Symptoms of Scabies

Those who have had scabies may only need to hear the name of this condition to reimagine the notable symptoms it causes. The main one is an extremely itchy (and unforgettable) rash caused when the Sarcoptes scabiei mite burrows itself beneath the skin. The rash may be red or purple and paired with pimples or pus.

Lines (burrows) may also be present, which can help differentiate a scabies rash from another skin concern. Pain, inflammation, and infection can also result, sometimes indicating more severe or advanced cases. As scabies can be passed from person to person, it's important to recognize its signs and symptoms and seek treatment early.

Frequent Symptoms

scabies symptoms
Illustration by Joshua Seong. © Verywell, 2018.

Scabies is most commonly characterized by intense, persistent itching of the skin around the chest, arms, hands, legs, and genital area. Normally, the itching can be temporarily relieved with topical or oral anti-itch medications. That said, those options will not eradicate the mite.

Scabies often causes a visible rash that's usually seen between the fingers, on the wrists, in the armpits, around the waist, and in the genital area. The rash is not unique, however, as it resembles that of dermatitispsoriasishot tub folliculitis, and pityriasis rosea.

Characteristics of the rash can (but may not always) include:

  • Red or purple color
  • Tiny lines, known as burrows, connecting colored areas
  • Small pimples
  • Bumpy skin
  • Visible white pus

These symptoms begin after an incubation period and are associated with the mature stage of the parasite, during which it tends to settle deep in the skin. 

You are considered contagious and can spread the parasite to others from the time you pick up the infection yourself (during the incubation period) until about 24 hours after you begin treatment. 

Rare Symptoms

Photos of the Itchy, Painful Rash. CDC

Scabies can be quite uncomfortable, and that's especially so when the rash is associated with a painful sensation, which usually develops as the result of superficial scratches, deep skin wounds from scratching, or bacterial infections that may develop.

If you experience pain in addition to itchiness, it can be reduced with topical or oral pain medication as your scabies resolves. 

It is uncommon, but the scabies rash can progress to be quite severe, with redness, inflammation or blisters (pictured) in some areas throughout the body. This intense reaction is expected to be more severe if you have an allergic response to the parasite.

If you have a more intense than usual reaction to scabies infection, your doctor may prescribe either topical or oral anti-inflammatory medication.

Visible mites are rarely seen with scabies infection, but they have been noted by people who have the infection and, occasionally, by doctors. 

Scabies normally involves the arms, legs, trunk, breasts, and genitals, and involvement of the scalp, face, palms of the hands, or soles of the feet is rare in adults. It may, however, occur in very young children who have scabies.

Complications

Photos of the Itchy, Painful Rash. CDC / Reed and Carnrich Pharmaceuticals

In severe situations, scabies can cause areas of skin to develop crusted sores. This complication, known as Norwegian scabies, is an advanced form of the condition that typically develops in people who have a weak immune system.

The crusted skin contains a higher concentration of mites than what is normally seen with scabies. This condition is more difficult to treat and is highly contagious.

Scabies lesions can become infected with bacteria, particularly after intense scratching leads to open sores and wounds. These bacterial infections are not normally contagious, but they can spread and cause scarring of the skin.

Bacterial skin infections require a different treatment than the treatment used for scabies itself. If you notice redness, swelling, or warmth of the skin, you may have a bacterial skin infection in addition to scabies. 

In areas of the world where scabies is common, people often suffer from recurrent infections. Recurrent infections may be uncomfortable, and make it difficult to eliminate the infection from the household.

Additionally, for some people, recurrent infections have been associated with serious problems, including bacterial infections of the blood (sepsis), although this is rare and usually caused by an immune deficiency. Most complications of scabies are limited to the skin. 

When to See a Doctor

Photos of the Itchy, Painful Rash. CDC / Susan Lindsley

Those who suspect they might have scabies and those who simply are around someone who has been diagnosed with scabies, regardless of their own symptoms or lack thereof, should see a doctor.

If You Have Excessive Itching

If you experience severe itching that does not quickly resolve on its own, a medical evaluation is necessary. Scabies may or may not be the cause of your itching, but severe itching can be treated regardless of the cause. 

If You Develop a Rash

If you suddenly develop a rash, this can be a sign of scabies or another health problem. Your doctor can identify the cause of your rash and initiate the appropriate treatment for you. 

It is important to identify whether your itching and rash are caused by scabies because, unlike most rashes, it can spread among your family members and community if left unrecognized and untreated. 

If You See the Mite or Burrows on Your Body

It is unusual to see the scabies mite without a microscope because it is extremely small, measuring less than a half millimeter. However, if you notice anything on your skin that seems to be alive or moving, you should get medical attention. If you see small areas of your skin that look like tunnels, these may be burrows produced by the scabies mite.

If You Have Been Exposed to Scabies

If you know that you have come in close contact with someone who has scabies, you should be treated. This includes spouses, sexual partners, or anyone with whom you have had prolonged skin-to-skin contact. However, you should also know that a quick hug or handshake is not likely to put you at risk of contracting scabies.

Because there is a delay in scabies symptoms after exposure to the mite, you should see a doctor even before you begin to experience itching or notice a rash. 

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