Infestations & Bites
Scabies
WHAT IS IT
An itchy rash from a tiny burrowing mite
HOW COMMON
Common worldwide; spreads person-to-person
CONTAGIOUS?
Yes — through close skin-to-skin contact
CURABLE?
Yes — with proper treatment of you & contacts
What Is It?
Scabies is an intensely itchy rash caused by a tiny mite that burrows into the top layer of skin. The itch is often worst at night. It spreads through prolonged skin-to-skin contact, so close contacts and household members usually need treatment at the same time, even if they have no symptoms yet.
Signs & Symptoms
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Intense itching, especially at night
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Thin, thread-like burrows or tiny bumps
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Common in finger webs, wrists, waist, armpits, groin
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A widespread bumpy, scratched rash
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Household members or close contacts also itching
Why Does It Happen?
The human scabies mite burrows into the skin to lay eggs, and the body's allergic reaction to the mites causes the intense itch. It spreads mainly through prolonged skin-to-skin contact, and sometimes through shared bedding or clothing. It is NOT a sign of poor hygiene — anyone can get scabies.
Treatment Options
Treatment kills the mites with a prescription cream or pills. Treat all close contacts at the same time, and decontaminate bedding and clothing to prevent reinfestation. Itch can linger for weeks after successful treatment.
PERMETHRIN 5% CREAM
Applied neck-down (all skin), left on 8–14 hours; usually repeated in 1 week.
ORAL IVERMECTIN
Prescription pills, often used for widespread cases or outbreaks; repeated in ~1 week.
TREAT ALL CONTACTS
Everyone in the household and close contacts are treated at the same time.
ITCH RELIEF
Antihistamines or mild steroid cream for the itch that lingers after cure.
Tips for Managing It at Home
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FOMITES: wash bedding, clothing & towels (used in the last 3 days) in hot water (≥50°C) and dry on high heat
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Items that can't be washed: seal in a plastic bag for at least 72 hours (up to 1 week)
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Vacuum floors and furniture; the mite rarely survives 2–3 days off skin
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Apply cream to ALL skin below the neck, including under nails and skin folds
When to Call Your Provider
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Itching or rash persists more than 2–4 weeks after treatment
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New burrows or bumps appear (possible reinfestation)
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Signs of skin infection: pus, spreading redness, or pain
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Contacts remain untreated or symptoms keep returning
Sources & further reading
The information in this handout is based on general dermatology guidance from the reputable organizations below. These links are provided for patients who wish to read more from trusted sources.
American Academy of Dermatology (AAD). Scabies: Overview. https://www.aad.org/public/diseases/a-z/scabies-overview
Centers for Disease Control and Prevention (CDC). About Scabies. https://www.cdc.gov/scabies/about/index.html
DermNet. Scabies. https://dermnetnz.org/topics/scabies
This handout is for general education and does not replace advice from your own provider. Always follow your provider’s specific instructions.
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