Scabies
Nonye Ogbuefi, BA and Brandi Kenner-Bell, MD

What is scabies?

Scabies is an infestation where tiny mites burrow into the skin and cause an itchy rash. Scabies is very contagious and affects both children and adults worldwide. The most common symptom of scabies is itching that is worse at night. As a result, scabies can be difficult to diagnose because itching is common in other skin rashes like eczema.^{1, 2} 

Scabies can affect any part of the body. Skin lesions appear as red or violet scaly bumps or patches. Skin lesions are commonly seen on the waistline, wrists, between the fingers, under the armpits and in the groin area. In infants and children, the rash is often seen on the palms and soles. In people who are immunocompromised, lesions often appear as thick, white scales or crusts. This is known as crusted scabies.^{2, 3}

What is the cause of scabies?

Scabies is caused by a mite called Sarcoptes scabiei var. hominis. It can easily be spread by being in close contact with someone who is infested with scabies. Scabies is commonly seen in people living in crowded areas, such as daycares and shelters and it often spreads to family members and caretakers.^{2, 3}

How do I know if I have scabies?

A dermatologist will diagnose scabies based on the history and physical exam. When examining the skin, the doctor may take samples from the lesions by scraping the skin to examine it under a microscope.³  

What treatments are available for scabies?

Scabies is treated using topical creams, such as permethrin. In some cases, oral medications may be needed. It is important to treat both the infected person and close contacts even if they do not have any symptoms. Itching may persist for several weeks after treatment, and the doctor may prescribe other medications, such as antihistamines, to help with the itching. Clothes and bed linen that were in contact with infected persons should be machine washed and dried at high temperatures to kill the mites.^1-3

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References 

1. Chosidow O. Scabies. New England Journal of Medicine. 2006;354(16):1718-27.
2. Karthikeyan K. Scabies in children. Archives of disease in childhood – Education & practice edition. 2007;92(3):ep65-ep9.
3. Thomas C, Coates SJ, Engelman D, Chosidow O, Chang AY. Ectoparasites: Scabies. Journal of the American Academy of Dermatology. 2020;82(3):533-48.