5 Skin Conditions Commonly Mistaken for Scabies

Scabies is a common infectious skin disease, affecting some 200 million people around the world every year, according to the World Health Organization (WHO). A scabies infestation can spread easily in crowded places, such as nursing homes, extended care facilities, prisons, and child care facilities where people are in close skin contact with one another. But while scabies is very common, other skin conditions can also cause similar signs and symptoms. Please keep reading to learn more about human scabies and some of the conditions a scabies rash can be confused with.

What are scabies mites?

Scabies mites (Sarcoptes scabiei) are microscopic eight-legged parasites that infest the human body, specifically human skin. When someone gets a scabies infection, the tiny mites burrow into the skin. The female mites lay their eggs in the upper layer of skin and live there. The mites themselves, as well as mite eggs and mite feces (poop), cause an allergic reaction in the body. This leads to intense itching, skin irritation, and a skin rash. Effective treatment is available to kill scabies mites.

What can be mistaken for scabies?

Here are some of the skin conditions that can be mistaken for scabies.

Contact Dermatitis or Poison Ivy

A contact dermatitis such as poison ivy occurs due to direct skin contact with a harsh or irritating substance, causing an allergic reaction. Symptoms of contact dermatitis include temporary itching, rash, and fluid-filled blisters, which can be mistaken for symptoms of scabies. However, contact dermatitis symptoms are usually limited to the area where the irritant or poison ivy came in contact with human skin.

Folliculitis

This is an infection and inflammation of the hair follicles in the skin. It causes a pimple-like rash that may resemble a scabies rash. However, the intense itch that is a characteristic of scabies is not present in folliculitis.

Insect Bites

Insect bites, especially bed bug bites, can cause an itchy rash and intense itching at night. This can be mistaken for scabies. Additionally, bed bug bites appear in a zigzag pattern that can resemble scabies burrows. Before suspecting or treating scabies, it’s important to rule out a bed bug infestation. A doctor can look at your rash and tell you whether it is from the scabies mite or bed bug bites.

Eczema or Atopic Dermatitis

Atopic dermatitis or eczema causes the skin to become itchy, irritated, inflamed, and thickened. This skin condition can be mistaken for scabies. However, eczema is not contagious and does not spread through skin-to-skin contact.

Psoriasis

This is an autoimmune condition in which new skin cells develop at a faster rate than normal, causing them to pile up on the skin surface in scaly patches. Psoriasis plaques can be itchy and can resemble crusted scabies or Norwegian scabies. However, unlike scabies, psoriasis does not spread from person to person with skin-to-skin contact.

Scabies: Frequently Asked Questions

Is scabies caused by poor hygiene?

No, scabies is not caused by poor hygiene. Scabies is a parasitic infection that spreads from person to person through skin contact.

It requires direct and prolonged skin-to-skin contact with an infected person to spread human scabies. Short hugs or quick handshakes do not usually spread typical scabies. However, sleeping in the same bed can lead to scabies transmission. As a result, scabies frequently spreads among sexual partners and members of the same household.

A severe form of scabies called Norwegian scabies or crusted scabies can occur in people with weakened immune systems. In this condition, highly contagious and thick crusts develop on the skin. Crusted scabies can spread through shared personal items like towels, bedding, and clothing.

Anyone can get scabies. However, scabies outbreaks are common in places where people live in crowded conditions.

What are the 5 symptoms of scabies?

The 5 most common symptoms of typical scabies are:

Pruritus (severe itching), which is usually worse at night.
A papular (pimple-like) skin rash with tiny blisters and scales.
Tiny, raised, and wavy/crooked burrows or tunnels (grayish-white or skin-colored lines) on the skin surface.
Skin sores and bacterial infection from constant scratching of the rash.
Common sites for a scabies rash in an infested person include skin folds such as the webbing between the fingers, wrists, elbows, knees, armpits, nipples, breasts, waist, buttocks, and penis. In infants and very young children, the head, neck, palms, and soles can be involved.

How do you know if you have scabies?

A doctor can make a diagnosis based on the signs and symptoms of scabies. If there is any confusion, they may send a skin scraping to the lab to look for scabies mites and eggs under the microscope.

People who have had scabies before usually develop symptoms soon after exposure to scabies mites, usually within 1-4 days. However, people who have not had scabies before may not have symptoms for 4-8 weeks after exposure. Remember, even if you don’t have symptoms yet, once you’re infected, you can spread scabies to others.

What kills scabies instantly?

Permethrin Cream

A medicine called permethrin is a very effective scabies treatment. This topical treatment (cream) is available with a doctor’s prescription. It needs to be applied to the entire body below the head, including the palms, soles, and webbing between the toes and fingers. In children, the cream should be applied to the scalp as well.

Permethrin cream must be left on the skin for 8-14 hours before it is washed off. Your doctor will probably advise you to apply it before bed and wash it off in the morning.

You will also need to wash your clothes and bed linen on a hot cycle in the washing machine and dry them on a hot dryer setting.

When your scabies treatment begins, your doctor may advise every close contact in your household to undergo treatment simultaneously.

Ivermectin

An oral antiparasitic medication called ivermectin is another treatment option for scabies. This medicine is given as a single dose, followed by another 1-2 weeks later. However, ivermectin is unsuitable for pregnant or lactating women or children weighing under 15 kg (35 pounds).

Other Medications for Treating Scabies

Your healthcare provider may recommend antihistamines (topical or oral) to relieve itching caused by scabies. They may prescribe antibiotics if you have a secondary bacterial infection.

When does itching go away after you treat scabies?

A single treatment with permethrin cream kills the scabies mites. Most people do not need to repeat the treatment. However, it can take two to six weeks for the itching to go away after the initial treatment.

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