Scabies: symptoms, treatment for the whole family and preventing re-infection
What causes scabies, why it itches most at night, how it is diagnosed, why everyone at home needs treatment at the same time, and how to stop it returning.
What scabies is
Scabies is a skin infestation caused by a tiny mite, Sarcoptes scabiei, too small to see with the naked eye. The female mite burrows into the top layer of skin and lays eggs. The body's allergic reaction to the mites, their eggs and droppings causes intense itching and a rash.
Scabies spreads mainly through prolonged skin-to-skin contact, such as sharing a bed, caring for a child, or close living. Less often it spreads through shared clothes, towels and bedding. It is common in crowded households, hostels, schools, care homes and other settings where people live closely. It is not a sign of poor hygiene; anyone can get it.
A severe form called crusted scabies, with thick crusts and very large numbers of mites, can occur in older people and those with weakened immunity. It is highly contagious and needs specialist treatment.
Symptoms
- Intense itching at night, often keeping people awake
- Small red bumps or blisters
- Burrows — thin, wavy, greyish lines on the skin
- Rash between the fingers, on the wrists, elbows, armpits, waist, buttocks, nipples and genitals
- In babies and young children, rash on the palms, soles, face and scalp
- Sores from scratching, which can become infected
- Several family members itching at the same time
In a first infestation, itching may not start for several weeks, so a person can spread scabies before they know they have it. In a repeat infestation, itching starts within days.
Who is at risk
- People living in crowded homes, hostels, shelters or care facilities
- Young children and their carers
- Older people in long-term care
- Sexual partners of someone with scabies
- People with weakened immunity, at risk of crusted scabies
Scabies left untreated can lead to bacterial skin infections, and in some settings these can cause kidney and heart complications, which is one reason prompt treatment matters.
How it is diagnosed
A doctor usually diagnoses scabies with a skin examination, looking for burrows and the typical pattern of rash, together with night-time itching and itching in other household members. Dermoscopy, using a handheld magnifier, can show mites in burrows. A skin scraping examined under a microscope may show mites, eggs or droppings, although a negative result does not rule scabies out.
Scabies can look like eczema, insect bites, hives or other itchy rashes. Some people have been treated wrongly with steroid creams for months before scabies is recognised, which can make the rash look unusual and spread further. If treatment has not worked, see a dermatologist to confirm the diagnosis.
Which doctor to see
A general physician or paediatrician can diagnose and treat most scabies. A dermatologist is the right choice for uncertain diagnosis, crusted scabies, treatment failure, or scabies in a young baby or pregnant woman.
You can find dermatologists in Bengaluru, general physicians and paediatricians on The Doctor Index.
Treatment
Everyone in the household and close contacts, including sexual partners, should be treated at the same time, even if they have no itching. Otherwise the mites pass back and forth.
Creams and tablets
Permethrin cream is the most commonly used treatment. It is applied to the whole body from the neck down — including between the fingers and toes, under the nails, and the genitals — and left on for the time your doctor advises before washing off. In babies and older people, the scalp and face may also need treatment. A second application after about a week is usually advised. Ivermectin tablets are an alternative or added treatment, especially for crusted scabies or outbreaks, but are not suitable for everyone, including young children and pregnant women. Other creams are used in some situations.
Washing clothes and bedding
Washing clothes and bedding used in the previous few days, in hot water, and drying them in hot sun or a hot dryer, kills mites. Items that cannot be washed can be sealed in a plastic bag for several days. Vacuum mattresses and sofas. There is no need to fumigate the house.
Preventing re-infection
Treat all contacts on the same day, including family members who live elsewhere but have stayed recently, and anyone who shares a bed. In hostels, care homes and schools, let the person in charge know, because several people may need treatment together to stop an outbreak. Avoid close contact and sharing clothes, towels and bedding until treatment is complete. Keep fingernails short and clean, as mites and eggs can collect under them, and apply the cream under the nails carefully. Children can usually return to school after the first full treatment. If itching continues beyond a few weeks, or new burrows appear, see your doctor again, as a repeat course or a different treatment may be needed.
When it is urgent
Scabies is not usually an emergency. See a doctor promptly for painful, pus-filled sores, spreading redness, fever, or thick crusting of the skin. Call 112 or 108 for swelling of the face or throat or difficulty breathing after a medicine, or if a young child becomes very unwell with fever and a spreading skin infection.
Questions to ask at your appointment
- Is this definitely scabies?
- Who in my household needs treatment?
- How do I apply the cream, and how long should it stay on?
- When do I repeat the treatment?
- How long will the itching last after treatment?
- What should I wash, and how?
Common questions
Questions people ask
- Why does the itching continue after treatment?
- The skin can keep reacting to dead mites and their debris for two to four weeks after successful treatment. This post-scabies itch does not mean treatment has failed. If itching continues beyond that, or new burrows appear, see your doctor for review.
- Does everyone at home really need treatment?
- Yes. People can carry mites for weeks before they itch. Treating only the person with symptoms usually leads to re-infection from others. Everyone in the household and close contacts should be treated on the same day.
- Can I get scabies from my dog or cat?
- Animals get a different type of mite infestation called mange. These mites can cause a brief itchy rash in people but do not survive on human skin. Human scabies spreads from person to person, not from pets.
- Is scabies a sign of being unclean?
- No. Scabies spreads through close contact and can affect anyone, regardless of how often they bathe. It is more common in crowded living conditions. Bathing does not remove mites; proper treatment of everyone affected does.
This condition is usually assessed by a dermatologist. Every profile shows the doctor’s registration and what has been checked.
Dermatologists in Bangalore
A few dermatologists listed on The Doctor Index. They are shown because of their speciality, not a stated interest in Scabies; ask the clinic whether the doctor sees it.
Related conditions
Practical reading
All postsSources
- MedlinePlus, US National Library of Medicine — Scabies
- World Health Organization — Scabies fact sheet
- MedlinePlus, National Library of Medicine — Scabies — Public-domain health-topic summary
Scabies: symptoms, treatment for the whole family and preventing re-infection is original text by The Doctor Index; the compiled source draft was used for research. Source: MedlinePlus, National Library of Medicine. Orphadata Science: Free access data from Orphanet. © INSERM 1999; July 2026 data, CC BY 4.0. This product uses the Human Phenotype Ontology (hp/releases/2026-09-01). Only sources listed for this article apply. Source material has been selected and arranged; HPO definitions are reproduced without alteration. No source organisation endorses this compilation. Köhler S et al. The Human Phenotype Ontology project: linking molecular biology and disease through phenotype data. Nucleic Acids Research 2014;42(D1):D966–D974. doi:10.1093/nar/gkt1026.
General information, not advice about your situation. Errors can be reported through the corrections process. Reference TDI-C-2094.