Last Updated: February 1, 2018
HealthLinkBC File Number: 09
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What is scabies?

Scabies is a common and highly contagious skin condition caused by an infestation of very small insect-like parasites called Sarcoptes scabiei or human itch mites.

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 presence of the mites and their eggs. Scabies spreads to other parts of the body when the eggs hatch in 3 to 4 days and the larvae move out to the surface of the skin. There they mature, mate and repeat the life cycle, gradually spreading the infestation.

How is scabies spread?

Scabies is usually spread by extended, close personal contact with an infested person. It often affects several family members at the same time, and can spread easily in institutions 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.

Sharing clothes, towels or bedding are less common ways of becoming infested with human itch mites. People are often embarrassed to learn they have scabies; however, it can happen to anyone and does not mean poor personal hygiene.

What are the symptoms?

Symptoms of scabies include a red rash and extreme itchiness. The itching is often worse at night. 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 in a few days.

Rashes usually appear in the web between the fingers, the inside of the wrists and elbows, the breasts, the male genitals, the waist, the back and the buttocks. Infants may have a rash on the head, neck, palms or soles.

Scratching can result in a secondary infection of the skin.

How do I know I have scabies?

The most common sign of scabies is constant, intense itching. 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. These are usually hidden by scratching. Because itchiness and skin rashes have many causes, only your health care provider can say for sure if you have scabies. Your health care provider can do this by looking at a tiny sample of skin scrapings under a microscope.

What if I have a weakened immune system?

If you have a weakened immune system, such as Human Immunodeficiency Virus (HIV) infection, 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.

For more information on HIV, see HealthLinkBC File #08m HIV and HIV Tests.

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
  • Skin on the face flaking off
  • Hair loss
  • Mild itching

How is scabies treated?

Scabies will not go away without treatment. Before you begin treatment, it is important that you speak with your health care provider.

There are many lotions and creams that you can buy from the pharmacy. Always read the label carefully and follow directions exactly. Some treatments may not be suitable for children, pregnant women, or breastfeeding women.

Because adults do not normally get scabies above the neck, you should not have to apply the lotion to your face and scalp. However, your health care provider may recommend applying the lotion to the head and scalp of children.

Itchiness will continue for 1 to 2 weeks after treatment. This is common and will get better. 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 regular 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, there is a good chance that others will have it too. They may not have symptoms yet. For this reason, all household members should be treated 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.

What should be cleaned?

Put on clean clothes and bedding after the treatment. Bedding and clothing that came into contact with infested skin in the 3 days before treatment began should be washed with detergent in hot water (50ºC) and dried on the hot cycle. Any clothing that cannot be laundered should be dry-cleaned or stored for several days to 1 week before reuse. Mites die if they are not in contact with skin for 3 days or more. You do not have to wash items such as mattresses and furniture. However, it is a good idea to give your house a thorough vacuuming, including soft or upholstered furniture and mattresses.