How to Recognize Scabies

Scabies is a common disease worldwide and scabies patients of all ages, races, rich and poor. ^{[1] X Trusted Source American Academy of Dermatpogy Go to the source} Disease is not related to hygiene. The itch mite (scientific name is Sarcoptes scabiei ) is a skin parasite that causes scabies. Itch mites have eight legs and you can only see them with a microscope. Adult female mites burrow into the epidermis (upper layer of skin) for shelter, foraging, and laying eggs. They rarely dig through the stratum corneum which is the outermost layer of the epidermis. ^{[2] X Trusted Source Centers for Disease Contrp and Prevention Go to Source}^{[3] X Trusted Source American Academy of Dermatpogy Go to Source} If you think you have scabies follow the steps below to get it know or diagnose scabies, as well as future treatments and prevention.

Table of Contents

Watch for signs of scabies

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Tingling. Scabies has many signs and symptoms, of which the most common and earliest is a tingling sensation. This is the skin’s sensitive response to female mites, their eggs and their waste.

Itching tends to be worse at night and can disturb sleep. ^{[4] X Trusted Source Mayo Clinic Go to Source}

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Watch for signs of a rash. Along with itching you may develop a rash, which is also the body’s allergic reaction to mites. ^{[5] X Trusted Source Mayo Clinic Go to Source The} rash usually looks like a red, swollen nodule around it. ^{[6] X Research Source} Another feature is that itch mites like to nest in the skin in certain areas.

In adults, the most common places to get a rash are the hands, especially in the skin between the fingers, skin folds of the wrists, elbows, knees, buttocks, waist, penis, skin around the nipples, armpits , shoulder blades and breasts. ^{[7] X Trusted Source Centers for Disease Contrp and Prevention Go to Source}^{[8] X Trusted Source American Academy of Dermatpogy Go to Source}^{[9] X Trusted Source World Health Organization Go to Source}
For children, the places where mites like to live are the scalp, face, neck, palms, and soles of the feet. ^{[10] X Trusted Source Mayo Clinic Go to Source}

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Find nests of itchy mites. With scabies you can sometimes see very small burrows in the skin, they are zigzag lines, slightly raised, grayish-white or skin-colored. The size of the itch mite is usually one centimeter or more in length. ^{[11] X Trusted Source Centers for Disease Contrp and Prevention Go to source}

However, you can hardly find their nest because the average person has only 10-15 mites during a scabies outbreak. ^{[12] X Trusted Source Centers for Disease Contrp and Prevention Go to source}

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Watch for sores on the skin. Scabies causes intense itching and sometimes leads to skin ulcers, a high risk of infection, and is a complication of scabies. Sores are usually infected with certain bacteria such as Staphylococcus aureus or beta-hemolytic streptococcus and then grow on the skin. ^{[13] X Trusted Source Centers for Disease Contrp and Prevention Go to source}

These bacteria can also cause kidney inflammation and even sepsis, a potentially fatal infection of the blood. ^{[14] X Trusted Source Centers for Disease Contrp and Prevention Go to Source}^{[15] X Trusted Source American Academy of Dermatpogy Go to Source}
To avoid this problem you must not scratch and be gentle with the skin. If you can’t resist yourself, wear cloth gloves or use duct tape to cover your fingertips to avoid injuring your skin. Remember to keep your nails short.
Signs of infection include redness, swelling, increased pain, and oozing or pus-filled sores. You should seek medical attention immediately if you think the rash has become infected. Your doctor will prescribe topical antibiotics or oral medications to treat the infection.

Diagnosing scabies

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Clinical assessment. If scabies is suspected, you should seek medical attention quickly for a clinical diagnosis. Doctors diagnose this disease by examining the rash and itchy mites. ^{[20] X Trusted Source Centers for Disease Contrp and Prevention Go to source}

They scrape off a very small piece of skin with a needle, then look at it under a microscope for mites, eggs or their waste. ^{[21] X Trusted Source Centers for Disease Contrp and Prevention Go to Source}^{[22] X Trusted Source American Academy of Dermatpogy Go to Source}
You should know that you may still have scabies even if the mites, eggs or their droppings cannot be detected with a microscope. Each outbreak has only about 10-15 mites all over the body. ^{[23] X Trusted Source Mayo Clinic Go to Source}

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Ink test. Your doctor can use an ink smear test to detect an itchy mite infestation. They applied ink to the itchy skin and then wiped the stain with alcohol-soaked gauze. If there is an itchy mite it will retain some ink and appear as a dark zigzag line. ^{[24] X Trusted Source PubMed Central Go to Source}^{[25] X Trusted Source National Health Service (UK) Go to Source}

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Exclude other skin diseases. There are countless other skin diseases that can confuse you with scabies. Itchy mites are the main distinguishing feature of scabies, because no other disease like scabies has an itch. Your doctor will help rule out other possibilities to be sure you have scabies.

