Symptoms of scabies

The main symptom of scabies is intense itching, which is usually worse at night and after a hot bath. A rash follows, but the pattern differs between people.

Typical symptoms

• Severe itching, often disturbing sleep.
• A pimple-like rash of small red bumps.
• Thin, wavy, greyish lines (burrows) a few millimetres long on the skin.
• Scratch marks, scabs and sometimes sores from scratching.

Common places on the body

• Between the fingers and on the wrists.
• Elbows, armpits and waistline.
• Genital area, buttocks and inner thighs.
• Around the nipples in women, and the breasts.
• Soles and palms.
• In babies and young children, it can also affect the face, scalp, palms and soles.

Symptoms in different groups

• Infants may be irritable, feed poorly and have blisters on the palms and soles.
• Older adults may have a less typical rash and little itching.
• People with weak immunity can have crusted (Norwegian) scabies, with thick, scaly crusts that are very contagious.

Signs of infection Honey-coloured crusts, pus, warmth, swelling or fever suggest a secondary bacterial infection, which needs medical care.

When to see a doctor See a doctor if you have a persistent night-time itch, if others at home are itching too, or if there is no relief after treatment. Early treatment prevents spread.

Itching after treatment Itch can last two to four weeks after the mites are dead, since the skin is still reacting. This does not always mean treatment failed.

Ayurvedic view (interpretive) Traditional descriptions highlight itching, small pustules and spread to close contacts. These match scabies but cannot confirm a diagnosis.

Remember Itching at night with a family member also itching is a classic scabies clue. Get it checked.