Once infected with scabies, signs and symptoms typically don't show up right away. However, once they do, the mites that have taken up residence in your skin make sure you're aware of their presence. Typical signs include extreme itching and the presence of a rash in specific areas of the body.
Will I Know?
If this is the first time you've been exposed to scabies, you might not know if you have an infestation right away. Scabies mites are extremely tiny (female mites are between 0.30mm to 0.45mm long and 0.25mm to 0.35mm in width) and cannot be seen with the naked eye. According to the Centers for Disease Control and Prevention, you may not note signs of scabies for up to two months after you're infested with the mite--although they may arise between two and six months after exposure. You can still spread scabies to others unknowingly during this time.
Signs of Scabies
The first signs of scabies is intense itching and the appearance of a rash caused by an allergic reaction to the mite's proteins and feces. Itching is typically worse at night. In adults, scabies prefers to inhabit specific parts of the body--particularly where the folds of the skin touch. These may include the webbing between the fingers, the folds of the elbow, inside the wrist, under the arms, between the shoulder blades and around the penis, nipples, waist and buttocks. Scabies infestations in children tend to be found around the head, neck and scalp. If you look closely, you may find evidence of the female mite's "burrow"--the place in the skin where she lays her eggs. These appear as slightly raised, serpentine patterns on the skin that are pink, gray or flesh-colored.
To get medical treatment for scabies, it's necessary to see a doctor. Often a physician can identify a scabies infection just by looking for the presence of burrows and the pattern of the skin rash. But if there is any doubt, a scraping of your skin may be taken and visualized under a microscope to detect the presence of the mite.
According to the American Academy of Dermatology, human scabies can quickly be resolved by applying a prescription topical lotion ("scabicide") that contains 5 percent permethrin. This topical is applied from the neck all the way down to the toes, including the foot soles, palms, groin and under the fingernails. The lotion is typically left on between eight and 14 hours, after which it's rinsed off. A doctor may recommend a second treatment a week after the first. Even after the itch mites and their eggs are killed with a scabicide, some residual itching will likely be noted--sometimes up to two weeks. Taking cool baths, applying soothing lotions (such as calamine) or using an over-the-counter antihistamine can relieve post-treatment scabies symptoms.
To assure that a reinfestation doesn't occur, all family members living in close proximity with an infested person should be treated with scabicide simultaneously. Scabies is most frequently spread between sexually active adults, so all intimate partners should be informed so they can get treatment as well. Additionally, clothing, linens, towels and other washable personal items should be washed in hot water and dried on high heat. Anything that can't be laundered, such as comforters and pillows, can be stored in plastic containers and placed in the garage for a week. Deprived of a human host, the scabies mites die after this time.