Scabies looks like pimple-like bumps plus tiny wavy burrow lines, concentrated between fingers, on wrists, waistline, and groin, with itching that rages at night and spreads through the household over weeks.
The distribution is the tell: finger webs, wrists, inner elbows, waistline, buttocks, groin (plus head, palms, and soles in infants). First infestations itch after a 2-to-6-week incubation, during which people spread it unknowingly; repeat ones itch within days. It spreads by prolonged skin contact and has nothing to do with cleanliness. Lookalikes: eczema (no burrows, no household spread), bed bugs (exposed skin, mornings), folliculitis (follicle-centered). Treatment: prescription permethrin cream neck-down for 8 to 14 hours, the whole household at once, hot wash of recent bedding and clothes, repeat in a week. The trap: itch persists 2 to 4 weeks after the mites die, an allergic aftermath, not failure, so do not keep re-treating without a clinician confirming live mites.
What to do
Common questions
What does scabies look like?
Scabies is a microscopic mite burrowing in the top skin layer, and the CDC describes its signature look: a pimple-like rash of small red bumps, sometimes with tiny wavy or thread-like gray-white lines on the skin surface, which are the burrows themselves. Where it lives tells you what it is: between the fingers, on the wrists, inner elbows, armpits, around the waistline and belt line, buttocks, and groin, and in infants also the head, neck, palms, and soles. The itch is the giveaway: intense, and characteristically much worse at night, often bad enough to wake people. The household pattern is nearly diagnostic: scabies spreads by prolonged skin contact, so when one person itches and then their partner or the whole house starts itching within weeks, think scabies before anything else. First-ever infestations take 2 to 6 weeks to start itching (that is the incubation window, during which people unknowingly spread it), while repeat infestations itch within days. It is not about cleanliness: anyone can catch it, and it spreads through households, dorms, care homes, and between partners. The lookalikes it gets mistaken for: eczema (no burrows, no household spread), bed bug bites (exposed skin, morning onset, no burrows), and folliculitis (centered on hair follicles). Treatment is a prescription permethrin cream applied from the neck down and left on 8 to 14 hours, with the whole household treated simultaneously, plus hot washing of recent bedding and clothing, and a repeat application a week later. The post-treatment trap: itching can persist for 2 to 4 weeks after the mites are dead, which is allergic aftermath, not treatment failure, so do not re-treat repeatedly without a clinician confirming live mites.