Scabies is a contagious skin infestation caused by the human itch mite Sarcoptes scabiei. The mites burrow into the top layer of skin and lay eggs, causing an intense itchy rash. Scabies is spread through direct, prolonged skin-to-skin contact with someone who has scabies. If you’ve been exposed to someone with scabies, quick action is important to treat the infestation and prevent spreading it to others.
How do you know if you’ve been exposed to scabies?
You may have been exposed to scabies if:
- You had direct, skin-to-skin contact with someone diagnosed with scabies
- You live with someone who has scabies
- You held hands with, hugged, or had intimate physical contact with someone with scabies
- You shared a bed, towels, clothes or linen with someone who has scabies
Even brief physical contact with someone with scabies can allow the mites to spread to you. The mites can live on objects like clothes or bedding for 2-3 days, though they die quickly if removed from human skin. Shared living spaces also raise the risk of exposure.
What are the symptoms of scabies?
Symptoms usually appear 2-6 weeks after exposure to scabies mites. Signs and symptoms include:
- Intense itching, especially at night
- Rash, often between the fingers, on wrists, elbows, armpits, breasts, waistline, genitals, thighs, lower buttocks
- Thin, spiderweb-like burrows visible on the skin, caused by the mites tunneling
- Sores and crusty patches from scratching
In infants and young children, the rash may appear on the head, neck, palms, and soles. The itching is often severe and worse at night. Vigorous scratching can lead to skin sores and secondary bacterial infections.
When should you seek medical care?
See your doctor right away if you suspect you’ve been exposed to scabies or develop symptoms. Quick diagnosis and treatment is key to relieving symptoms and preventing the infestation from spreading. Tell your doctor about any recent potential exposures and when symptoms started.
Get medical help immediately if you develop any signs of a skin infection from scabies, including:
- Increased pain, swelling, warmth, redness, or pus around a rash
- Red streaks extending from a rash
- Fever, chills, muscle aches
- Drainage of pus or fluid from skin sores
- Swollen lymph nodes near rash areas
Skin infections require prescription antibiotic treatment in addition to scabies medication.
How is scabies exposure diagnosed?
To diagnose scabies exposure and infestation, your doctor will:
- Ask about any exposure to scabies and symptoms
- Examine your skin for rashes and burrow tracks
- Look for signs of scratching and skin sores
- Take skin scrapings to identify mites or eggs under a microscope
If you have an itchy rash but your doctor doesn’t find signs of scabies, you may be diagnosed with scabies-like irritation instead of true scabies infestation. But prescription treatment is still recommended.
How is scabies treated?
If you’ve been exposed to scabies, treatment is recommended even if you don’t yet have symptoms. Treatment involves:
- Prescription topical medication – Topical permethrin cream or other scabicides are applied over the entire body, usually before bed. The medication kills the mites and eggs. You may need to repeat in 1 week.
- Oral medication – Ivermectin tablets can be prescribed for widespread infections. All close contacts should also be treated simultaneously.
- Soothing lotions and anti-itch medication – Your doctor may recommend over-the-counter lotions, antihistamines, or low-dose steroid creams to manage itching.
It can take 2-4 weeks for itching to fully resolve after treatment. Notify your doctor if symptoms don’t improve.
How do you prevent spreading scabies?
To prevent spreading scabies to others, follow these precautions:
- Avoid direct skin contact with others until at least 24 hours after starting treatment.
- Wash clothes, towels, and bedding used in the last 3 days in hot water and dry on high heat.
- Vacuum carpeting, furniture, mattresses, and car seats thoroughly.
- Disinfect items that can’t be washed like books or stuffed animals.
- Trim fingernails short to reduce skin damage from scratching.
- Have close contacts and household members get treated at the same time, even if no symptoms.
Are there complications from scabies?
Complications of scabies can include:
- Skin infections – Bacterial infection can develop from excessive scratching and skin sores.
- Permethrin resistance – Some mites may become resistant to permethrin, requiring alternative medications.
- Crusted scabies – A rare, severe form involving the entire body can develop in people with weakened immune systems.
With prompt treatment, most cases of scabies resolve without complications. But seek medical care if symptoms worsen or persist.
FAQs about scabies exposure
How soon after exposure do scabies symptoms appear?
If you develop scabies after exposure, symptoms typically appear 2-6 weeks later. But it can take up to 2 months after exposure for symptoms to begin.
Can you get scabies without having symptoms?
Yes, it’s possible to be infested with scabies mites without having any symptoms, especially right after initial exposure. But symptoms nearly always develop within a few weeks in those who don’t receive early treatment.
Can scabies go away on its own?
No, scabies will not go away without treatment. The mites can survive on the skin for 1-2 months. Treatment with prescription medication is necessary to kill the mites and eggs.
Does scabies spread quickly?
Scabies spreads quickly between close contacts like household members, sex partners, and caregivers. Outbreaks can occur in group settings like nursing homes, schools, and prisons due to the mites’ easy spread through skin contact.
How do you disinfect for scabies?
To disinfect for scabies, thoroughly clean any items used by the infested person in the last 3 days. Wash clothes and bedding on hot and dry on high heat. Vacuum and steam clean furniture, carpets, and mattresses. Disinfect non-washable items in acaricides or by sealing in bags for a week.
Can scabies spread by hugging?
Yes, brief skin-to-skin contact like hugging someone with scabies can allow mites to spread. The longer the contact, the higher the risk. Holding hands, linking arms, and other direct touching can also transmit scabies.
The bottom line
If you think you may have been exposed to scabies, see a doctor right away for evaluation and treatment. Quick action is key to killing the mites before a widespread infestation and itchy rash develops. With prescription topical medication, scabies is treatable. But be sure to disinfect your surroundings to avoid reinfestation or spreading mites to others.
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Scabies Diagnosis and Treatment