What Is Scabies?

Scabies is a highly contagious skin condition caused by tiny mites called Sarcoptes scabiei. These mites burrow into the top layer of your skin to live and lay eggs, triggering an intense allergic reaction. Scabies isn’t always thought of as a sexually transmitted infection (STI), but it often spreads through prolonged skin-to-skin contact — including during sex.

Scabies mites are microscopic and cannot be seen with the naked eye, but their presence causes relentless itching and a distinctive rash. The infection spreads easily in close living conditions — like between sexual partners, family members, or roommates. Anyone can get scabies, regardless of age or background.

What Are Symptoms of Scabies?

Scabies symptoms are caused by your body reacting to the mites and their waste. The main symptom is severe itching, especially at night. Itching often starts 2 to 6 weeks after first exposure but may appear sooner in people who’ve had scabies before.

Symptoms in people with female biology:

• Itching in the breasts, belly, thighs, buttocks, or around the genitals
• Small red bumps or lines in skin folds or creases
• Sore or broken skin from scratching

Symptoms in people with male biology:

• Itching around the penis, scrotum, lower belly, or inner thighs
• Thin, curving burrow marks (like grayish lines) on the skin

In anyone:

• Itching that gets worse at night
• Rash that can look like pimples, hives, or eczema
• Burrow marks between fingers, wrists, elbows, waist, or genitals

Scratching may cause open sores and skin infections, especially if left untreated.

What Does Scabies Look Like?

Scabies often appears as a bumpy, itchy rash, especially in areas where skin touches skin — like the armpits, groin, waistline, between fingers, or around the nipples or genitals.

Classic signs include:

• Tiny red bumps, sometimes in a line
• Thin grayish-white burrows (from the mites tunneling under your skin)
• Crusting or thickened skin in severe or long-term cases

The rash can resemble eczema, allergic reactions, or even pubic lice — which is why medical diagnosis is important. You can’t see the mites themselves, but their tracks and the intense itching are the giveaways.

How Is Scabies Transmitted?

Scabies spreads through direct skin-to-skin contact with someone who has it. It’s most commonly passed between:

• Sexual partners
• Household members
• People sharing beds, towels, or clothing

You can also get scabies through shared items, but the mites don’t live long off the human body — usually less than 2–3 days.

Is scabies an STI?

Not technically — but it often spreads through sex. Because it requires prolonged contact, it behaves like an STI in many situations. Scabies is especially common in people with multiple partners or who live in close quarters.

Can I get it from a toilet seat?

Very unlikely. The mites don’t survive well on cold, hard surfaces and need warmth and skin contact to thrive.

How Do You Test for Scabies?

There’s no swab or blood test for scabies. It’s usually diagnosed by a physical exam and your symptoms.

How is scabies diagnosed?

• A healthcare provider examines the rash and may look for burrow lines
• They might scrape the skin and examine it under a microscope to confirm the presence of mites or eggs

If you’re unsure, don’t wait — scabies is easier to treat early, before it spreads.

How Is Scabies Treated?

Scabies is treated with prescription creams or oral medications that kill the mites. Over-the-counter lice treatments don’t work for scabies.

Common treatments:

• Permethrin cream 5% — applied to the entire body from neck down and left on overnight
• Ivermectin pills — sometimes used if cream doesn’t work or in large outbreaks

All close contacts — including sexual partners and housemates — should be treated at the same time, even if they don’t have symptoms.

In addition:

• Wash all bedding, clothing, and towels used in the past 3 days in hot water and dry on high heat
• Items that can’t be washed should be sealed in a plastic bag for at least 72 hours

Symptoms may continue for a few weeks even after the mites are gone. This doesn’t mean treatment failed — it’s a reaction to the mites and eggs left behind.

Complications of Scabies

Scabies can lead to complications if not treated, including:

• Secondary skin infections from scratching
• Crusted (Norwegian) scabies in people with weakened immune systems — a more severe and highly contagious form
• Emotional distress or sleep problems from constant itching

If left untreated, scabies can spread throughout the body and to others in your household or sexual network.

Outlook & Prognosis

Scabies doesn’t go away without treatment, but once treated properly, it’s curable. Most people feel relief within a week or two, though itching may linger for up to a month.

Reinfection is common if your close contacts aren’t treated or your environment isn’t cleaned. Always follow your provider’s instructions and make sure everyone in your home or sexual network is treated together.

Living With Scabies

Dealing with scabies can feel overwhelming or embarrassing, but you’re not alone — millions of people get it each year. Scabies isn’t a sign of poor hygiene or bad habits. It spreads through closeness, not dirt.

While treatment is in progress:

• Avoid sexual or skin-to-skin contact until cleared
• Be kind to your skin — use soothing creams for itching (like hydrocortisone or calamine)
• Follow cleaning instructions carefully to avoid reinfection

Scabies is more frustrating than dangerous. With a bit of care and patience, you’ll get through it.

How to Tell Your Partner(s) You Have Scabies

Telling someone you have scabies might feel awkward, but it’s a sign of respect and care. The infection is common and treatable, and letting partners know helps everyone heal faster.

Try saying:

“I just found out I have scabies — it’s a skin condition caused by mites and spreads through close contact. I’ve started treatment, and you might want to get checked or treated too, just to be safe.”

Make it clear that:

• Scabies is not dangerous, just uncomfortable
• It doesn’t mean anyone did anything wrong
• Treating it together avoids passing it back and forth

Your honesty makes a big difference — and most people will appreciate your openness.

Last reviewed: May 2025
This content is regularly reviewed and updated to reflect the latest medical guidelines.

• Caused by: Mite (Sarcoptes scabiei)
• Spread through: Prolonged skin-to-skin contact; sex; shared bedding or clothing
• Symptoms: Intense itching, especially at night; red bumps; burrow lines
• Testing: Visual exam or skin scraping by a provider
• Treatment: Prescription creams (permethrin); oral meds (ivermectin); hygiene and household cleaning
• Risk if untreated: Skin infections, spread to others, crusted scabies in immunocompromised people
• How common: Millions of cases worldwide each year; frequently seen in STI clinics and close living quarters