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.
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.
RELATED: Is Itchy Skin Normal?
What is Scabies?
This section explains what scabies is, who gets it, how mites behave, what the rash looks like on different skin tones, and what the mites look like under magnification.
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.
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.
Once the eggs hatch, the larvae travel to the skin’s surface and can spread to other parts of the body—or to other people—notes the Mayo Clinic.
What does scabies look like? 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.
Under magnification, the mite is creamy-white, round-bodied, eight-legged, and about the size of a needle tip, the Cleveland Clinic says.
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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.
What does scabies look like? It may resemble hives, tiny bites, knots under the skin or even eczema-like scaly patches, according to the American Academy of Dermatology (AAD). Sores may develop from scratching.
The rash can appear red or pink on lighter skin, and are often easy to spot. On darker skin, there can be inflammation and redness, with colors ranging from pink to violet, according to Verywell Health. Rashes on darker skin most often appear skin-colored or only slightly lighter.
Under magnification, the mite is creamy-white, has eight legs and a round body. It is roughly the size of a needle tip, according to the Cleveland Clinic.
How to identify scabies
A doctor can best do this, but signs can include the rash and intense itching that worsens at night.
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, according to the AAD.
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 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.
Crowded conditions can also contribute, according to the CDC. Outbreaks are common in nursing homes, prisons and childcare facilities.
What causes scabies? It’s a mite known as Sarcoptes scabiei var hominis.
Incubation time ranges from just one to four days if you’ve had scabies before to four to eight weeks, according to the CDC.
Scabies symptoms
Scabies cause 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.
Scratching too much can cause a skin infection, such as impetigo, according to Mayo Clinic. Untreated scabies can even lead to complications such as chronic kidney disease, according to the Frontiers in Medicine report.
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.
