What does scabies look like?

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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.

What does scabies look like?

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