SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferences

Information for Patients

View all Images (119)

See also in: Anogenital
Other Resources UpToDate PubMed


See also in: Anogenital
Contributors: Susan Burgin MD, Belinda Tan MD, PhD, Sarah Hocker DO, Lowell A. Goldsmith MD, MPH
Other Resources UpToDate PubMed


This summary discusses adult patients. Scabies in children is addressed separately.

Scabies is an intensely pruritic eruption caused by the mite Sarcoptes scabiei var. hominis. It is transmitted most often via direct person-to-person contact and less frequently by fomites. It is extremely contagious, spreading between individuals who share close contact or living spaces. Prevalence rates are higher in children, residents of long-term care facilities, and sexually active persons, although scabies can appear in individuals of all ages and socioeconomic groups. Factors that contribute to the persistence and spread of scabies are overcrowding, delays in diagnosis, and poor public health awareness. Outbreaks in health care facilities, such as nursing homes, can result in dozens of patients and staff becoming infected.

In a typical infestation, there are 10-20 mites. Most patients mount an intense hypersensitivity reaction to the mites, which burrow into and just below the stratum corneum of the epidermis. This results in a widespread and highly pruritic eruption. The hypersensitivity reaction usually develops 2-6 weeks after initial infestation. Without medical treatment, the condition persists because the mites lay eggs, causing continued infestation. Scabies can cause a generalized eruption resembling erythroderma in the elderly, the institutionalized, and patients with immunosuppression or neurologic dysfunction (crusted scabies). In these patients, the mite burden is much higher, with thousands to millions of mites present on affected skin.


B86 – Scabies

128869009 – Infestation caused by Sarcoptes scabiei var hominis

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

Scabies presents a diagnostic challenge. Some of the conditions scabies is mistaken for include the following:
  • Arthropod bite or sting
  • Papular urticaria
  • Canine scabies – This mite can transiently infect humans but does not have the classical distribution of human scabies and cannot subsequently be passed from person to person.
  • Atopic dermatitis
  • Nummular dermatitis
  • Folliculitis
  • Nonbullous impetigo
  • Bedbug bite
  • Varicella
  • Allergic contact dermatitis
  • Dermatitis herpetiformis
  • Seabather
  • Dyshidrotic dermatitis
  • Lichen planus
  • Autoeczematization
  • Neurotic excoriations
  • Prurigo nodularis
  • Bullous pemphigoid – Urticarial phase

Best Tests

Subscription Required

Management Pearls

Subscription Required


Subscription Required


Subscription Required

Last Reviewed:11/28/2022
Last Updated:01/08/2017
Copyright © 2024 VisualDx®. All rights reserved.
Patient Information for Scabies
Contributors: Medical staff writer
Premium Feature
VisualDx Patient Handouts
Available in the Elite package
  • Improve treatment compliance
  • Reduce after-hours questions
  • Increase patient engagement and satisfaction
  • Written in clear, easy-to-understand language. No confusing jargon.
  • Available in English and Spanish
  • Print out or email directly to your patient
Copyright © 2024 VisualDx®. All rights reserved.
See also in: Anogenital
A medical illustration showing key findings of Scabies : Axilla, Buttocks, Excoriated skin lesion, Umbilicus, Wrist, Anogenital, Pruritus
Clinical image of Scabies - imageId=177763. Click to open in gallery.  caption: 'Excoriations and a burrow at the wrist.'
Excoriations and a burrow at the wrist.
Copyright © 2024 VisualDx®. All rights reserved.