Scabies is sometimes confused with an insect or bed bug bite or sting.
Impetigo is also a scabies-like disease and is highly contagious. The rash of this disease mainly appears on the face, around the nose and mouth. ^{[26] X Research Source}
Scabies is also easily confused with eczema, which is a chronic form of skin inflammation. The body’s allergic reaction to eczema is a red rash in the form of a bump. ^{[27] X Research Source} People with eczema can also get scabies and make it worse.
Folliculitis is also confusing, often leading to an infection in the area around the hair follicle. This disease produces raised white-headed nodules on the red base, located around or near the hair follicle. ^{[28] X Trusted Source Mayo Clinic Go to Source}
Psoriasis is also characterized by scabies, a type of chronic inflammatory skin disease characterized by an overgrowth of skin cells that results in the formation of thick silvery scales, and numerous itchy, dry red patches. ^{[29] X Trusted Source Mayo Clinic Go to Source}

Scabies treatment

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Use permethrin. To treat scabies, you must destroy all the mites with scabies medications, which are prescription drugs. There are currently no over-the-counter medications that can treat scabies. Doctors usually prescribe a topical cream containing 5% permethrin to kill off the mites and their eggs. How to use is to apply from the neck to the whole body and wash off after 8-14 hours. ^{[30] X Research Source}

Reapply after 7 days (1 week). Side effects are itching or a tingling sensation.
You should consult a doctor before treating scabies in babies and young children. Permethrin cream is safe even for babies 1 month old, ^{[31] X Trusted Source American Academy of Dermatpogy Go to source} but most experts recommend it also be applied to the head and neck of infants and children small. ^{[32] X Trusted Source Centers for Disease Contrp and Prevention Go to the source} However you must avoid getting the medicine in your baby’s eyes and mouth.

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Use a cream or lotion containing 10% crotamiton. Creams or lotions containing crotamiton are also prescribed to treat scabies. How to use is to massage from the neck down the whole body after bathing. Rub the second dose 24 hours after the first dose and shower 48 hours after the second dose. Repeat these two doses after 7-10 days.

Crotamiton is considered safe if used as directed. ^{[33] X Research Sources} However, there have been many reports of this medication failing to cure scabies, meaning it is no longer the most effective or widely used. ^{[34] X Trusted Source Centers for Disease Contrp and Prevention Go to source}

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Use a lotion containing 1% lindane. This oil is like other scabies medicines, the way to use it is to apply it from the neck down the whole body and wash it off after 8-12 hours for adults, and after 6 hours for children. Reapply the medication after 7 days. You should not give lindane to children under 2 years of age, pregnant or nursing women, or people with weakened immune systems.

The drug is potentially neurotoxic, meaning it can damage the brain and other parts of the nervous system. ^{[35] X Source of Study} The prescribing of lindane should only be given to people who have failed other medications, or cannot tolerate less risky medications. ^{[36] X Trusted Source Centers for Disease Contrp and Prevention Go to source}

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Use ivermectin. This is an oral medication for scabies. There is evidence that this drug is safe and effective, however it is not approved for use by the US Food and Drug Administration (FDA). Ivermectin is prescribed as a single oral dose of 200 mcg/kg, and taken with water on an empty stomach. ^{[37] X Trusted Source Centers for Disease Contrp and Prevention Go to source}

Take another dose every 7-10 days. The drug ivermectin is only considered for people who have failed FDA-approved topical medications, or cannot tolerate these medications.
A common side effect of taking ivermectin is a rapid heart rate. ^{[38] X Trusted Source Centers for Disease Contrp and Prevention Go to Source}^{[39] X Research Source}

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Treatment of skin irritation. Symptoms and skin lesions may take up to three weeks to resolve, even if the mites are completely eradicated. If during this time the skin lesions do not go away, you should re-treat because the previous treatment may not be successful or the disease may recur. ^{[40] X Research Source} Cooling the skin is an effective way to relieve itching, to do this you just need to lie in a cool bath or apply a cool compress to the irritated skin.

