How to Identify and Treat Scabies?

It’s common to get red itchy lesions over the skin. Redness anywhere would mean that there is something irritable. This could be an infection, some bug, mosquito bite, pimple or some kind of allergy.

A physical examination by a dermatologist is usually required to ascertain what the lesion is.

Skin Lesions due to a Parasite

This is a skin lesion caused due to a mite. This one is an ecto parasite that stays over the human skin. It loves places that are a bit moist, soft and easy to make a burrow into.

The mite digs the skin to form a minute burrow inside it. It penetrates to enter into it, where it resides and lays around 8 to 25 eggs at a time.

Lesions are formed over the skin. These look like pimples or mosquito bits. Sometimes they may be as small knots under the skin. Rarely, they may be crusted and present as patches. In such cases, the mites lay much more eggs than usual, may be thousands at a time.


As they mites reside over our skin surface and lay eggs, they produce symptoms. These are as follows-

  • Red itchy bumps or rashes over the skin. They may appear like pimples or mosquito bits.
  • Sometimes, blisters may get formed. These are fluid filled and occur singly or in clusters.
  • Itching is intense. It’s especially more in the night times, or early morning, say 4 o’ clock, when the parasite is active. The eggs laid by the parasite secrete certain allergens. Our skin surface itches, so as to attempt to remove away those parasite and its eggs.
  • In an attempt to itch, the affected individual scratches his skin surface. This produces chances of infection over the lesions. There are numerous bacteria present over skin surface and under our nails. As we scratch, there are chances that these bacteria get a chance to go inside the deeper skin layers. This causes pus filled lesions over the skin surface, which are usually painful.
  • There is a condition called Norwegian scabies. Here, the lesions are not small. They are big, present as big papules over the skin which are very itchy. Crusts may get formed over the papules. This form of scabies is more severe.
  • There is no fever, or any other symptom beside the skin lesion. The patient appears alright.

Commonly Affected Areas

Regions which are moisture, have skin creases and softer skin surface, so that the mite is able to penetrate easily into the skin. These include-

  • Web spaces between the fingers and the toes.
  • Groin creases
  • Below the breast
  • Armpits
  • Elbow, behind the knee joint
  • Over the wrist area, tummy

In general, the severity of infestation is more in children, as they have a softer skin surface.

Differentiating Pimples from Scabies

Though both the lesions may appear similar, the cause is entirely different and so is the expression. The skin lesions in scabies are extremely itchy, especially at night hours. Pimples may be symptom less, slightly itchy or painful, if infected.

Scabies spreads, if left untreated. Pimples may occur as a solitary lesion over the skin.

Importantly, scabies is contagious. That is, you may get infected if you touch someone who has scabies. Apart from touching, it also spreads via use of common linen, towels, while playing together, as in kids.

Differentiating a Mosquito Bite From Scabies

Mosquito bites are usually painful. The lesion appears red and inflamed. It may be slightly itchy. Mosquito bites do not spread.

It’s common for mosquito bites to get infected and become filled with pus. This is because, as the mosquito bites the skin, it inserts bacteria from over the skin to inside it.

What if Scabies is Left Untreated?

If left untreated, lesions multiply and scabies spreads. The mites give more and more eggs to cover larger skin areas over the body.

Symptoms intensify and the patient is in discomfort.

If the lesions get infected while we scratch them, there are chances of infection. Infection may travel from over the skin surface into deeper skin layers.

It may then enters the blood stream to cause septicemia, presenting as high fever, chills and a drop in blood pressure.


Management include alleviating the symptoms and killing the mite.

To kill the mite and destroy its egg, medications are available, which penetrate into the skin surface and kill the ectoparasite.

These include-

5% permethrin cream
25% benzyl benzoate lotion
10% sulphur ointment
10% crotamiton ointment

These medications may be used in children and pregnant women also.

How to Apply the Medication?

  • Bathe yourself properly and dry dab your body.
  • Apply the medication over the whole of the body from below the neck till the toes, sparing all mucosal surfaces. Avoid the medicine going into your eyes or mouth.
  • Let it dry, then wear your clothes. Wear loose cotton garments till you are being treated. This is to avoid moisture from accumulating over the skin surface. Moisture helps to let the mite survive.
  • One application may last for 6 to 8 hours, after which you need to repeat the application.
  • You may concentrate the medication more at areas at are itchy or appear to be affected more.

Other Medication

To alleviate itchiness, an antihistaminic may be taken at night hours.
If the lesions look infected or appear to be filled with pus, topical antibiotic ointments may be required.

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