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Public Health - Seattle & King County


What is it?

  • Scabies is a contagious skin infection that is caused by a type of mite.
  • Mites are insect-like creatures that burrow, or tunnel, under the outer layer of skin. Mites lay eggs under the skin and feed themselves on the blood from their victims.
  • Mites are about the size of a dot at the end of a sentence and usually cannot be seen. They are grayish in color and nearly transparent.


  • Involved skin becomes itchy, irritated, warm, reddened and blistered.
  • Itching is usually worse at night.
  • The skin irritation is more likely to be seen in the following locations: a) between the fingers and toes; b) around the wrist or navel; c) in the folds of the elbow, armpit, belt-line, abdomen, groin; d) in the genital area.
  • Small children or babies may have involvement of the face, scalp, palms of the hands, or soles of the feet.
  • Itching and rash may not become apparent until as long as 6 weeks after becoming infested. The itching occurs as a result of an allergic reaction to the mites and their waste.
  • When a person has scabies symptoms, an accurate diagnosis by a medical professional is important in order to ensure appropriate prescription treatment.

How is it spread?

  • Scabies is spread by direct skin-to-skin or close bodily contact.
  • Even the cleanest person can become infested when there is direct, skin-to-skin contact with a person who has scabies.
  • Contact must be prolonged (a quick handshake or hug will usually not spread infestation).
  • Pets (dogs, cats and rabbits) and some farm animals (goats, horses, cattle and pigs) can be infected with scabies mites, but these are of a different type than human scabies mites. If you have close contact with an animal that has scabies, the mites could get under your skin and cause temporary skin irritation and itching. However, the mites die in a couple of days, and you do not need to be treated with special medication to kill the mites. If a pet or farm animal has scabies, it is important to have the disease treated by a veterinarian or you could continue to get reinfected from the animal.

Diagnosis and treatment

Diagnosis of scabies occurs by close examination of the skin, including finding and recognizing the mite in a small skin scraping and recognizing the mite burrows.

  • Treatment consists of applying an insecticidal creme or lotion and cleaning the infected person's recently used clothing and bedding.
  • All household members and intimate contacts should also be treated at the same time as the infected person. Intimate contacts are persons who have had prolonged skin-to-skin contact with someone who has scabies. Treating everyone at the same time prevents re-infestation with scabies from other persons who might be infected but not have symptoms yet.
  • Obtain the prescription treatment creme or lotion from a health care provider.
  • Always follow the directions provided with your scabies treatment.
  • Never use the treatment more often than recommended. Some insecticide treatments can be dangerous when too much is used.
  • Wash and dry all bedding, clothing, and towels used by the infected person within the four days before the treatment was started. Use hot water and the high heat setting on the dryer.
  • Items that cannot be washed and dried can be placed in a sealed plastic bag and stored for a minimum of seven days to allow time for the mites and eggs to die.
  • Vacuum furniture and bedding. There is no need to use pesticides or insecticide sprays to control scabies on household objects or in the environment.


  • Quick identification and treatment is very important to control further spread of scabies.
  • Infected persons should be excluded from school or work until the day after treatment.
  • When an outbreak occurs in a hospital, or nursing home facility, please contact the infection control practitioner for advice on special precautions.

What else do I need to know?

  • A person is no longer contagious once treatment has been completed although itching may persist for several weeks. There are medications that can help relieve the itching.
  • Sometimes the sites infested with scabies can become infected with bacteria such as "staph" and "strep". If an infection has occurred, antibiotic treatment is available.

What if scabies comes back or if the treatment fails to work?

  • It is possible to get scabies again (re-infestation) if you come in contact with mites.
  • To avoid re-infestation, it is extremely important to follow instructions exactly for treatment and cleaning and laundering contaminated clothing, bedding, and other objects.
  • If a new skin rash or sores occur, consult your health care provider.