What is Scabies? Causes, Symptoms and Treatment

What is scabies?

Scabies is a skin infestation caused by the mite sarcoptes scabiei var. hominis. The female mite burrows small tunnels (burrows) into the outermost layer of skin — the epidermis — where she lays her eggs. The body's immune reaction to the mite, its eggs and faecal matter is what triggers the intense itching and inflammation.

Contrary to what many believe, scabies has nothing to do with poor hygiene. Anyone can get scabies — regardless of age, lifestyle or socioeconomic status. It is, however, more common in crowded environments and places with close physical contact.

What does scabies look like?

Scabies can appear in several ways:

• Intense itching — especially at night: The most prominent symptom is itching, which often worsens significantly in warm environments and at night when lying under the covers. This can make it difficult to sleep.
• Small, red bumps: These resemble small pimples or hives and are typically found on the wrists, fingers, elbows, armpits, nipples, genitals and groin. In infants, the entire body may be affected.
• Thin, irregular burrow lines: The characteristic thin, greyish-white or light lines on the skin that mark the mites' tunnels. They are often short (a few millimetres) and slightly serpentine.
• Thick, scaly skin (in chronic cases): In untreated scabies over a longer period, the skin can become thick, rough and scaly, especially on the hands and feet.

Why does scabies happen?

Scabies primarily spreads through direct, extended skin-to-skin contact with an infected person. Since the mite cannot jump or fly, transmission requires relatively prolonged contact:

Close contact (primary route)

Scabies spreads easily between family members, sexual partners and people who share a bed. Brief handshakes or casual contact rarely result in transmission.

Shared objects (less common)

In rare cases the mite can be transmitted via shared towels, bedding or clothing. This is most relevant in heavy infestations or institutional settings. The mite typically only survives 2–3 days outside human skin.

Incubation period

If it is the first time you have had scabies, it can take up to 4–6 weeks before symptoms appear. In reinfection in people who have previously had scabies, symptoms typically appear within 1–4 days, as the immune system already reacts faster.

Who gets scabies?

Scabies affects everyone — regardless of age, gender, ethnicity or hygiene standard. Certain factors, however, increase the risk:

• Close living conditions: Families, dormitories, nursing homes and prisons are typical places where scabies spreads.
• Sexual contact: Adults with scabies often get it through close physical contact with an infected partner.
• Weakened immune system: People with HIV/AIDS or other conditions that weaken the immune system may develop more severe scabies (crusted scabies).
• Institutional settings: Elderly care homes and institutions with limited healthcare staff have a higher prevalence.

How is scabies treated?

Scabies is uncomfortable but is effectively treated with prescription medication. The most important rule is: everyone in the same household must be treated at the same time — even if they have no symptoms:

Frequently asked questions