Scabies is a skin condition caused by microscopic mites called Sarcoptes scabiei. When these mites burrow into the skin, they can cause an allergic reaction and rash. Scabies mites are very small, only about 0.3-0.4 mm long, and are nearly invisible to the naked eye. However, the itchy rash and bites left by scabies are quite distinctive.
Typical Location of Scabies Bites
Scabies mites often burrow into the skin between the fingers, on the wrists, elbows, armpits, beltline, thighs, genital area, nipples, and lower buttocks. Babies and young children tend to have infestations on the head, neck, palms, and soles of the feet. The mites do not usually burrow into the skin of the face or scalp unless the infestation is severe.
What Scabies Bites Look Like
When scabies mites tunnel into the skin, they form burrow tracks called scabies tunnels. These tunnels appear as thin grayish-white or skin-colored lines on the skin, about 2-15 mm long. They are often found in creases of the skin and can be easier to see on people with dark skin tones.
As the mites burrow, they deposit eggs and feces, which trigger an allergic reaction and rash. Scabies bites often look like small bumps, pimples, or blisters that may be red, white, or skin-colored. Some bites may contain watery or pus-filled fluid. They can be found scattered across the infested area or clustered together in a line or a zig-zag pattern.
Common Characteristics of Scabies Bites:
- Small bumps, pimples, vesicles, or blisters
- Red, pink, white, or skin-colored
- Pinpoint to pinhead size
- May contain fluid
- Often found in clusters or zig-zag lines
Differences Between Scabies and Bed Bug Bites
Scabies bites are sometimes confused with bed bug bites, as both can cause red, itchy bumps on the skin. However, there are some differences:
| Scabies Bites | Bed Bug Bites |
|---|---|
| Burrows visible | No burrows |
| Found between fingers, on wrists, etc. | Usually on exposed areas like face, neck, arms |
| Zig-zag pattern common | Bites often in a line or cluster |
In addition, bed bug bites usually appear red immediately after being bitten, while scabies bites can take up to 2-6 weeks to manifest.
What Does Scabies Rash Look Like?
Along with the burrows and bites, scabies also causes an intensely itchy rash. The scabies rash is made up of small red bumps or blisters on the skin that may ooze or crust over when scratched. The rash often appears first on the wrists, fingers, elbows, armpits, and genital area before spreading across the body.
On babies and children, the scabies rash tends to appear on the head, face, neck, palms, and soles first. As the infestation becomes more severe, the rash can spread across the entire body.
Common Features of Scabies Rash:
- Intensely itchy, gets worse at night
- Small red bumps, vesicles, pustules, blisters
- May crust over when scratched
- Appears first on wrists, fingers, etc.
- Spreads across body over time
When Do Scabies Bites Appear?
For a person who has never had scabies before, symptoms will usually start 2-6 weeks after initial infestation. However, if a person has had scabies previously, symptoms occur much faster within 1-4 days of re-exposure due to a hypersensitivity reaction.
After the mite burrows into the skin, it takes time for the body to react to the foreign proteins, producing the rash and itching. In subsequent infestations, the immune system responds more quickly, leading to faster onset of symptoms.
Scabies Bite Timeline:
- Initial infestation – Bites appear 2-6 weeks after exposure
- Re-infestation – Bites appear 1-4 days after exposure in previously infected persons
Who is Most Susceptible to Scabies?
Scabies mites are opportunistic parasites that can infest anyone. However, certain populations are at higher risk:
- Young children
- Elderly living in nursing homes
- Immunocompromised people
- People living in overcrowded conditions
- Sexually active people
In addition, people with weakened immune systems may develop an extremely severe form of scabies known as crusted or Norwegian scabies, characterized by thick crusty patches all over the skin that contain thousands of mites.
When to See a Doctor
It is important to consult a doctor for proper diagnosis and treatment if you suspect you have scabies. Try to avoid excessive scratching, as this can cause infection. To diagnose scabies, the doctor will examine the rash and burrows and may take a skin scraping to look for mites or mite eggs under the microscope.
Prescription medication is needed to get rid of scabies infestations. Common treatments include topical permethrin cream, ivermectin pills, and sometimes sulfur ointments. All clothes, towels, and bedding used in the last 3 days should also be thoroughly washed and dried to prevent re-infestation.
Can Scabies Go Away On Its Own?
No, scabies will not resolve without treatment. The mites can live on the skin for up to 2-3 months, continuously re-infesting and laying new eggs. Scabies must be treated with specific medications that kill the mites and eggs.
Some people may think scabies went away on its own because symptoms seem to disappear after a few weeks. However, this is likely due to the normal cycle of the scabies mite. Symptoms improve when the older mites die off, but eggs will still hatch and continue the infestation if not treated.
How to Prevent Getting Scabies
Here are some tips to avoid getting scabies:
- Avoid direct, prolonged skin-to-skin contact with an infested person
- Avoid sharing clothing, towels, bedding with someone who has scabies
- Wash hands frequently
- Be aware of scabies outbreaks in communities, nursing homes, etc.
- Get prompt treatment if you develop symptoms
- Wash all clothes, bedding, and towels after treatment
Conclusion
Scabies bites and rash can be quite uncomfortable. Typical signs include small bumps or blisters that may contain fluid and burrows seen as grayish-white lines on the skin. The rash is very itchy, especially at night. It often first appears between the fingers, on wrists, elbows, and genital area before spreading across the body. Proper diagnosis and prescription treatment is key to getting rid of scabies mites. With medications and by washing items in hot water, the infestation can be cured and further transmission can be prevented.