This image displays erosions and burrows at the wrist in a patient with scabies. This image displays a track on the skin, known as a burrow, typical of scabies. While scabies is usually seen as irregular red, scaling, scratched patches anywhere on the body, there are usually some spots noted on the hands or feet. As displayed in this image, bleeding can accompany scabies due to scratching the affected area. This image of the pubic area shows the itchy red bumps of scabies that may be all over the body (widespread). This image displays a very fine line with scale in the webbed area of the hand due to burrowing of the scabies mite. This image displays red, crusted, scaling patches on a patient's hand, typical of scabies. This image displays a typical example of scabies lesions. This image displays the mite of scabies magnified under a microscope.
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Picture of Scabies: This image displays erosions and burrows at the wrist in a patient with scabies. Divider line
This image displays erosions and burrows at the wrist in a patient with scabies.
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Treatments Your Physician May Prescribe
Your physician may be able to diagnose scabies simply by examining your skin for typical lesions, such as burrows. A skin scraping, called a scabies preparation, may be examined under a microscope for mites, eggs, or mite droppings (feces).

In most cases of scabies, your doctor may recommend a topical cream or lotion, such as:
  • Permethrin cream – After application, wash the cream off after 8–14 hours. Use the permethrin cream again in one week.
  • Crotamiton lotion or cream – Apply once daily for 5 consecutive days.
  • Sulfur ointment – Apply nightly for 3 consecutive nights. This is often the best choice for babies and for pregnant and nursing women because it is very safe to use.
  • Lindane lotion or cream – Wash the cream or lotion off after 8 hours. Lindane may be toxic to some people. Therefore, young children, pregnant or breast-feeding women, and people with diseases affecting the nerves (neurological diseases) should not use lindane.
When using a topical cream, lotion, or ointment, be sure to follow these steps (unless your physician gives other instructions):
  • Apply to the entire body.
  • Smear the product beneath the fingernails and toenails.
  • Apply to body folds, including inside the navel, in the buttock crease, and between the fingers and toes.
In more severe cases of scabies, your doctor may prescribe oral medications:
  • Ivermectin pills – Take once and then repeat 1–2 weeks later
  • Antihistamine pills
  • Antibiotic pills, if any scratched areas appear to be infected with bacteria 
     
Itching may take up to 3 weeks to go away as your immune system continues to react to dead mites. However, new burrows and rashes should stop appearing 48 hours after effective treatment.

Your doctor should remind you to launder towels, bed linens, and clothes used in the previous 72 hours and to vacuum carpets, rugs, and upholstered furniture.

Household members, sexual partners, and anyone else with prolonged skin-to-skin contact with an infested person should also seek treatment from their doctor. Because the initial development (incubation time) for scabies infestations can be from 6–8 weeks, people may be infected with scabies, but because they do not yet feel itchy, they are unaware that they have an infestation. If untreated, these close contacts could pass the mites back to you. Ideally, everyone should be treated at the same time in order to prevent re-infestation.

Last Modified: 28 Feb 2008
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