Frequently Asked Questions

Answers to the most commonly asked questions about Scabies

What is Scabies?

Scabies is caused by the human itch mite Sarcoptes scabiei. This microscopic mite will burrow underneath the skin where it lives, breeds and lays eggs.  

The mite causes a very intense itch, particularly at night.  The most common signs is a pimple-like itchy rash.

The itching and rash each may affect much of the body. Common sites where the Scabies mite likes to burrow is the wrist, elbow, armpit, webbing between the fingers, nipple,groin area, waist, belt-line, and buttocks. The rash also can include tiny blisters and scales. Scratching the rash can cause skin sores which can cause secondary infection.
Once a person has been infested with the scabies mite, symptoms make take up to 4-6 weeks to appear.  Even if a person is not showing symptoms during this time, they are contagious and can spread the infestation.

How do you get Scabies?

The WHO considers scabies to be a water-related disease because of the connection between bathing and personal hygiene to prevention or control of its spread.  However, the mite that causes scabies is not dependent on water for transmission or for any part of its life cycle.

Scabies is a contagious skin infection that spreads rapidly in crowded conditions and is found worldwide.

Scabies is spread by direct skin-to-skin contact and to a lesser extent through contact with infested clothing, towels, and bedding. Environments that are particularly vulnerable to the spread of scabies include hospitals, childcare facilities and any crowded living conditions.

Contact generally must be prolonged; a quick handshake or hug usually will not spread scabies. Scabies is spread easily to sexual partners and household members. Scabies in adults frequently is passed between sexual partners.

Scabies sometimes is spread indirectly by sharing articles such as clothing, towels, or bedding used by an infested person; however, such indirect spread can occur much more easily when the infested person has crusted scabies.

Scabies mites are found worldwide, affecting all socioeconomic classes and in all climates.
However, according to the World Health Organization, epidemics have been linked to poverty, poor water-supply, sanitation and overcrowding.

What Does Scabies Feel Like?

One of the most common symptoms of scabies is intense itching.  The itch is so relentless; you just want to rip your skin off.

Some people experience a crawling sensation associated with the itch.

Itching tends to become worse at night, during exercise, and with hot baths.

Even though the itch is insidious, you really should avoid scratching as much as possible.

Every time you scratch, you’re likely to pick up mites and dead skin underneath your fingernails. Not only will you be spreading the mites across your body, you will be spreading them throughout your environment.

When you scratch elsewhere on your body, you will be spreading the mite to other parts of your body.

You can also spread the mites to surfaces you touch and potentially infect someone else.

With heavy scratching the mites and dead skin can be introduced into the open and will fall to the ground and contaminate your carpet, couch, car, etc.

Although the mites can live up to 72 hours without a host, if they are attached to pieces of dead skin, their lifespan can be extended putting others at risk of becoming contaminated.

Scratching also brings about risk of secondary infection.

If you must scratch, one way to scratch without damaging your skin and spreading the mites is by wearing gloves, particularly at night when the itch is at its worst.

How do I know if I have Scabies?

Scabies can often be confused for bed bug bites or mosquito bites or some sort of allergic reaction.

Scabies is very contagious so you want to treat it ASAP before it gets worse and to prevent spreading it to others.

How do you determine and diagnose if you do have Scabies?

Here are some tell tale symptoms to help determine if you have Scabies:

1. Itching
Scabies causes a very intense itch and you can find yourself itching uncontrollably, particularly at night.

You may notice a spot or two that will not stop itching no matter what you do.

After a few days, the itch may begin to spread to other parts of your body.
2. Rash
The Scabies mite causes a rash. You’ll see bumps start to form which is where the eggs were laid.

The bumps will form a line which is where they burrrow. You’ll want to take note of where these bumps are located. The scabies mite likes to make their home on parts of your body where the skin folds over itself or touches itself on creases.

Often times they are found between your legs, your toes and your fingers, inside your elbows and wrists, genital areas and under your breasts.

3. Are you noticing crusts on your skin?
If you are noticing skin crusts, that is a sign of crusted scabies. Crusted scabies develops when a person’s body cannot develop any resistance to the mites. Without resistance, the mites quickly multiply.

A common sign of crusted scabies is widespread crusts on the skin that tend to be thick and crumble easily when touched.

Who should be treated for Scabies?

Anyone who is diagnosed with scabies, as well as their sexual partners and other contacts who have had prolonged skin-to-skin contact with the infested person, should be treated. Treatment is recommended for members of the same household as the person with scabies, particularly those persons who have had prolonged skin-to-skin contact with the infested person. All persons should be treated at the same time to prevent reinfestation.

Scabies mites do not survive more than 2-3 days away from human skin. Items such as bedding, clothing, and towels used by a person with scabies can be decontaminated by machine-washing in hot water and drying using the hot cycle or by dry-cleaning.

Items that cannot be washed or dry-cleaned can be decontaminated by removing from any body contact for at least 72 hours.

Because persons with crusted scabies are considered very infectious, careful vacuuming of furniture and carpets in rooms used by these persons is recommended.
Fumigation of living areas is unnecessary.

