Decision support for health professionals ». South Island general practice support ». Practice acquisition and careers in health ». Click here to register ». Forgot your login? Login to my bpac. Remember me. Allergies and immunology Dermatology Infections. Scabies - diagnosis and management Scabies manifests as an itchy skin rash, as a result of an allergic reaction to the female scabies mite.
In this article Transmission of scabies usually occurs by the transfer of fertilised female mites Diagnosis is usually made clinically Treatment — malathion and permethrin are effective treatments for scabies Reducing transmission — treat all recent contacts The itch may persist for weeks even though the mite is gone References In this article.
Key concepts Scabies transmission occurs when there is transfer of a fertilised female mite by direct, approximately five minutes skin-to-skin contact with an infected person.
Diagnosis is usually made clinically. Laboratory diagnosis is not usually necessary but may be useful for uncertain cases or cases in residential care. Malathion and permethrin are effective treatments for scabies. All recent contacts should be treated. The itch may persist for weeks even though the mite is gone.
However itch beyond six weeks may indicate treatment failure. Transmission of scabies usually occurs by the transfer of fertilised female mites Scabies transmission occurs when there is transfer of a fertilised female mite by direct, prolonged approximately five minutes skin-to-skin contact with an infested person.
Life cycle of scabies mite After mating the male mite dies. Diagnosis is usually made clinically Scabies infestations can be difficult to diagnose. In the presence of a burrow the ink will track down the burrow, forming a characteristic dark, zig-zag line.
Laboratory diagnosis is not usually necessary Microscopy of burrow contents, or scrapings from the hands of a patient with crusted scabies, may reveal mites, eggs or faeces. Treatment — malathion and permethrin are effective treatments for scabies Permethrin and malathion are the most frequently used treatments for scabies.
Reapplied after seven days. Not reapplied. Lindane should only be used if other treatments have failed, and should not be used in patients weighing less than 50 kg, those with a seizure disorder or pregnant and lactating women. Reducing transmission — treat all recent contacts Household members and anyone with recent direct and prolonged body contact should be treated at the same time even if they are not itchy. The itch may persist for weeks even though the mite is gone Do not assess treatment response until four weeks after treatment is finished.
Fig 6: Nodular scabies Itch beyond six weeks after initial treatment may indicate treatment failure particularly if itch persists at the same level or is increasing in intensity. References Heukelbach J, Feldmeier H.
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Diagnosis To diagnose scabies, your doctor examines your skin, looking for signs of mites, including the characteristic burrows. Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references AskMayoExpert. Mayo Clinic; Goldstein BG, et al. Scabies: Epidemiology, clinical features, and diagnosis. Scabies sometimes also can be spread by contact with items such as clothing, bedding, or towels that have been used by a person with scabies, but such spread is very uncommon unless the infested person has crusted scabies.
Scabies is very unlikely to be spread by water in a swimming pool. Except for a person with crusted scabies, only about scabies mites are present on an infested person; it is extremely unlikely that any would emerge from under wet skin.
Although uncommon, scabies can be spread by sharing a towel or item of clothing that has been used by a person with scabies. Scabies mites do not survive more than days away from human skin. Items such as bedding, clothing, and towels used by a person with scabies can be decontaminated by machine-washing in hot water and drying using the hot cycle or by dry-cleaning. Items that cannot be washed or dry-cleaned can be decontaminated by removing from any body contact for at least 72 hours.
Because persons with crusted scabies are considered very infectious, careful vacuuming of furniture and carpets in rooms used by these persons is recommended.
Back To Top. The rash and itching of scabies can persist for several weeks to a month after treatment, even if the treatment was successful and all the mites and eggs have been killed. Your health care provider may prescribe additional medication to relieve itching if it is severe. Symptoms that persist for longer than 2 weeks after treatment can be due to a number of reasons, including:.
If itching continues more than weeks or if new burrows or rash continue to appear, seek the advice of a physician; retreatment with the same or a different scabicide may be necessary. The doctor can examine the person, confirm the diagnosis of scabies, and prescribe an appropriate treatment. Sleeping with or having sex with any scabies infested person presents a high risk for transmission. The longer a person has skin-to-skin exposure, the greater is the likelihood for transmission to occur.
Although briefly shaking hands with a person who has non-crusted scabies could be considered as presenting a relatively low risk, holding the hand of a person with scabies for minutes could be considered to present a relatively high risk of transmission.
However, transmission can occur even after brief skin-to-skin contact, such as a handshake, with a person who has crusted scabies.
In general, a person who has skin-to-skin contact with a person who has crusted scabies would be considered a good candidate for treatment. To determine when prophylactic treatment should be given to reduce the risk of transmission, early consultation should be sought with a health care provider who understands:. Contact Us. Skip directly to site content Skip directly to page options Skip directly to A-Z link.
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