Scabies (Sarcoptes Scabiei Var. Hominis)
Scabies is an infestation of the skin by the human itch mite (Sarcoptes scabiei var. hominis). Severe infestations are called crusted scabies (formally Norwegian scabies).
Transmission
Anyone can get scabies. Institutions such as nursing homes, extended-care facilities, prisons and child care facilities are often sites of scabies outbreaks. Scabies is spread via:
- Person to person by prolonged direct skin-to-skin contact with an infected person
- Scabies in adults is frequently sexually acquired
- Environment to Person. Transmission via clothing, towels, or bedding used by an infested person
- Indirect spread occurs more easily when the infested person has crusted scabies.
Scabies can be spread if a person remains infested with the mites and is not treated. Repeat infestations can occur.
Crusted scabies is very contagious and can spread easily. The elderly and those with compromised immune systems are more likely to develop crusted scabies.
Symptoms
The first time a person gets scabies, they usually have no symptoms. Symptoms can typically take 4-8 weeks to develop. For people with previous scabies infestations, symptoms will develop 1-4 days after infestation. Symptoms of scabies include:
- Itchy pimple-like rash. Itching may become more severe at night
- This may affect much of the body or a specific location such as the wrist, elbow, armpit, webbing between the fingers, nipple, penis, waist, beltline and buttocks o Tiny blisters (vesicles) and scales may be present
- Burrows may appear on the skin as tiny raised grayish-white or skin-colored lines on the skin surface
- These are caused by the female scabies mite tunneling just beneath the surface of the skin. Individuals with crusted scabies may not show the usual signs and symptoms, such as the characteristic rash or itching.
Diagnosis
A health care provider can diagnose scabies by the appearance and distribution of the rash and the presence of burrows. A skin scraping can be evaluated for the presence of the mite or eggs.
Treatment
Scabies can be treated with scabicides which kill scabies mites and eggs. A doctor will prescribe:
- Scabicide lotions or creams. No “over-the-counter” (non-prescription) products have been tested and approved for humans.
- Always carefully follow the instructions.
- Retreatment may be necessary if itching continues more than two-four weeks after treatment or if new burrows or rash continue to appear.
All household, sexual and close contacts with prolonged skin-to-skin contact with an infested person within the preceding month should be examined and treated.
Individuals with crusted scabies should receive quick and aggressive medical treatment for their infestation to prevent outbreaks of scabies. For more information about the treatment of scabies, contact your health care provider or visit CDC - Scabies.
Prevention
- Avoid direct skin-to-skin contact with an infested person or with their personal items.
- Close contacts should be treated including household members, child care contacts, and others who have had prolonged direct skin-to-skin contact with someone who has scabies.
- Clean bedding and clothing used three days before treatment is started. Launder in a washer with hot water and dry on high heat.
Exclusion Guidance
Individuals with scabies should not be excluded from work, school, or child care unless the general exclusions apply.
- Exclusion and treatment of individuals in child care and school can occur at the end of the day, with return the following day after their first treatment.
- Health care workers should be treated and check with their infection control practitioner before returning to work.
- Those who have jobs requiring frequent direct contact with people can return to work after completing treatment.
For additional information about scabies,
contact the North Dakota Health and Human Services’ Division of Public Health at 800.472.2180.