Scabies

Alternative names
Sarcoptes scabiei

Definition
Scabies is a contagious skin disease caused by a species of mite that is very small.

Causes, incidence, and risk factors

Scabies is found worldwide among people of all groups and ages. It is spread by direct contact with infected individuals and less often by sharing clothing or bedding. Sometimes whole families are affected.

The mites that cause scabies burrow into the skin and deposit their eggs, forming a characteristic burrow that looks like a pencil mark. Eggs mature in 21 days. The itchy rash is an allergic response to the mite.

Mites may be more widespread on a baby’s skin, causing pimples over the trunk, or small blisters over the palms and soles. In young children, the head, neck, shoulders, palms, and soles are involved. In older children and adults, hands, wrists, genitals, and abdomen are involved.

Symptoms

     
  • Itching, especially at night  
  • Thin, pencil-mark lines on the skin  
  • Rashes  
  • Abrasions of the skin from scratching and digging

Signs and tests
Examination of the skin shows characteristic signs of scabies. Tests include microscopic examination of skin scrapings taken from a burrow.

Treatment

The objective of treatment is to eliminate the infestation. There is no known home remedy. Prescription creams and lotions are applied all over the body. It may be necessary to treat the whole family or sexual partners of infected individuals, even if no symptoms are present.

Many prescription products are available. The most commonly used cream is Elimite (permethrin). In difficult cases, an oral antibiotic called ivermectin may be used.

Itching may persist after treatment begins, but will disappear if treatment continues exactly as your health care provider prescribes. Itching can be minimized by cool soaks and calamine lotion. Your doctor may additionally recommend an oral antihistamine.

Expectations (prognosis)
Most cases of scabies can be cured and resolve without any long term problems.

Complications
A secondary skin infection such as impetigo can occur because of intense scratching.

Calling your health care provider
Call your health care provider if you have symptoms of scabies, or if someone with whom you have close (not necessarily sexual) contact has been diagnosed with scabies.

Prevention
Avoid contact with infected persons.

Johns Hopkins patient information

Last revised: December 5, 2012
by David A. Scott, M.D.

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