Scabies

Symptoms

Symptoms of scabies include:

• Intense itching - This itching is often worse at night, and it can involve any part of the skin, not just areas that have rash or nodules.

• A rash - The scabies rash typically affects the following skin surfaces: the hands, especially webbed skin between the fingers; skin folds at the wrists, knees, elbows, underarms, waist or buttocks; the genitalia; the breasts, especially the dark area around the nipple; and the shoulder blades. In adults and older children, the scabies rash often looks like tiny red bumps that are similar to small insect bites. In infants, it can appear as tiny vesicles (small fluid-filled blisters). Also, the rash can extend to the neck, head, palms, and soles of the feet in babies who are younger than 2 years old.

• Red or brown nodules (larger skin bumps) - In some cases, a person with scabies develops skin nodules rather than a rash. These nodules can be up to 5 millimeters (one-quarter inch) wide, and they usually occur on skin that is covered by clothing, such as the trunk and upper legs.

Symptoms of scabies are part of the immune system's reaction to the scabies parasite and its waste products. This reaction usually takes a few weeks to develop in people who have never had scabies before. For this reason, people with their first episode of scabies may not develop an itchy rash until two to six weeks after the skin infestation starts. However, in people who have had previous episodes of scabies, the body's reaction is triggered sooner, so itching and rash often begin within one to four days.