Scabies
What is scabies?
Scabies is a skin infestation caused by the parasite Sarcoptes scabiei or the human itch mite. Scabies is common and highly contagious.
The human itch mite burrows just under the surface of the skin to live, feed and lay eggs. Scabies symptoms occur when the skin reacts to the mites, their eggs and/or their feces.
How is scabies spread?
Scabies is usually spread by extended, close, skin‑to-skin contact with an infested person. It spreads easily between family members, sexual partners and people in facilities such as care homes. You can spread mites to other people before and after you develop symptoms and for as long as you remain untreated.
Although less common, scabies can be spread by sharing clothes, towels or bedding. Anyone can get scabies and it does not mean you have poor personal hygiene.
What are the symptoms?
Symptoms of scabies include a red rash and extreme itchiness. The itching is often worse at night. Scratching can result in a secondary infection of the skin.
Rashes may appear in these areas:
- Web between the fingers
- Inside of the wrists and elbows
- Breasts
- Genitals
- Waist
- Back
- Buttocks
Infants and elderly people may have a rash on the head, neck, palms of hands or soles of feet.
If you have not had scabies before, it may take several weeks for symptoms to appear. For those who have had scabies before, symptoms usually start within a few days.
How do I know I have scabies?
The most common sign of scabies is intense itching that is worse at night. In some cases, you will be able to see the burrows made by the mite. The burrows look like grayish wavy, thread-like raised lines on the skin surface. Scratching can make the burrows harder to see. Because itchiness and skin rashes have many causes, only your health care provider can confirm if you have scabies.
What if I have a weakened immune system?
If you have a weakened immune system, you are at risk of developing a severe case of scabies known as crusted (Norwegian) scabies.
Crusted (Norwegian) scabies is highly contagious and difficult to treat because of the large number of mites found in and on the skin.
How do I know I have crusted (Norwegian) scabies?
Signs of crusted (Norwegian) scabies include:
- Scaly, crusted sores on hands, feet, scalp, face and body
- Hair loss
- Mild itching
How is scabies treated?
Scabies will not go away without treatment. Speak with your health care provider before you begin treatment.
Topical scabies treatments (creams) are available to buy at the pharmacy. Always read the label carefully and follow directions exactly. Some treatments may not be suitable for children, pregnant people or those who are breastfeeding/ chestfeeding.
Because adults do not normally get scabies above the neck, you should not have to apply the cream to your face and scalp. However, your health care provider may recommend applying the cream to the head and scalp of children or elderly people. If applying scabies treatment to the head or scalp, avoid applying the cream to mouth, nostrils and eyes. Put on clean clothes and bedding after applying treatment
Itchiness may continue for up to 4 weeks after treatment. This is common and will improve. Do not repeat the treatment unless advised by your health care provider. Your health care provider may recommend a second treatment 1 week after the first treatment.
Crusted (Norwegian) scabies is very contagious and can be difficult to treat. Medicine used to treat classic scabies may not work. For more information, speak with your health care provider.
How do I prevent spreading scabies?
If a person in your family or household has scabies, it is likely that others will have it too. They may not have symptoms yet. For this reason, all household members should receive treatment at the same time.
Children may return to school or daycare after they have completed their treatment.
Inform your public health unit if the person who has scabies:
- Attends school or day care
- Lives in a care home or other setting where close personal contact is difficult to avoid
To prevent further spreading, make sure to vacuum and clean clothes and bedding. To prevent further spreading, make sure to vacuum and clean clothes and bedding. Talk to your partners about safer sex, since condoms might not stop scabies from spreading
What should be cleaned in my environment?
Wash sheets and clothes that touched infested skin in the 3 days before treatment began. Use detergent in hot water (50ºC) and dry on the hot cycle.
Items that cannot be washed should be dry cleaned or put in a sealed plastic bag for at least one week. Mites die if they are not in contact with skin for 3 days or more. Vacuum your home well, including furniture and mattresses.