Rash: Many people get the scabies rash. This rash causes little bumps that often form a line. The bumps can look like hives, tiny bites, knots under the skin, or pimples. Some people develop scaly patches that look like eczema.
The main symptoms of scabies are intense itching and a rash in areas of the body where the mites have burrowed. The itching is often worse at night, when your skin is warmer. It may take 4 to 6 weeks before the itching starts because this is how long it takes for the body to react to mite droppings.
Unfortunately, in practice, scabies is largely diagnosed based only on the clinical picture, which may lead to a misdiagnosis. A broad differential diagnosis of scabies can include atopic dermatitis (AD), allergic contact dermatitis, nummular eczema, arthropod bites, dermatitis herpetiformis, etc. (1, 7).
A common sign of crusted scabies is widespread crusts on the skin. These crusts tend to be thick, crumble easily when touched, and look grayish in color. Sometimes the crusts appear on one or a few areas of the body such as the scalp, back, or feet.
Scabies is caused by a tiny, eight-legged mite. The female mite burrows just under the skin and makes a tunnel where it lays eggs. The eggs hatch, and the mite larvae travel to the surface of the skin, where they mature. These mites can then spread to other areas of the skin or to the skin of other people.
The scabies rash takes the form of small, red bumps that may look like pimples, bug bites, hives or knots under the skin. You might be able to see the burrow tracks created by the mites, which appear as raised lines of tiny blisters or bumps. Some people develop scaly patches that resemble eczema.
Scabies sometimes leave noticeable burrows on the skin. The result of female tunneling, burrows looks like small, raised lines on the surface of the skin and may appear skin-colored or grayish-white. Burrows can be difficult to find if only a few mites are living in the skin.
The most common symptoms of scabies are intense itching and a pimple-like skin rash. The scabies mite usually is spread by direct, prolonged, skin-to-skin contact with a person who has scabies. Scabies occurs worldwide and affects people of all races and social classes.
Can I test myself at home for scabies? There is no self-test for scabies. You can become familiar enough with the physical symptoms to suspect you've been infected with the mites that cause scabies, but you can't know for sure without being diagnosed by a healthcare provider.
Can Scabies Mites Be Seen? Most people with scabies only carry 10 to 15 mites at any given time, and each mite is less than half a millimeter long. This makes them very difficult to spot. To the naked eye, they may look like tiny black dots on the skin.
Permethrin kills the scabies mite and eggs. Permethrin is the drug of choice for the treatment of scabies. Two (or more) applications, each about a week apart, may be necessary to eliminate all mites. Children aged 2 months or older can be treated with permethrin.
Small, raised, crooked lines on your skin (caused by the scabies mites burrowing under the surface of your skin).
Itch can deteriorate over the night (nocturnal crescendo). This, however, is not specifically applicable to scabies, as other common skin diseases also display a nighty worsening of itch, that is, atopic dermatitis and psoriasis (19–22).
In addition, when treating infants and young children, scabicide lotion or cream also should be applied to their entire head and neck because scabies can affect their face, scalp, and neck, as well as the rest of their body.
How long does it take before a person with scabies has symptoms? In people that have never been infested with scabies before, symptoms (like itching and redness of the skin) usually appear 2 to 6 weeks after coming in contact with someone who has scabies and becoming infested.
Scabies can spread rapidly under crowded conditions where close body and skin contact is frequent. Institutions such as nursing homes, extended-care facilities, and prisons are often sites of scabies outbreaks. Child-care facilities also are a common site of scabies infestations.
Key points about scabies
Scabies mites are very contagious. They often spread from person to person while they are sleeping in the same bed, or during other close contact. Scabies should be treated quickly to keep the mites from spreading.
Scabies is highly contagious and is spread by close contact. If untreated, it can last indefinitely. Scabies is not caused by poor hygiene.
Items like bedding, clothing, and towels used by an infested person can be cleaned by washing with hot water and drying on high heat. For items that cannot be washed, store in a sealed plastic bag for at least 72 hours to kill any mites. Vacuum and clean rooms and furniture used by the person with scabies.
Medicines work quickly to kill the mites, but the itchy rash may last for several weeks after treatment. Marks on the skin from scabies usually go away in 1 to 2 weeks, but sometimes take a few months to go away.
Crotamiton cream or lotion (10%): Approved to treat scabies in adults, this medication usually requires two applications. You apply the second application 24 hours after the first. Benzyl benzoate lotion (25%): This may be used to treat crusted scabies.