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Division of Epidemiology
275 East Main Street
Frankfort, KY  40621
502-564-3418 or 3261

What is scabies?

Scabies is a communicable condition caused by tiny Sarcoptes scabiei mites burrowing under the skin to lay eggs. Mites usually burrow into skin folds such as those between the fingers, wrists, elbows, armpits, breasts, waist, buttocks, knees, ankles, toes and feet. 

How is scabies spread?

Mites can be transmitted from an infested person to a susceptible person through direct skin-to-skin contact. It is also possible for mites to be transferred from the underwear, bedclothes and bedding to another person who touches these items immediately after the infested person has been in contact with them.

Who is at risk for scabies?

Any person exposed to an infested person, especially if there is prolonged, close personal contact, is at risk for scabies, regardless of economic status, ethnic background or personal hygiene.

What are the symptoms of scabies?

Symptoms include intense itching, skin redness and usually raised skin rash. At night, the itching can be more intense. The rash can resemble eczema, dermatitis, poison ivy/oak, or chickenpox, and can start any place on the body. However, the rash usually does not appear on the face. Itching and rash may take up to 8 weeks to appear after first exposure; the average is 2-6 weeks. With reinfestations, symptoms usually occur within 1 to 4 days. Secondary bacterial infections can occur if there is constant scratching, producing skin abrasions where the bacteria can enter.

How is scabies diagnosed and treated?

For an accurate diagnosis, skin scrapings must be performed to identify mites and rule out other skin rashes. All household members and close contacts of someone with scabies should also be checked for rashes. Treat anyone who has had skin-to-skin contact with an infested person.

Permethrin 5 percent, a pesticide, is the drug of choice of most medical professionals for the treatment of scabies. However, lindane, crotamiton and ivermectin are alternative drugs which may be used. Scabicidal lotions or creams must be applied to the entire skin surface to be effective. In the elderly, babies and people with weakened immune systems, the drug may be applied to the face, scalp and behind the ears. Avoid getting the scabicide into the eyes or mouth. Fingernails and toenails should be clipped and scabicide applied under the nails. A second and third application may be necessary to be effective. However, itching may persist for 1-2 weeks after treatment due to dry skin and while the body absorbs eggs and fecal pellets left by the mites under the skin.

How can scabies be prevented?

Exclude infested persons from school or work until the day after treatment. Observe contact isolation for hospitalized and institutionalized individuals for 24 hours after treatment. Launder underwear, bedclothes and bed linens in hot water and dry on the heat cycle of a dryer. Vacuum upholstered furniture, rugs and other items that cannot be washed that have been in close contact with the infested person. Items which cannot be washed or dry-cleaned may be placed inside a plastic bag and sealed for 10 days.

Guidelines for Scabies Prevention and Control


Last Updated 12/16/2008