Scabies

Key facts

• Scabies is a skin infestation caused by Sarcoptes scabiei, a tiny mite that burrows into the skin's outer layer to lay eggs.
• It spreads through prolonged skin-to-skin contact, making it common in households, care homes and other crowded living situations.
• The signature symptom is intense itching, often worse at night, with small red bumps or thin, wavy burrow lines.
• Treatment usually involves a topical antiparasitic cream, or oral ivermectin when topical treatment is impractical or in severe, crusted scabies.

What the infestation looks like

The signature symptom is intense itching that tends to worsen at night. The rash typically appears as small red bumps or thin, wavy burrow lines in the skin. Common sites are the finger webs, wrists, elbows, armpits, waist and genitals; in young children the face, scalp and palms can also be affected. Symptoms usually take two to six weeks to appear after first exposure, though someone who has had scabies before may react within days of re-exposure.

Treating scabies

Treatment targets both the mites and their eggs. Ivermectin is an oral antiparasitic used when topical treatment is impractical, or in cases of crusted (Norwegian) scabies, a more severe form with a high mite burden. All household members and close contacts are usually treated at the same time to prevent re-infestation, and clothing, bedding and towels should be washed in hot water on the day of treatment.

Itching can persist for two to four weeks after successful treatment, as the skin reacts to dead mites and eggs. This does not mean treatment has failed.

When to see a doctor

See a doctor if itching and rash don't improve within a few weeks of treatment, if crusted or widespread skin changes develop, or if several household members develop symptoms at once, since everyone in close contact usually needs treating together.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.