Note: A video of a doctor explaining scabies can be found at the end of the article.

Scabies is a common skin condition that affects millions of people worldwide, and yet, it remains widely misunderstood. Often mistaken for other skin conditions such as rashes, fungal infections, or even shingles, scabies can cause significant discomfort and distress. So, what exactly is scabies, and how can you recognize it? This article will break down the details of scabies, from symptoms to treatment, and explain why it is essential to seek medical attention if you suspect you have it.

What Is Scabies?

Scabies is caused by a tiny mite known as Sarcoptes scabiei, which burrows into the top layer of the skin. The mite lives and reproduces in the skin, causing an intense allergic reaction. This infestation leads to a red, itchy rash that can be both painful and distressing. The condition is highly contagious and spreads through prolonged skin-to-skin contact. However, it can also be transmitted by sharing clothing, bedding, or towels with an infected person.

The infestation occurs when the mites burrow under the skin, where they lay eggs. As the eggs hatch and the larvae mature, they continue to burrow deeper into the skin, spreading the rash further and exacerbating the itching.

Symptoms of Scabies

The symptoms of scabies can often be confused with other types of rashes, which is why it’s important to understand the specific signs associated with it. Here are some of the most common symptoms:

1. Itching (Pruritus): The most significant symptom of scabies is intense itching, particularly at night. The itching is caused by an allergic reaction to the mites, their eggs, and waste products under the skin. While itching is the primary symptom, it can become severe and persistent, leading to broken skin and potential infections from scratching.

2. Red or Irritated Rash: The rash itself is often red or irritated and typically appears in small, raised bumps. It can occur in various parts of the body, but the most common areas affected include the hands, wrists, elbows, underarms, buttocks, genitals, and around the waist.

3. Blisters and Sores: In more severe cases of scabies, the skin may develop small blisters filled with fluid. If scratching continues, these blisters can break open, leading to sores and crusts. The broken skin can then become a breeding ground for bacteria, leading to secondary infections.

4. Burrows (Tunnels) in the Skin: Scabies mites burrow into the skin, and in some cases, you may notice small, thin lines or tunnels under the skin. These are the burrows where the mites lay their eggs. The burrows often appear in areas like the webs between fingers, along the wrists, or near skin folds.

5. Crusted Scabies (Norwegian Scabies): In more severe cases, scabies can lead to a condition called crusted scabies, where the skin becomes thick, crusted, and covered in scaly lesions. This form is highly contagious and often affects people with weakened immune systems, such as the elderly or those with HIV/AIDS.

How Scabies Spreads

Scabies is highly contagious and spreads primarily through direct skin-to-skin contact. It can also spread through shared items such as towels, bedding, or clothing. In fact, the mites can live on fabric for up to 48 hours, making it possible for scabies to spread indirectly.

It is important to note that scabies does not discriminate by hygiene or cleanliness. Even individuals who maintain good personal hygiene are at risk of contracting scabies, as the mite can spread in any community setting where close contact occurs. This includes households, schools, nursing homes, and even daycare centers.

When to Seek Medical Attention

While scabies itself is not typically dangerous, it can lead to complications if left untreated. If you notice the symptoms of scabies, particularly if the rash persists and is accompanied by intense itching, it is important to seek medical attention promptly. A healthcare professional will be able to diagnose scabies based on the appearance of the rash and the presence of burrows under the skin.

In some cases, a skin scraping may be taken to confirm the presence of mites or eggs under a microscope. Once diagnosed, the doctor will prescribe appropriate treatment, which is typically a topical scabicide that kills the mites.

It is important to treat all household members and close contacts if one person is diagnosed with scabies to prevent the infestation from spreading.

Treatment Options

Scabies treatment typically involves topical medications known as scabicides. These medications work by killing the mites and their eggs. Here are the most common treatments:

1. Permethrin Cream: This is the most commonly prescribed treatment for scabies. It is a topical cream that is applied to the entire body, from the neck down, and left on for 8 to 12 hours before being washed off. It is typically recommended to repeat the treatment after one week to ensure that all mites and eggs are eradicated.

2. Ivermectin: In some cases, oral ivermectin may be prescribed. This is typically used for severe cases of scabies or when topical treatments are not effective. Ivermectin is taken in pill form and works by killing the mites.

3. Crotamiton: This is another topical treatment option that can be used for scabies. It is applied to the skin and left on for 24 hours before being washed off. It is generally used as a secondary option if permethrin is not effective or well-tolerated.

4. Other Medications: In certain cases, corticosteroid creams may be prescribed to reduce inflammation and itching. Additionally, antibiotics may be given if secondary infections occur due to excessive scratching.

In addition to medical treatment, it is essential to clean and disinfect personal items such as clothing, bedding, and towels to prevent re-infestation. Washing these items in hot water and drying them on a high heat setting will kill any remaining mites.