What Kind of Doctor Treats Scabies?

Scabies is highly contagious. If you suspect you may have scabies, you’ll want to see a doctor for proper diagnosis and treatment.

The type of doctor you will want to see is a dermatologist. aka, skin doctor.

A dermatologist deals with the structure, function, and disorders of the skin, hair and nails.

A dermatologist evaluates and treats skin rashes, growths, infections, hair loss, and nail problems. Dermatologists remove warts, biopsy skin for skin cancers, and treat skin cancer of mouth, and external genitalia. Disorders a dermatologist treats include nail fungus, psoriasis, dermatitis, eczema, acne, rosacea, urticaria, scabies, herpes zoster, ring worm, hives, dandruff, and fungal infections. Dermatologists have extensive experience in treating skin cancers, moles, skin tumors, contact dermatitis and infectious diseases. Dermatologists manage scars and other cosmetic disorders.

A dermatologist can diagnose scabies by visually examining a patient’s skin from head to toe.

To determine and properly diagnose if a patient has scabies, a dermatologist will scrape off a tiny bit of skin. This is painless. The doctor will put the skin on a glass slide and look at the slide under a microscope. If the doctor sees scabies mites or their eggs, you do indeed have scabies and can prescribe proper treatment.

You can refer to the American Academy of Dermatology to find a qualified dermatologist in your area.

How is scabies treated?

If you suspect you have scabies, you’ll want to get it diagnosed and treated ASAP to prevent re-infestation and spreading it to others.

While you are undergoing treatment, those you have come in close contact with, sexual partners and household members should also be treated for scabies even if they are not showing signs of infestation to prevent the spread and re-infestation of scabies.

A doctor will prescribe a “scabicide”. Scabicides are used to treat human scabies and are available only with a doctor’s prescription.

While undergoing treatment, it is very important that you carefully follow treatment instructions.

The lotion or cream should be applied to a clean body and left on for the recommended time before washing it off. Clean clothing should be worn after treatment.

Because the symptoms of scabies are due to an allergy to mites and their feces, itching still may continue for several weeks after treatment even if all the mites and eggs are killed.

If itching still is present more than 2 to 4 weeks after treatment or if new burrows or pimple-like rash lesions continue to appear, retreatment may be necessary.

There are over the counter remedies to treat scabies should you decide not go with a prescribed scabicide.

If you are going to go this route, your best bet is to go with an all natural sulfur based product.

Carefully follow the manufacturer’s recommendation for usage and treatment to effectively treat scabies and avoid reinfestation and spread of scabies.

Homecare Treatment Guidelines:

While you are being treated for scabies, wash all bedding, clothing, towels, etc. in hot water to decontaminate.

Any items that are not washable or can be dry-cleaned should be stored in a plastic bag for up to 72 hours.

Carefully vacuum carpets, rugs and upholstered furniture.

Wipe down all surfaces with a disinfectant.

How to treat scabies when you're pregnant?

If you get scabies while you’re pregnant, your first concern is for your unborn child. While you should contact your doctor, you can rest assure that scabies will not affect the fetus.

There are no official guidelines as to how scabies should be treated in pregnancy.

Should you find yourself with scabies you’ll want to take the following steps:

1. Get yourself treated for scabies ASAP.

2. Make sure that you and other contacts don’t catch it again. This means that all family members and sexual contacts must be treated, whether they are itchy or not. There is typically a delay of four to six weeks between the onset of infestation and the onset of itching, so even if someone is not showing symptoms, they are still contagious while in the incubation stage.

3. Several preparations are effective in the treatment of scabies. It is worth checking that the preparation you have been given is one specially designed for use in scabies. Follow in detail the instructions issued with your treatment.

4. Be sure to launder all bedding and clothing that may have been exposed to the mites.

What happens to scabies if left untreated?

Complications of Untreated Scabies

If scabies is left untreated, the scabies female will continue laying more eggs, which mature in 21 days and continue to spread to other areas of the sufferer’s body and create even more severe problems. Among them is the unsightly skin rash and raised tunnels of bumps or blisters that show on the skin wherever the mite has burrowed.

As the infestation continues to grow and spread, the itching becomes more intense and widespread.

Secondary Infections:
Excessive scratching can cause open sores or scabbing that can ultimately result in scarring of the affected areas.

According to the CDC,the sores can become infected with bacteria on the skin, such as Staphylococcus aureus or beta-hemolytic streptococci. Sometimes the bacterial skin infection can lead an inflammation of the kidneys called post-streptococcal glomerulonephritis.

This is superimposed on the initial Sarcoptes scabiei infection and is often referred to as a super-infection. Bacterial infections require antibiotic treatment, which is a different treatment than the medication used to eliminate the scabies itself.

If left untreated, as the bacterial infection spreads, it can progress beyond a superficial skin infection, causing an infection of the blood called septicemia, which is extremely dangerous and difficult to treat once it reaches an advanced stage.

This in turn puts stress on the kidneys which can cause further complications which can further progress and potentially become fatal.

CDC – Scabies
Livestrong – What if Scabies Goes Untreated

How do you know if you are cured of scabies?

