Scabies is a contagious skin condition caused by the human itch mite Sarcoptes scabiei. It leads to intense itching and a pimple-like skin rash. Scabies mites crawl under the skin and lay eggs, causing an allergic reaction and rash. Scabies is spread through direct, prolonged physical contact with someone who has scabies. Even after treatment, you can still be contagious for a period of time while any remaining mites or eggs under your skin hatch and die. So how long after treating scabies are you still contagious?
How is Scabies Spread?
Scabies mites spread easily to sexual partners and household members. You can get scabies from prolonged skin-to-skin contact with an infested person, often without knowing it. Contact must be prolonged, such as holding hands for an extended time. Brief casual contact usually does not spread scabies.
Scabies mites can also spread through contaminated objects such as clothes, towels or bedding. But mites can only survive for 48-72 hours off a human host. Infested bedding, clothing or furniture that has not been used for more than 3 days is not a source of mites.
Scabies Treatment
There are a few treatment options for scabies:
Permethrin Cream
Permethrin cream is the most common scabies treatment. It kills the mites and eggs. Permethrin is applied to all areas of the body from the neck down and washed off after 8-14 hours. Often one application is enough to kill all the mites.
Ivermectin
Ivermectin is an oral medication that kills the mites. A second dose is often prescribed 7-10 days later to kill any newly hatched mites.
Lindane
Lindane is also applied to all areas of the body from the neck down. It is left on for 8 hours before rinsing off. Lindane is only recommended when other treatments have failed.
Sulfur Soap/Crotamiton Cream
Sulfur soap and crotamiton cream help relieve itching but do not kill mites. They are often used in combination with other treatments.
How Long After Treatment are You Contagious?
You can spread scabies until all mites and eggs have been killed. Even after successful treatment, it takes time for all mites and eggs to die. You can be contagious for up to one month after beginning treatment. Here is a timeline:
1-3 Days After Treatment
You are still very contagious in the first few days after treatment. Mites may still be alive and eggs may still hatch and spread. Avoid close contact during this time.
1 Week After Treatment
Most mites are dead by one week after treatment. But eggs can survive and hatch over the next 2-3 weeks. It’s best to avoid skin-to-skin contact until your doctor confirms you are no longer contagious.
2-3 Weeks After Treatment
By 2-3 weeks, most eggs have hatched and died. You may get the “all clear” from your doctor at this point if your rash and itch are resolved. But some eggs can survive up to 4 weeks.
1 Month After Treatment
One month is a safe amount of time to assume you are no longer contagious after finishing treatment. By 4 weeks, all mites and eggs should be dead.
Steps to Prevent Spreading Scabies After Treatment
To avoid spreading scabies after treatment, take the following precautions:
– Avoid direct skin-to-skin contact with others for at least one week. No hugging, hand-holding or sexual contact.
– Wash clothes, towels and bedding in hot water and dry on high heat. This will kill any mites or eggs.
– Vacuum carpets, furniture and mattresses to pick up any dead mites or eggs.
– Keep fingernails short to prevent mites from burrowing under them.
– Shower and change into clean clothes and underwear daily.
– Disinfect surfaces like doorknobs, phones and keyboards.
– Tell close contacts like family that they may have been exposed. They should see a doctor.
– Wait 24-48 hours after last treatment before returning to school or work.
– Avoid sharing clothing, towels and bedding with others during treatment.
– Put lotion on any itchy spots to avoid infecting others through scratching.
When is it Safe to be Around Others After Scabies Treatment?
Here are some general guidelines for when it is safe to be around others after scabies treatment:
| Time After Treatment | Safety Around Others |
|---|---|
| 1-3 days | Avoid direct contact |
| 1 week | Limited contact, but avoid skin-to-skin contact |
| 2 weeks | May resume normal contact after doctor approval |
| 1 month | Safe to assume you are not contagious |
In general, avoid direct skin contact for one week after treatment. Wait 2-4 weeks before resuming activities like sports or intimacy where skin touches often. Seek doctor approval before returning to work or school after treatment. After one month, you are likely clear of scabies infestation.
When are You No Longer Contagious After Scabies?
You are considered no longer contagious after the following have occurred:
– It has been 4 weeks since you began treatment
– You have no evidence of active mites, such as new burrows or rash
– Household contacts do not show signs of scabies infestation
– Your doctor has confirmed you are clear of infestation
Once all mites and eggs have died and no one else is infected, you are no longer contagious. This may take 4 weeks or longer from the start of treatment to confirm.
Can Scabies Return After Treatment?
Yes, it is possible for scabies to return after treatment. This occurs in 15-50% of cases. Reasons scabies can return include:
– Not properly following treatment instructions
– Not treating all close personal contacts
– Missing spots when applying topical medication
– Bedding, clothing or furniture still infected with mites
– Getting re-exposed from an infected contact
– Weakened immune system unable to fight re-infestation
If itching and rash return after treatment, see your doctor right away. You will likely need a repeat application of scabies medication. All close contacts should also be re-treated.
Conclusion
After treating scabies, you can remain contagious for up to one month. Scabies mites and eggs under the skin can survive and hatch even after treatment. Avoid direct skin contact for at least one week after finishing treatment. Seek doctor approval before contact sports, intimacy or returning to work/school. After one month it is usually safe to assume you are no longer spreading scabies. However, if itching and rash return, get retreated right away and alert your doctor. With proper treatment and precautions, scabies can be cured and you can eliminate further spread to others.
