Is It Scabies? Why Your Skin Is Itching & Proven Medical Next Steps

If your skin won't stop itching—especially at night—you may be wondering: Is it scabies?

Itching is one of the most common skin complaints. In many cases, it's caused by dry skin, eczema, allergies, or contact with an irritant. But sometimes, persistent itching is due to scabies, a contagious skin condition caused by tiny mites.

This guide explains what scabies is, how to recognize it, how doctors diagnose it, and what proven medical treatments work. The goal is to give you clear, reliable information—without unnecessary fear—so you can take the right next steps.

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What Is Scabies?

Scabies is a skin infestation caused by a microscopic mite called Sarcoptes scabiei. The mite burrows into the top layer of the skin, where it lives and lays eggs.

The body reacts to the mites, their eggs, and waste products—causing intense itching and a rash.

Scabies is:

• Common worldwide
• Highly contagious through close skin contact
• Treatable with prescription medication

It is not caused by poor hygiene. Anyone can get scabies.

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What Does Scabies Feel Like?

The hallmark symptom of scabies is intense itching, often worse at night.

Other common symptoms include:

• Small red bumps or pimple-like rash
• Thin, wavy, thread-like lines on the skin (burrows)
• Sores from scratching
• Thick crusts in severe cases

The itching may begin 2–6 weeks after exposure if you've never had scabies before. If you've had it in the past, symptoms can start within days.

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Where Does Scabies Usually Appear?

Scabies tends to affect specific areas of the body.

In adults and older children, common locations include:

• Between the fingers
• Wrists
• Elbows
• Armpits
• Waistline
• Buttocks
• Genitals
• Around the nipples

In infants, young children, older adults, or people with weakened immune systems, it can also affect:

• Scalp
• Face
• Neck
• Palms and soles

If your itching is widespread but especially strong in these areas, scabies becomes more likely.

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How Do People Get Scabies?

Scabies spreads through prolonged skin-to-skin contact. This often happens:

• Between household members
• Between sexual partners
• In nursing homes or care facilities
• In crowded living conditions

It is less commonly spread by clothing or bedding, but this can happen—especially in more severe cases.

You generally cannot get scabies from a brief handshake or quick hug.

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When It Might Not Be Scabies

Many itchy rashes are not scabies. Other common causes include:

• Eczema (atopic dermatitis) – Dry, inflamed skin often linked to allergies
• Contact dermatitis – Reaction to soaps, detergents, plants, or metals
• Psoriasis – Thick, scaly patches
• Hives – Raised, itchy welts that move around
• Fungal infections – Ring-shaped or scaly rashes

If itching improves with moisturizers, antihistamines, or over-the-counter hydrocortisone, it may not be scabies. Scabies usually does not go away without prescription treatment.

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How Doctors Diagnose Scabies

A healthcare professional typically diagnoses scabies by:

1. Examining the rash
2. Reviewing symptoms and exposure history
3. Sometimes taking a skin scraping to look for mites under a microscope

In many cases, diagnosis is based on appearance and symptoms alone.

If multiple household members are itching, that's an important clue.

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Proven Medical Treatments for Scabies

The good news: scabies is treatable.

First-Line Treatment

Doctors usually prescribe:

• Permethrin 5% cream

This is applied from the neck down (and sometimes scalp in certain groups), left on for 8–14 hours, and then washed off.

A second treatment one week later is often recommended to kill newly hatched mites.

Other Treatment Options

If permethrin isn't appropriate, a doctor may prescribe:

• Oral ivermectin
• Other topical medications in specific cases

Treatment choice depends on age, pregnancy status, immune health, and severity.

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Important: Treat Close Contacts

To prevent reinfestation:

• All household members and close contacts should be treated at the same time
• Bedding, towels, and clothing used in the previous 3 days should be:
  • Washed in hot water
  • Dried on high heat

Items that can't be washed can be sealed in a plastic bag for at least 72 hours.

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Why Am I Still Itching After Treatment?

This is common—and frustrating.

Even after successful treatment, itching may continue for:

• 2–4 weeks

This does not always mean treatment failed. The body may still be reacting to dead mites and debris.

A doctor may recommend:

• Antihistamines
• Mild steroid creams
• Moisturizers

However, if new burrows or bumps appear, or symptoms worsen, follow up with your healthcare provider.

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When Scabies Becomes Serious

In some people—especially those with weakened immune systems—crusted scabies can develop.

This severe form includes:

• Thick, crusted skin
• Thousands to millions of mites
• Extremely high contagiousness

Crusted scabies requires urgent medical treatment and sometimes combination therapy.

Additionally, excessive scratching can lead to:

• Bacterial skin infections
• Impetigo
• Rarely, more serious complications if infection spreads

If you notice spreading redness, warmth, swelling, fever, or pus, seek medical care promptly.

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Should You Do a Symptom Check?

If you're unsure whether your itching is due to scabies, a free AI-powered scabies symptom checker can help you understand your symptoms and decide whether to seek medical care.

A structured symptom check can help you:

• Understand how closely your symptoms match scabies
• Decide whether you should seek care
• Prepare better questions for your doctor

It's not a diagnosis—but it can be a helpful starting point.

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When to Speak to a Doctor

You should speak to a doctor if:

• Itching is severe or worsening
• Multiple people in your household are affected
• You suspect scabies exposure
• Symptoms last more than two weeks
• You see signs of infection (pus, fever, spreading redness)
• You have a weakened immune system
• An infant or elderly person is affected

If symptoms are severe, spreading rapidly, or accompanied by fever or signs of serious infection, seek urgent medical care.

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Key Takeaways About Scabies

• Scabies is common and treatable.
• The main symptom is intense itching, especially at night.
• It spreads through close skin contact.
• It does not go away without prescription treatment.
• Everyone in close contact should be treated at the same time.
• Itching can continue after treatment but usually improves.
• A doctor's evaluation is the most reliable way to confirm the diagnosis.

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Final Thoughts

Persistent itching can be exhausting and stressful. While scabies is uncomfortable and contagious, it is not a reflection of cleanliness—and it is very treatable with proper medical care.

If your symptoms match the classic signs, take action early. Consider doing a symptom check, and don't hesitate to speak to a healthcare professional. Getting the right diagnosis and treatment can bring real relief—and prevent the condition from spreading to others.

If anything about your symptoms feels severe, unusual, or potentially serious, speak to a doctor right away. Your skin—and your overall health—deserve proper care.