Talk about the stuff of nightmares: you’re suddenly itching like crazy at night, scratching at a new rash, and wondering what just crawled into your life.
Literally.
If you’ve reached the point of Googling “what is scabies?” you’re not off-base — these are some of the most common early signs.
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Scabies is a highly itchy skin condition caused by tiny mites that burrow into the skin. It can appear as a pimple-like rash, lines under the skin, or scaly patches, and it tends to worsen at night.
Understanding what is scabies, and how it spreads can help you get treatment quickly and avoid passing it to others.
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How is Scabies Caused?
Scabies is caused by the human itch mite, a parasite that lives and lays eggs in the upper layer of your skin, the CDC explains.
Under magnification, the mite is creamy-white, round-bodied, eight-legged, and about the size of a needle tip, the Cleveland Clinic says.
It affects about 200 million people worldwide at any given time, including up to 10% of children in low-resource settings, according to the World Health Organization.
How to Identify Scabies
A doctor can best do this, but signs of scabies can include the rash and intense itching that worsens at night.
What does scabies look like on the skin? It can mimic hives, small bites, knots under the skin, or even eczema-like scaly patches, according to the American Academy of Dermatology (AAD). Scratching can lead to sores.
On lighter skin, the rash often looks pink or red. On darker skin, the signs can be subtler—rashes may appear skin-colored, slightly lighter, or show inflammation in shades of pink to violet.
Mites are most commonly found between the fingers, around the fingernails, on elbows, wrists, at the belt line, in the genital area, and around the nipples, according to the AAD.
Sometimes children will have an all-over rash, including their scalp. Infants typically have it on the palms and soles.
Although scabies is contagious, children can typically return to school the day after treatment, according to an article recently published by HealthDay.
A severe form called crusted scabies, or Norwegian scabies, leads to widespread crusts on the skin with hundreds or thousands of mites, instead of 15 or 20. It can impact someone with a weakened immune system, according to the AAD.
How Do You Get Scabies?
Scabies is commonly spread between sexual partners or among members of the same household. Once the eggs hatch, the larvae can travel to the skin’s surface, spreading to other areas or other people, according to the Mayo Clinic.
Crowded conditions can also contribute, according to the CDC. Outbreaks are common in nursing homes, prisons, and childcare facilities.
Scabies Symptoms
Scabies causes an “intense, unbearable itch,” according to a report published recently in the journal Frontiers in Medicine. This is caused directly by the mites and the body’s immune response to them.
A later rash can look like lines on the skin that are grayish or skin-colored, according to the Cleveland Clinic.
Symptoms of scabies on darker skin can include:
- A rash that can look pimply: On darker skin, scabies lesions can look only slightly lighter, but in lighter areas like the inner arm or palm, they can be brown or black.
- Burrows: Burrows are short lines (about 1 centimeter in length) where mites crawl into the skin. This manifests as a small bumpy line punctuated with a tiny dark bump. On darker skin, burrows might have to be felt or viewed with a dermatoscope, a small handheld device doctors look through to see clearly.
- Intense itching: An itch that can be intense enough to keep people awake at night is another symptom of scabies.
Scabies treatment
Scabies medications include creams and pills, according to the Mayo Clinic. The condition won’t resolve without treatment.
What is a good treatment for scabies? Apply a prescription cream that contains permethrin to clean skin on the entire body, including palms and soles of the feet. Children may also need it on the scalp.
Leave the cream on for eight to 14 hours before washing it off, the Cleveland Clinic advises.
The veterinary drug ivermectin, which gained fame during the pandemic as a failed treatment for COVID-19, can be used in small doses to treat parasites, according to a recent HealthDay story.
Ivermectin is given in two doses separated by a week or two under a doctor’s guidance. It shouldn’t be used by someone who is pregnant or lactating or in children weighing less than 35 pounds, according to the Cleveland Clinic.
Bumps and itching may persist for up to four weeks even though the mites are dead. Antihistamines can help with the itching. Anyone who has had close contact with a person infected with scabies should also be treated.
Wash clothing and bedding in hot water followed by a hot dryer. Vacuum carpets and furniture well, especially if someone has had crusted scabies, the CDC recommends.
A Final Word on Scabies
Knowing what is scabies and recognizing its symptoms early is key to stopping the spread and relieving the intense itch. With proper treatment and precautions, scabies can be effectively cleared—so don’t wait to seek help if you notice the signs.
