Dr. M.J. Bazos, MD. Patient Handout

About Your Diagnosis

Scabies is an extremely itchy rash caused by a tiny mite that burrows into the skin. Although the mite is only slightly larger than the head of a pin and only burrows a short distance into the skin, it causes an intense itching. The condition is very widespread and although anyone can catch scabies, it is much more common in young children. Often children will bring the mite infection home and spread it to family members. It is also common in individuals who live close together, such as those in nursing homes and extended care facilities. The infection is transferred from person to person. Fortunately scabies is easy and quick to treat. It is not a dangerous infection and does not usually lead to permanent damage. Excessive scratching, however, can cause the scabies rash to become infected with bacteria. This bacterial infection may lead to serious cellulitis and scars. Therefore prompt and correct treatment is necessary. Physicians are able to make the diagnosis by close skin examination. Occasionally the tiny mite can be seen, but in most cases it is necessary to painlessly scrape the skin. This will bring the mite onto a slide for microscopic examination.

Living With Your Diagnosis
The itchy rash of scabies can occur almost anywhere on the body. Because it is an allergic reaction, there may or may not be mites in the rash site. The rash is often identified by its linear nature, following the burrow of the mite. It consists of little red bumps, bites, or pimples often in a row. The most common areas of the body for infection by the mite are in the body creases or where straps and bands constrict the skin. These areas are primarily the hands, wrists, ankles, groin, waist, and arm pits. Nonetheless, because the rash is allergic, it can appear anywhere. The earliest and most common symptom of scabies is nighttime itching, even before the rash appears.

The standard treatment of scabies consists of applying an insecticide lotion on the skin, such as permethin, lindane, crotamiton, or sulfur. These lotions require total body application and must be left on for a specific length of time (varies depending on lotion). The lotion is then washed off. The lotion must cover the entire body below the face including the genital area, hands, breasts, and feet. These medications are usually safe, but caution is especially important with infants younger than 2 years and with pregnant women. All such medicine should be used under a physician’s supervision. All close family contacts should be treated at the same time. Careful washing of all clothes, bedding, and toys with hot, soapy water is required. You do not have to boil clothes or bedding. The itching usually disappears rapidly within a week or two of treatment. If symptoms do not go away, retreatment may be needed. The severe itching may be treated with antihistamines or topical emollients and/or steroids. If it is determined that a secondary bacterial infection has occurred, you will need to be treated with antibiotics.

The DOs
• See a physician immediately. Anyone can get scabies. It is not a reflection on your personal cleanliness.
• Wash clothing, bed linens, towels, and toys in hot, soapy water and machine dry.
• Vacuum entire house and dispose of bag.
• Follow precisely your physicians directions for use of lotions and medications; wash off thoroughly when time is up.
• Wash hands frequently to avoid spreading the mites.

The DON’Ts
• Don’t treat with home remedies such as detergents, scrubbing, or kerosene; these often make it worse.
• Don’t use steroid creams unless prescribed by your doctor.
• Try to avoid scratching heavily or picking at the rash.

When to Call Your Doctor
• The rash shows signs of infection (redness, pus, swelling, or pain) after treatment.
• Persistent itching or pain 1–2 weeks after treatment.
• New unexplained symptoms.