Scabies – Symptoms, Diagnosis, prevention and Treatment of Scabies

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Scabies is a highly  itchy skin disease that is caused by the infestation of the skin by a tiny skin mite called Sarcoptes scabiei. Scabies disease is very contagious as well. Here, we have simplified all the things you should know about scabies including the Treatment of Scabies.

What is Scabies Infection?

Scabies disease is a highly contagious itchy skin disease that is caused by the infestation of the skin by a tiny skin mite called Sarcoptes scabiei. These mites are too tiny to be seen with the naked eyes.

The scabies mites live and reproduce on the skin but can also burrow into the skin and live.  If untreated, the scabies mites can live on the skin for months if not even years causing a highly itchy skin rash.

Scabies occurs worldwide. All races, ages and social classes can be affected by scabies irrespective of the level of hygiene. It is estimated that scabies affect millions of people from across the world at every given time.

It is very important to note that Scabies is not by any means an indication of poor hygiene.

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THE SCABIES MITE (Sarcoptes scabei)

Mode of Transmission Of Scabies: How do one get Scabies Infection?

Scabies is spread through skin-to-skin contact with people affected by the disease eg by holding hands, sexual intercourse etc. The commonest means of spread of scabies among sexually active young adults is through sexual intercourse. Therefore, Scabies can easily be passed on to friends, family members, and sexual partners.

Scabies can also be transmitted through towel, underwear, clothing, or bedding  that have been freshly contaminated by an infested person. These scabies mites can only survive for 48 to 72 hours outside the human body. This means of transmission is not very common.

Symptoms Of Scabies: How does Scabies Present?

Following the exposure the the scabies mite, scabies symptoms do not start immediately.  The symptoms of scabies begin 2 to 6 weeks in freshly infected individuals but starts within 1 to 5 days in individuals previously exposed to scabies. This is called the incubation period of the illness.

The main symptoms of scabies infection is rash and intense persistent itching. This itching is usually worse at night and starts from the area first exposed to the disease. Scabies rashes usually appear as tiny bites, hives, bumps under the skin, or pimple-like bumps with the burrow tracks sometimes seen as red discolored lines on the skin.

Though scabies rashes can affect the whole body, there are parts of the body that are more commonly affected. The parts of the body  most commonly affected by scabies are;  the area between the fingers, wrist, elbow, armpit, nipple, penis, waist, buttocks. In children and immunocompromised adults, scabies can also affect the face, head, neck, hands, and soles of the foot as well.


In the severe form of scabies infection called Norwegian Scabies or crusted scabies, the symptoms are more severe. It presents as mashes rashes, skin crusts, sores and may even affect the whole body . This form of scabies is more contagious. It is common in immunocompromised individuals such as HIV/AIDS, people on steroid medications etc. The scabies treatment here should be more aggressive.

Excessive or aggressive scratching can lead to sores. These sores can then get infected by bacteria.

Diagnosis Of Scabies

The diagnosis of scabies is mostly clinical. Your doctor can diagnose the illness by taking a history and doing a physical examination. Scabies diagnosis can be confirmed by examining skin scrapings for scabies mite with a microscope. Scabies rashes is often mistaken for a fungal infection so ensure you see your doctor when you see the symptoms.

Scabies Of Treatment: How is Scabies Treated?

The main goal of the treatment of scabies is to get rid of the infestation with lotions, creams or ointments called topical scabicides.  They are applied directly to the skin. Oral medications for Scabies Treatment (systemic scabicides) are also available. Examples are listed below.

For simple scabies infestation, only the application of the cream or lotion will be enough. For more effective treatment of scabies, it is advised that you combine the topical agent with the systemic drugs. Usually a single application of the right medication is enough for simple scabies infection though scabies symptoms may take some time to clear off completely.

In crusted or Norwegian scabies, treatment should be repeated after one week. In these cases oral Ivermectin should be taken along with the body cream.

PLEASE NOTE: Over the counter medications are usually not effective in the treatment of scabies and it is highly discouraged. All contacts should be treated to avoid recurrence.

Topical medications for treatment of Scabies

The topical medications for treatment of scabies includes.

  • 5 percent permethrin cream
  • 1 percent lindane lotion
  • 10 percent sulfur ointment
  • 25 percent benzyl benzoate lotion
  • 10 percent crotamiton cream

They are applied on the skin for between 12 to 24hours depending on which of them that you are using. Example you apply Permetthrin cream on your whole body and leave it on for 12 hours. On the other hand if you are using Benzyl benzoate lotion in scabies treatment, you will allow it stay on your body for 24hours before you can wash it off. You need to bath and towel dry yourself properly before applying the medications.

Oral Medication for the Treatment of Scabies

Ivermectin (Mectizan, Stromectol)

Additional medications in the Treatment of Scabies Infection

  • Use of Antibiotics if there is bacteria super infection especially in cases of crusted scabies.
  • Steroid creams to relieve swelling and itching
  • Antihistamine to help control  itching.
  • Treat all contacts as well.


Prevention of Scabies

Scabies infection can be prevented by the following ways.

  1. Avoiding skin-to-skin contact with an infected person
  2. Wash clothing, towels, pillow and bedding with hot water and dry on very high heat for at least 10 to 30 minutes.
  3. All items that cannot be washed should be thoroughly vacuumed and the vacuum well cleansed and disinfected with bleach thereafter.
  4. All contacts of an infested person like friends, family and sexual partners should be treated along.

For your questions, comments and clarifications on Scabies and treatment of scabies, please use the comment box below.