Athlete's foot (tinea pedis)
Itchy, scaly skin between the toes.
Infection
Medically reviewed by Dr. A.M. van Coevorden, dermatologist
± 4 min read
Scabiescaused by a tiny skin mite
Learn what scabies is, how to recognise it and how to treat it with a step-by-step plan. In plain language, based on the patient information leaflet from the NVDV.
What is scabies?
Scabies is a contagious skin condition caused by the scabies mite: a tiny, spider-like creature that digs shallow burrows in the skin and lays its eggs there. The mite cannot be seen with the naked eye. Scabies has nothing to do with hygiene; anyone can get it.
How do you get scabies?
The mite crawls from one person to another through skin-to-skin contact, usually only after contact lasting longer than 15 minutes, such as sharing a bed, cuddling or sex. People you live with are at extra risk. Briefly shaking someone's hand does not pass it on.
Other risky moments are:
- lying in an unchanged bed that someone with scabies has lain in during the past 3 days
- wearing or using clothing, towels or soft toys that someone with scabies has used in the past 3 days
What symptoms does scabies cause?
Scabies causes a lot of itching, especially at night, disturbing your sleep. Symptoms usually begin 2 to 6 weeks after infection. You see scaly burrows, red pimples or blisters, especially between the fingers, at the wrists, in the armpits and around the feet. In women also around the nipples, in men on the penis and scrotum. In adults scabies is not found on the head; in young children it is.
Is scabies contagious?
Y
Yes. Scabies is contagious. From 12 hours after an effective treatment you are no longer contagious to others.
How does the doctor make the diagnosis?
With clear burrows between the fingers, night-time itching and itching in people around you, the doctor thinks of scabies straight away. Often the doctor also takes a skin scraping to find the mite or its eggs under the microscope, or examines the skin with a dermatoscope.
How do you treat scabies?
Scabies is treated with a cream, gel or tablets that kill the mites and eggs. Always treat everyone you live with and any bed partners at the same time; they may already be infected without symptoms. Repeat the treatment after 7 days.
Prepare
Set aside clean clothing, towels and bed linen for 3 days. Cut your finger- and toenails short and use disposable gloves.
Apply cream or gel (permethrin)
Apply it from the jawline down to under your feet, including the armpits, buttock cleft, genitals, around the ankles and between the toes. In babies also the head and face. Leave the cream or gel to work for 12 hours.
Or tablets (ivermectin)
Take the tablets on an empty stomach: do not eat for 2 hours before and 2 hours after taking them.
Wash and clean
Wash all laundry from the past 3 days at 60°C. Anything that cannot be washed goes into a closed bag for 3 days in a room at 18°C or warmer. Vacuum fabric furniture, soft toys and car seats.
Repeat on day 8
Carry out the whole plan again after 7 days, so that newly hatched mites and eggs are killed too.
Does scabies go away?
Scabies is easy to treat and you recover from it completely. The itch is usually clearly less within 3 days, but it can take 4 to 6 weeks before the skin and the itch are fully gone. Does the itch come back afterwards with new spots? Then get in touch: you may have been reinfected (the 'ping-pong effect' when not everyone was treated at the same time).
What can you do yourself?
If you have confirmed scabies, avoid skin-to-skin contact with others until 12 hours after treatment. Do not feel ashamed: scabies does not come from poor hygiene. Do warn the people you may have infected, so that they can be treated too.
Frequently asked questions about scabies
How long until I get symptoms?
Usually 2 to 6 weeks after infection. People you live with and bed partners may therefore already be infected without noticing, so always treat them at the same time.
When am I no longer contagious?
From 12 hours after an effective treatment you are no longer contagious to others.
Why does everyone in the house need to be treated at the same time?
Otherwise you keep reinfecting each other. This is called the ping-pong effect. So treat everyone you live with and any bed partners at the same moment, even if they have no symptoms yet.
The itch continues after treatment. Has it failed?
Not necessarily. The itch can last another 4 to 6 weeks while the scabies is already gone. If instead you get more itching with new skin changes, get in touch: you may have been reinfected.
Do you get scabies from poor hygiene?
No. Scabies has nothing to do with hygiene; anyone can get it.
Sources and more information
- NVDV patient leaflet on scabies (nvdv.nl)
- RIVM animation 'What is scabies?' (rivm.nl)
- Huid Nederland (huidnederland.nl)
Source: Dutch Society of Dermatology and Venereology (NVDV).