    All content solely developed by the American Academy of Dermatology.