How Do You Know If You Have Scabies?

Find out everything you need to know about this itchy mite called scabies and how to get rid of it.

Sanaz Majd, MD,
February 2, 2017

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How Is Scabies Diagnosed?

No testing is required to diagnose these mites.  Basically, doctors diagnose scabies based just on the history the patient provides along with the physical exam.  The following clues are the dead giveaways:

  • Severity of itching

  • Location of itching

  • Itching that becomes worse at nighttime

  • Family members with similar symptoms

  • Itch that occurs without much of a rash

How Can You Get Rid of Scabies?

The bad news is that, yes, the thought of having scabies is totally gross.  However, there is some good news --there is a good cure. 

The medication: Your physician will prescribe you a cream called permethrin that you apply from the neck down all the way to the soles of the feet at night before bedtime.  One quick and dirty tip is to not forget to apply it behind the ears, in the groin and buttocks folds, and even in between the webs of the fingers and toes.  Make sure you cover every nook and cranny.

The cream needs to be left on the body for at least 8 hours, so I typically tell my patients to rinse off upon awakening in the morning.  And everyone can go back to school or work that morning, and should no longer be contagious! 

The cream needs to be used by every single member of the household, whether or not they are symptomatic.  Like I mentioned before, it can take up to one month for people to show any symptoms.  People can have scabies without realizing it, and if not everyone is treated they can continue to swap it back and forth.  So everyone in the house has to apply the cream at the same time, whether or not they have symptoms.

Some people may still have some milder itching for a couple of weeks after treatment due to an allergic reaction to the eggs.  I often recommend that my patients do one more application of the cream 7  days after the first treatment just to make sure no remaining eggs went uneradicated.

The laundry: It’s not over though. After your super cream fest, it’s laundry time!  Any clothing worn in the past week, all bedding, and all stuffed animals should be washed in hot water and dried in heat.  Alternatively, if you are unable to wash something in water you can place it in a plastic bag, tightly close it, and leave it alone for one week.  If the mite does not have a human host in several days, it cannot survive.

Treating your pets is not recommended; as I mentioned before, scabies is transmitted from person to person only.  Fogging or fumigating the home is not necessary.  Vacuuming and cleaning fabric surfaces may be a good idea, however. 

How Can You Get Rid of the Itch?

Taking over-the-counter diphenhydramine can help make the itching more tolerable.  Diphenhydramine does make people sleepy, so for during the day, I would recommend any of the non-drowsy anti-histamines, such as loratidine or cetirizine.

Once you’ve treated the whole family with the cream, finished laundry night, and rinsed off in the morning, the nightmare should be all over. Congratulations, you have successfully survived scabies!

To learn even more about scabies, check out the CDC website on this topic, along with a thorough article in the New England Journal of Medicine.

You can also share your ideas and learn more quick and dirty tips with us on the House Call Doctor’s  Twitter and Pinterest pages! If you learned anything here today, or simply enjoy all-things-medical, you can also listen and subscribe to the House Call Doctor podcast on iTunes, Spotify, Soundcloud, GooglePlay, and Stitcher.

Please note that all content here is strictly for informational purposes only.  This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider.  Please always seek a licensed physician in your area regarding all health related questions and issues. 

Itching image from Shutterstock


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