Scabies – Diagnosis and Treatment
Diagnosis
Doctors check for scabies by looking for a pimple-like rash, visible burrows, and intense itching, especially at night. Sometimes, they take a skin scraping and examine it under a microscope to find scabies mites or their eggs.
Direct skin-to-skin contact spreads the infection. Severe cases like crusted scabies show more noticeable symptoms.
Doctors may also ask about recent close contact with others, especially in group settings like nursing homes or shared living spaces. In some cases, they might check family members or people you live with to see if they have symptoms too.
Scabies can sometimes look like eczema, allergic rashes, or other skin conditions, so a close exam helps rule those out.
Treatment
Doctors manage scabies with medicines called scabicides. These medicines kill the mites and their eggs. Scabicides come as creams, lotions, or pills. Only a health professional can prescribe them.
Most treatments need to be applied to the whole body from the neck down. Patients usually leave the medicine on their skin for 8 to 14 hours.
Common Medications:
| Medicine | Who Can Use It | Special Info |
|---|---|---|
| Topical scabicide | Adults, children over 2 months, pregnant and breastfeeding individuals | Apply overnight; kills mites and eggs |
| Topical sulfur-based scabicide | Infants under 2 months, pregnant people | Apply for several nights; considered safe |
| Oral antiparasitic | Adults and teens; not for small children, pregnant or breastfeeding | Use if creams do not work, for crusted scabies |
Doctors may recommend that all household members receive treatment, even if they do not have symptoms. This step helps stop scabies from spreading.
Sometimes, doctors prescribe a second round of treatment if symptoms return or do not go away. After the mites are gone, itching can last for weeks.
Other medicines can help with symptoms:
- Antihistamines: Reduce itching and allergic reactions.
- Antibiotics: Treat skin infections caused by scratching.
If a patient cannot use standard medicines, healthcare providers choose other safe options. Infants, people with weak immune systems, or those who cannot use certain creams may get different treatments.
Follow all instructions from the health provider. Treat everyone in close contact to prevent the mites from spreading.
Daily Habits and Remedies
Itching may continue after treatment. Over-the-counter creams like calamine or oral allergy medicine can reduce discomfort.
Wash bedding and clothing in hot water and dry on high heat, or seal them in a plastic bag for storage. Advise household members and sexual partners to get checked and follow cleaning steps to prevent spread.
Dry-clean items that cannot be washed or make sure they are decontaminated.
Getting Ready for Your Visit
Steps to Take Before You Go
Write Down Symptoms: List any signs like rash or itching and how long they have lasted.
Think About Possible Exposure: Note if anyone you had close or direct skin contact with has had similar symptoms or a known case of scabies.
Record Medical History: Write down any other health issues, medications, or allergies for yourself or your child.
Prepare Questions: Bring a list of things you want to ask the healthcare provider, such as recommended treatment, how long you are contagious, and how to stop scabies from spreading.
| Checklist for Appointment Prep | Description |
|---|---|
| List symptoms | Type and duration of all symptoms |
| Note close contacts | Anyone recently in direct contact |
| Medical information | Medications, other health conditions |
| Questions for provider | Important questions to ask |
Example Questions:
- What causes these symptoms?
- Which treatment is best?
- When will symptoms get better?
- How can scabies be prevented from spreading to others?
What the Provider Might Ask
Healthcare providers ask questions to decide the best next step and lower the risk of complications.
They may ask:
- When did the symptoms begin, and have they changed or gotten worse?
- Which areas of the body are affected?
- Have you had close contact with anyone with a rash or itching?
- Have you or your child been ill recently or taken any medicines?
- Is anyone in your home at risk, such as young children or people in daycare?
Having this information ready makes your visit more helpful and can lead to a faster diagnosis and treatment plan.
Actions to Take While You Wait
While you wait for your scheduled appointment, you can manage symptoms and help prevent the spread of scabies.
Use over-the-counter options like oral allergy pills or calamine lotion to ease itching. Check with a healthcare provider to make sure these are safe for you or your child.
Do not share clothes, towels, or bedding with others. This lowers the chance of passing scabies through direct contact.
Limit close contact with others until you start treatment. Be especially careful around young children, the elderly, or people with health problems.
