Scabies facts

What is scabies

Scabies is itchy rash caused by a microscopic mite (Sarcoptes scabiei var. hominis) that burrows into the upper layer of the skin where it lives and lays its eggs.

Symptoms of scabies

• Intense itching, especially at night, AND small raised bumps on skin – usually found on finger/toe webs, wrists, elbows, armpits, nipples, buttocks, and penis. The head, face, neck, palms and soles are not involved in adults but may be in infants and young children.
• Tiny “burrows” on the skin where the female mite is tunneling under the skin. Burrows look like tiny grayish or white crooked lines on the skin surface.
• Scabies symptoms may take up to 4-6 weeks after exposure to begin. Symptoms can appear much sooner in someone who has had scabies before.

How scabies spreads

Scabies is spread by direct, prolonged, skin-to-skin contact with a person who has scabies (for example, sexual partners and family members). A quick handshake or hug will not spread scabies. It is possible but not common for scabies to spread through sharing clothing or towels with a person infected with scabies. The scabies mite does not hop or fly and cannot live off the host body for more than 72 hours.

How to check if you have scabies

At City Clinic we diagnose scabies by typical appearance and location of the rash/bumps. In some settings the diagnosis may be made by a skin scraping and microscope exam for mites, eggs or mite feces.

How to cure scabies

• To get rid of scabies you need to use a prescription cream called Elimite (permethrin). Apply half of the cream to the entire body, starting at the neck and going to the toes. Leave on for 8-14 hours then wash off. Put on clean clothes after treatment. Apply the second half of the cream one week later. There are no over the counter products that are effective against scabies.
• Wash all clothing and bedding in hot water and dry on hot cycle. Things that cannot be washed can be dry-cleaned or placed in a sealed bag for at least 3 days.
• Make sure that your sexual partners and close personal contacts get treated at the same time (especially those who share your bed).

Itching may continue after treatment

It is common to continue itching for up to two weeks after treatment due to parts of the scabies mite still being under your skin. This does not mean treatment failed. Cortisone cream/ointment and over-the-counter oral antihistamines (Benadryl, Claritin or Zyrtec) can be used to relieve itching.

Scabies is very often misdiagnosed. You may still be itching due to another cause.

Repeat treatment might be necessary if you are still itching after 4 weeks, and/or new burrows or bumps occur in the usual locations on your body.

This information is provided by San Francisco City Clinic.

Visit our homepage at sf.gov/cityclinic.

Information last revised January 2024