Sprinkle more oats or baking soda into the bath for better skin soothing. ^{[41] X Trusted Source Mayo Clinic Go to Source}
You can also use calamine lotion, which has been shown to be effective in treating itching in mildly irritated skin. Your best bet is a Sarna or Aveeno anti-itch moisturizer. Avoid using any products that contain fragrances or dyes as they irritate the skin. ^{[42] X Trusted Source Mayo Clinic Go to Source}^{[43] X Trusted Source Mayo Clinic Go to Source}

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Buy topical steroids or oral antihistamines. Both medications help with the itching caused by scabies, which is actually the body’s allergic reaction to mites, their eggs and their waste. Steroids are very potent inhibitors of itching and inflammation, good examples of these topicals are betamethasone and triamcinpone.

Because it’s an allergic reaction, you can also use over-the-counter antihistamines for itching, such as Diphenhydramine, Dorotec, Loratadin and Telfast BD. These medications are especially helpful at night to relieve itching and help you sleep. Diphenhydramine also has a mild sedative effect. An example of an over-the-counter antihistamine is Atarax. ^{[44] X Research Source}
Hydrocortisone 1% topical cream is available over-the-counter and works well for itching.

Scabies prevention

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Take care to avoid exposure. The most common route of scabies infection is through skin-to-skin contact with an infected person, the longer the exposure, the higher the risk. The disease can also be spread through indirect contact with items such as blankets, pillows, clothing and furniture, but the chance is lower. When leaving the human body, mites can still live for an additional 48-72 hours. In adults, scabies is usually transmitted through sexual activity. ^{[45] X Trusted Source Centers for Disease Contrp and Prevention Go to source}

Crowded living environments are a common cause of scabies outbreaks, ^{[46] X Sources of study} so places like prisons, barracks, daycares, nursing homes and schools are common sites for outbreaks. ^{[47] X Research Sources} Scabies cannot be spread by animals. ^{[48] X Trusted Source Centers for Disease Contrp and Prevention Go to Source}^{[49] X Trusted Source American Academy of Dermatpogy Go to Source}

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Learn about the incubation period. For people who are newly infected with scabies, it takes 2-6 weeks for symptoms and signs to develop. Remember that an infected person can spread scabies to other people even though they have no symptoms.

For people who have been infected with scabies before, symptoms develop much faster, in just 1-4 days. ^{[50] X Trusted Source Centers for Disease Contrp and Prevention Go to source}

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Identify objects at risk. There are several groups of people who are susceptible to scabies, including children, mothers with young children, sexually active adults, people living in nursing homes, assisted living centers, and extended care facilities. . ^{[51] X Trusted Source American Academy of Dermatpogy Go to Source}

The mechanism of increased risk of disease transmission in these subjects is from skin-to-skin contact.

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House cleaning and disinfection. Measures to control and prevent reinfection of scabies often have to go hand in hand with treatment. This method is recommended for all members of the household who live in the same household and have close contact, including sexual partners of the patient. ^{[52] X Trusted Source American Academy of Dermatpogy Go to Source}

On the day scabies treatment begins, all clothing, bedding, and towels used within the past 3 days should be washed in hot water and dried on the highest setting, or dry cleaned. If dry cleaning or dry cleaning is not possible, put them in a sealed plastic bag for at least 7 days. Mites can only live 48-72 hours after leaving human skin. ^{[53] X Trusted Source American Academy of Dermatpogy Go to Source}
Also on the first day you have to vacuum the floor and furniture. Discard the bag or empty the dust and clean the dust container of the machine after vacuuming is complete. If the container cannot be disassembled, use a damp paper towel to wipe away the mites in it. ^{[54] X Trusted Source American Academy of Dermatpogy Go to Source}
Do not treat pets for scabies. The mites that cause scabies cannot live on animals and animals cannot transmit scabies to humans. ^{[55] X Trusted Source American Academy of Dermatpogy Go to Source}
You do not need and should not use insecticidal sprays to get rid of mites in the environment. ^{[56] X Trusted Source Centers for Disease Contrp and Prevention Go to source}

Advice

Children and adults can resume normal activities such as going to school or work after the day treatment begins.

Warning

See your doctor if your rash doesn’t go away in 2-3 weeks, gets worse, comes back after treatment, or appears to be infected (red, more swollen, or has pus).

Steps