In most cases, scabies is cured after one or two treatments. Most people continue to experience itching and a rash two to four weeks after treatment.

This is due to dead mites and their debris that in the burrows beneath the skin. To lessen the itch, medication may be prescribed or an over the counter antihistamine will help relieve the itch.

If itching continues more than 2-4 weeks after initial treatment or if new burrows or rash continue to appear (if initial treatment includes more than one application or dose, then the 2-4 time period begins after the last application or dose), retreatment with scabicide may be necessary.

With proper treatment and hygiene, scabies will go away in about two to three weeks.

A small percentage of people may not be cured after one or two treatments and in those cases repeat applications on a weekly basis may be necessary until cured.

With the right treatment pursued and all precautions taken, you will feel better in less than a week. But, don’t let yourself believe that the mites have gone completely. Continue the treatment for at least a month.

To be on the safeside to avoid reinfestation, you’ll want to avoid close contact with those who may be contaminated or undergoing treatment. Continue washing bedding, clothing and towels to avoid accidental re-contamination even though scabies cannot survive without a host for more than 72 hours.

WHO Guidelines for treating Scabies

When a person initially gets scabies, while they usually do not show symptoms during the first 2 to 6 weeks they are infested, it is important to note that they can still spread scabies during this time.

Those who have been in close contact with the infected person, (household members, sexual partners, etc) should also begin treatment for Scabies.

It is very important that all bedding, clothing and towels used prior to treatment by those in the household who are infested, as well as close contacts be decontaminated by washing in hot water and drying in a hot dryer, by dry-cleaning, or by sealing in a plastic bag for at least 72 hours.

It is recommended that infected persons do their best to relegate themselves to one room of the house or choose the same piece of furniture to sit on, etc., to avoid re-infestation and spreading the mite to others in the household.

Although Scabies mites generally do not survive more than 2 to 3 days away from human skin, you may want to vacuum furniture and carpeting during and after treatment.

Because Scabies is very contagious, you want to seek treatment right away.   There is a variety of treatments available for Scabies.  Some people opt to see a doctor to treat their scabies and some people opt to treat them on their own.

Whichever route you use to get treatment, you’ll want to fully research your treatment options to see which one is best for you.

While you are being treated for scabies, you’ll want to make sure to carefully read and follow the instructions.

Use of insecticide sprays and fumigants is not recommended for treating scabies.

Are Scabies Sexually Transmitted?

Scabies is an infestation, not an infection caused by the mite Sarcoptes scabiei.

The female mite burrows beneath the skin where she not only lays her eggs but also leaves fecal matter as well. The infestation causes a rash that is unbearably itchy.

Scabies is highly contagious and is passed on when having prolonged skin to skin contact with an infested person.

Scabies mites cannot fly or jump, they crawl slowly instead, so the only way for them to move from one person to another is wait for the people to have extended physical contact.

Holding hands can transmit scabies but typically it is not spread through a hug or a quick handshake.

The disease can be quickly passed between sexual partners or household members. Shared personal items may be to blame if they are contaminated. Scabies parasites can survive outside the body for 24 to 36 hours.

Scabies can be contracted through wearing clothes or sleeping in bedding that is infested.

There’s an elevated risk of contracting scabies in confined environment. Such institutions as extended-care facilities, nursing homes and prisons are common sites of scabies outbreaks as well as child care facilities.

Is Scabies an STD?

Although Scabies doesn’t necessarily have to be contracted via sexual contact, Scabies can be considered an STD as it is often contracted during sexual contact with an infested person.

While it can be classified as a sexually transmitted disease, it should not be confused with various other STDs and needs to be approached differently.

If your partner has genital scabies, you should see a doctor as soon as possible.

Both partners should undergo the same treatment in order to prevent re-infection.

Avoid sex or other forms of prolonged bodily contact until the treatment is completed both by you and your partner.

Do I have bed bugs or Scabies?

You wake up one morning and notice you have an itchy rash that wasn’t there when you went to bed.

Is it scabies or bed bugs?

While bed bugs and scabies are different, it is important that you quickly determine what is causing the bites and get proper treatment.

How to tell the difference between bed bug bites and scabies bites

Bed bugs and scabies like to feed on your blood.  However, one bites at the surface, while the other one will burrow itself under your skin.

Bed bugs come out at night to feed of you and then scurry back into hiding.  Scabies will burrow beneath your skin to make it’s home where it  feeds and lay it’s eggs.

Bed bug bites look like raised flat welts and where you will see three to four in a row.

Scabies burrow beneath your skin and appear as raised lines which become red and inflamed.

Bed bug bites will appear where skin is exposed during sleep, particular where bedding touches the body, particularly around the shoulders, back, arms, legs and face.

Scabies like to dig their burrows in the folds of your skin, between your fingers, around the beltline, genitals, arms, elbows, wrists, etc.

While bed bug bites do itch, they are nothing in comparison to scabies.   Scabies produces a very intense itch, particularly at night.  The infestation is very contagious and can spread.

If you do have scabies, you should seek medical attention right away.

If you have bed bugs, you should contact a professional pest management service.

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