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How Do You Know If You Have Scabies?

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

By
Sanaz Majd, MD
June 8, 2011

Page 1 of 2

Every once in a while, I get a distraught patient in my office and the visit goes a little something like this:

Patient, scratching uncontrollably:  “Doc, I’m itching all over.  On my neck, on my butt, in my groin, on my legs, on my arms…everywhere.  You gotta help me!” 

These patients look so very uncomfortable and are unable to sit still. So what’s the cause of their pain and agony?  More often that I would like, it’s scabies. Of course before I make that diagnosis, I have to make sure they don’t suffer from other causes of itchy skin.  I ask itchy patients about allergic reactions, new medications, and other health related problems that can cause itching (such as problems with the liver).  But when I see such helpless scratching and itching, scabies is always at the forefront of my small doctor brain. 

What Is Scabies?

Scabies is a type of mite less than half a millimeter in size that is just small enough to be invisible to the naked eye.  The scabies mite digs underneath the surface of the skin and lays its eggs there.  These eggs hatch about three days later, producing more mites that further thrive on the human body.

Scabies is transmitted from person to person, and despite popular belief, is not passed on from animals to humans. 

What Are the Symptoms of Scabies?

The severe itching that comes as a result of scabies begins about one month after a person first becomes infected--with one exception.  If you’ve had scabies before, symptoms may begin within several days, not weeks, since the body has already been sensitized to these parasites before. 

Itching is enough to drive my patients completely nuts.  It’s bad.  And the itching tends to be even worse in the evenings when you are less distracted. 

What Are Other Signs of Scabies?

I like to think of scabies as an itch without much of a rash.  What I mean by that is for an infestation that is so itchy, there really is not much of a visible rash.  There might be small (less than 1 cm) red, raised spots with small scabs on top (typically from scratching).  But overall, there’s not too much to see.

What is really diagnostic, but not always present, is a thin, linear, red line of several millimeters up to two centimeters long referred to as a “burrow.”  But again, many patients with scabies don’t show up with any of these burrows.

What Body Parts Do Scabies Attack?

Although scabies can attack any part of the body, it really doesn’t affect the face or scalp (except in some young kids).  In fact, body parts that a scabies mite likes to dig under are often the following:

  • Between the webs of the fingers and toes

  • In the groin or genitals

  • In the buttocks

  • In the folds of the abdomen or waistline

  • Underneath the breasts

  • On the neck

  • Underneath the armpits

  • Elbows

  • Wrists

  • Knees

  • Ankles

But again, it can really affect anywhere from the neck and downward.

Who Is Most At Risk of Scabies?

Those who spend time in enclosed, crowded spaces full of people are at a greater risk of contracting scabies.  For instance, hospitals, nursing homes, and prisons are notoriously known for housing these organisms and passing them from person to person rapidly.

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