Scabies is a contagious skin infestation caused by the human itch mite. The microscopic mites burrow into the upper layer of the skin and trigger an allergic reaction. Anyone can get scabies. It is not caused by poor hygiene.
Symptoms
- Intense itching, often worse at night
- A raised, spotty or pimple like rash
- Fine, wavy burrow lines in the skin
- Scratch marks, crusting or sores
Common sites include the spaces between the fingers, wrists, elbows, armpits, waist, buttocks, genitals, nipples and shoulder blades. In babies and young children, the head, neck, palms and soles may also be affected. Symptoms can take several weeks to appear after a first infestation, but the person can still spread scabies during that time.
How scabies spreads
Scabies usually spreads through prolonged, close skin contact, including household and sexual contact. Less often, it spreads through recently used clothing, towels or bedding. A brief handshake or hug is less likely to transmit ordinary scabies.
Crusted scabies is a severe form with large numbers of mites. It can be highly contagious and may look like thick, scaly or crusted skin. It is more likely in people who are frail, have reduced sensation or have a weakened immune system, and it requires urgent medical management.
Diagnosis and treatment
A pharmacist or healthcare professional may diagnose scabies from the rash, its distribution and the history of close contact. Sometimes a skin sample or magnified examination is used.
Scabies requires a medicine that kills the mites. Depending on local guidance, this may be a cream or lotion applied to the skin or a prescribed oral medicine. Follow the instructions exactly, including where to apply the product, how long to leave it on and whether treatment must be repeated. Advice differs for babies, young children, pregnancy and breastfeeding, so obtain professional guidance.
All household members and other close contacts usually need treatment at the same time, even if they do not yet itch. This helps prevent reinfection. Itching may continue for several weeks after successful treatment because the allergic reaction takes time to settle. New burrows, new spots or persistent itching beyond the expected period may mean that reassessment or repeat treatment is needed.
Preventing reinfection
- Treat close contacts at the same time.
- Wash recently used bedding, towels and clothing according to local treatment instructions.
- Seal items that cannot be washed in a closed bag for the period recommended by a pharmacist or healthcare service.
- Avoid close skin contact and sharing bedding, towels or clothing until treatment guidance says it is safe.
- Vacuum upholstered furniture and mattresses when advised, especially with crusted scabies.
Do not use insecticide sprays or fumigants on the body or throughout the home. Human scabies mites do not survive for long away from human skin, and correct treatment of people and recently used items is the priority.
When to seek medical advice
Seek advice if you think you have scabies, because prompt treatment limits spread. Contact a healthcare professional if treatment has not worked, if new burrows appear, or if you develop crusted or widespread skin changes. Early assessment is important for babies, older or frail people, pregnant people and anyone with a weakened immune system.
Get prompt medical care if scratched skin becomes increasingly painful, hot, swollen, weeping or pus filled, or if you develop a fever. These signs may indicate a bacterial skin infection.
Related information
Find more guidance in our Skin Health and Infections sections. Scratching can lead to impetigo.
Sources
- NHS: Scabies
- Centers for Disease Control and Prevention: About scabies
- Centers for Disease Control and Prevention: Treatment
- Centers for Disease Control and Prevention: Prevention
- World Health Organization: Scabies
Using this information
This information supports general understanding and preparation for a conversation with a qualified healthcare professional. It does not replace an individual medical assessment, diagnosis or treatment.
Reviewed: 28 August 2026