HealthLinkBC File Number: 
Last Updated: 
February 2013

What is scabies?

Scabies is an infestation of the skin caused by a very small insect-like parasite called a mite.

The female scabies mite lays her eggs just under the surface of the skin. The eggs hatch in 3 to 4 days and the larvae move out to the surface of the skin where they mature. There they 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.

Sharing clothes, towels or bedding are less common ways of becoming infected with scabies. 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?

For 2 to 6 weeks after infestation, there may be no symptoms. Then you will develop a red rash and will usually begin to feel an extreme itchiness. This is often worse at night.

Rashes appear more commonly in the webs between the fingers, the insides of the wrists and elbows, the breasts, the male genitals, the belt line, 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.

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 scabies?

The most common sign of scabies is constant, intense itching. In some cases, you will be able to see the tiny, grayish white scabies – also known as burrows. They look like wavy, thread-like lines just under the skin surface. These are usually hidden by scratching before you are seen by a health care provider. 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 the microscope.

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; or
  • Mild itching.

How is scabies treated?

Scabies will not go away without treatment.

See your health care provider before treating scabies. There are a number of lotions or creams that you can buy from pharmacies. It is important to 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; or
  • Lives in a nursing 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 also be washed. They should be washed with detergent in hot water and dried on the hot cycle. Mites die if they are not in contact with skin for 3 days or more. Any clothing that cannot be laundered should be stored for several days to 1 week before reuse. You do not have to wash items such as mattresses and furniture. It is a good idea to give your house a thorough vacuuming, including soft or upholstered furniture.

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Is it an emergency?

If you or someone in your care has chest pains, difficulty breathing, or severe bleeding, it could be a life-threatening emergency. Call 9-1-1 or the local emergency number immediately.
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