Scabies
Scabies is a contagious infection which causes an itchy skin condition caused by the borrowing of small microscopic mites in the skin folds. Due to its infectiousness, your clinician may advise Scabies treatment for your whole close relations.
Fortunately, it is an easily treatable condition with medications widely available for this.
Symptoms
What are the symptoms of Scabies?
The typical symptom of Scabies is a terrible itching in the areas where mites burrow and it can be substantially worse at night.
These skin lesions due to Scabies usually appear in skin folds. The most common skin regions involve includes:
- Space between your fingers
- Armpits
- The inner side of your elbow
- around waist region
- Soles of the feet
- Around breast
- Around male genitals
- Hips region
- Knees
How long does it take for Scabies to show?
If you have had Scabies in the past, then you may develop symptoms within 1 to 4 days after exposure.
However, for those infected with Scabies for the first time, it may take upto 6 weeks for signs and symptoms to show.
Even if you have no signs and symptoms of Scabies, please note that you can still pass it onto other people.
How long can Scabies mites remain alive?
On a human host, Scabies can remain alive for 6-8 weeks. However, without a host, it can not survive more than 48-72 hours.
Causes
How can I get Scabies?
It is unlikely that you get scabies following a brief, casual contact. However, contact for longer than 5-10 minutes can increase the risk of transmission. This can include oral, vaginal and anal sex.
It is unlikely that you will Scabies from a toilet seat. Getting Scabies from a swimming pool is also unlikely unless someone with Crusted Scabies (highly infectious) has infected the water.
Can I get Scabies from animals?
You can get a temporary skin reaction following prolonged contact with an animal with Scabies. The chances of getting more severe Scabies exist, if the animal mites and have been in contact with human mites.
Diagnosis
How is Scabies diagnosed?
Scabies is diagnosed by a physical examination from the site of the rash and the presence of mites & burrows.
What other skin conditions can mimic Scabies?
You can have any of the following skin condition that can have similar symptoms as that of scabies:
Eczema – A skin condition that causes itchy, dry and scaly patches on the skin. It gets better with the application of emollients, lotions or steroid cream.
Contact dermatitis – A skin allergy that occurs when the skin comes in contact with certain things such as detergent, acid, or drain cleaners. It causes itchy, dry, blistered or crack skin.
Drug reaction – An allergic reaction triggered after taking several medications such as NSAIDs, PPIs, beta-lactam antibiotics or hypnotics.
Impetigo – A skin infection secondary to cuts or breaks in the skin, resulting in pus or water-filled pus skin lesions.
Urticaria – An allergic reaction characterized by a raised and red itchy welts that appears and fades along the course. It is usually a chronic condition lasting up to six weeks, and its reoccurrence is common within six months or one year.
Seborrheic dermatitis – A Skin disease is also known as dandruff, in which the scalp gets itchy and flaky. It usually involves the scalp but can affect any region of the body.
Psoriasis – A skin condition in which red and raised patches with silver scales appear on the skin of knees, scalp, and elbow. Fully recovery from psoriasis is hardly possible. It results in frequent flare-ups, and sometimes it may go into remission.
Treatment
How is Scabies treated?
Scabies is treated using creams and ointments which may be applied from the neck down. Depending on the extent of your symptoms, multiple applications of these creams may be required.
Along with the prescribed medications, your clinician may recommend you to:
- Wash your beddings and clothes in use with hot water (50 degrees centrigade or higher)
- Dry your clothes with a hot iron
- If your clothes cannot be washed, place them in a sealed bag for at least three days
- If you have babies or young children who suck their hands/feet, place socks/gloves on their hands/feet
- Abstain from sexual intercourse/close physical contact until after your treatment
- Avoid sharing bedding, clothes or towels with a person infected with Scabies
How long does the medications take to work?
Scabies mites usually die with the onset of treatment, but you might have an itch for a few weeks. Please consult your clinician if you have symptoms after two weeks of completing treatment.
What happens if the treatment does not work?
If your symptoms do not disappear after 2 weeks, we may consider the following possibilities
- Re-infection – This may be due to your carpet/clothes/bedding which are still infested with Scabies mites.
- Secondary infection – You have an infection in addition to Scabies. This will require further investigation and treatment.
- An alternative diagnosis – You have another infection rather than Scabies
- Crusted Scabies – You have crusted scabies or an intense form of scabies in which scaly lesions do not allow proper penetration of topical medicine. In this case, your doctor will prescribe you both oral and topical medications.
- Treatment failure – In this case, we will offer you another course of medications
Can I treat Scabies at home?
Please be cautious when treating yourself for Scabies. You can not use agricultural insecticides to get rid of Scabies as this can be dangerous for your health.
Also, there is no over the counter medication to treat scabies. Therefore, it is advised to contact your doctor, who will prescribe you the effective medicine to treat scabies.
However, you can relieve the symptoms by:
- Applying a wet cloth to the affected areas
- Using a calamine lotion
- Use anti-allergy medications to help soothe any allergic symptoms due to Scabies
What happens if Scabies is left untreated?
Untreated Scabies can result in intense itching, which can cause a break or cracks in the skin and make it more susceptible to other infections.
Page reviewed by Dr. Manoj Malu (Clinical Director)
Last reviewed date: 26 April 2021
Next review due: 26 April 2024
Whilst this content is written and reviewed by sexual health specialists, it is for general guidance only. It is not intended to replace the advice of your clinician.
References & Further Reading
- NHS: Scabies
- Mayo Clinic: Scabies – Symptoms and causes
- PLOS Neglected Tropical Diseases: The Potential for a Blood Test for Scabies
- CDC – Scabies – General Information – Frequently Asked Questions (FAQs)
- Australian Family Physician: Scabies: A clinical update