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Scabies: Recognize, Treat, and Prevent

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You wake up in the middle of the night with intense itching and notice tunnels, blisters, and other spots on your skin that you don’t recognize. It could be that you have scabies. Scabies is currently becoming more common in the Netherlands; since 2014, the number of people with scabies has more than doubled! It is a very annoying but fortunately treatable condition. Are you curious about how to recognize scabies and what the symptoms are? Or how do you find out if you might have scabies? Then read on.

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What is scabies?

Scabies is a condition caused by the scabies mite. The scabies mite is a very small creature that you can hardly see with the naked eye. If this mite lands on your skin, it will dig a small tunnel in the top layer of your skin, where it lays eggs. The eggs hatch, and the new mites dig a new corridor in a different place on your body, so the cycle repeats itself.

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Figure 1

How do I recognize scabies?

Scabies can be very difficult to recognize because there are not always visible skin abnormalities, and the complaints can also indicate other common skin conditions, such as eczema. As discussed above, a scabies mite burrows into the top layer of the skin. These tunnels can sometimes be seen in specific places, giving the classic symptoms of scabies.

Scabies symptoms

If you have been in contact with someone with scabies, it may take another two to six weeks for you to develop scabies symptoms. The scabies mite will then cause the following complaints:


Itching is the most common scabies symptom. This itching is very intense and occurs mainly in the evenings and nights. The itching is caused by your immune system reacting to the feces of the scabies mite in the skin tunnels.

Skin abnormalities:

Another scabies symptom is scaly spots; these are the tunnels of the scabies mite. They are mainly seen between fingers and toes, on wrists, on elbows, or in armpits but can also occur in the groin, around the nipples, or around the genitals. They appear as short (about 1 cm) tunnels, which are scaly and red. Sometimes you also see blisters on them, which are bumps filled with fluid.

Scratching injury:

Due to the intense itch, you will scratch a lot, which can cause additional skin abnormalities, such as blisters and pimples. The skin can also become inflamed from scratching, causing scabs, redness, and extra itching

Recognize scabies

Scabies can be recognized by typical skin abnormalities. You can see these skin abnormalities in the photos below.

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Image 2

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Image 3

How do I get scabies?

Scabies is an infectious disease. It occurs because you have had skin-to-skin contact with someone with scabies for an extended (15-minute) period. But you can also get it by being in the same bed with someone with scabies or by using the same towels or clothes. This is why scabies is more common in houses where many people live together, such as college dorms, care facilities, or housing for the homeless.

Do you want to know if you have scabies? Take the test for scabies.

Related tests

What is the treatment for scabies?

Scabies is an unpleasant condition that is fortunately easy to treat.

Permethrin cream is prescribed by a doctor. Treat yourself, but also the people around you who have an increased risk of also having scabies, such as your housemates, people you have slept with, and people with whom you have had sexual contact. It is important to do the treatment all at the same time to prevent re-infestation.

This is how you perform the treatment:

  • Cover your entire body with the cream, except your face. Then go to sleep in a clean bed.
  • After 8 to 12 hours, shower the cream off again.
  • Dry off with a clean towel and put on clean clothes.
  • After 1 to 2 weeks, repeat the treatment. Only people with skin defects need to do this treatment. Others don’t.
  • In addition to the treatment, it is important to wash bedding, towels, and clothes from the past three days at 60 degrees Celsius.
  • If you can’t wash your clothes at 60 degrees, the scabies mite survives on clothing (at room temperature) for about three days. Put these clothes in a plastic bag, store them at room temperature for three days, and then wash them at a lower temperature.
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It is crucial to carry out the treatment exactly in this way. If not performed correctly, there is a good chance that the scabies mite will not disappear completely, so the complaints can return.

After the treatment, the itching complaints can persist for at least two weeks, sometimes even worsening initially. The skin lesions can persist for another six weeks.

Does the itching persist for more than four weeks after the treatment? Or do you still get new spots after performing the treatment correctly? Then contact a doctor.

How can I prevent scabies?

Prevention is always better than cure. People with a weakened immune system are more likely to get scabies. So ensure your immune system is up to standard by striving for a healthy lifestyle; eat healthily, sleep enough, lower your stress levels, and exercise daily.

Additionally, try to avoid skin-to-skin contact with someone with scabies, always wash your bedding at 60 degrees Celsius, and do not use other people’s bedding or clothing.

drs. Elise Janssen

Approved by a doctor

drs. Elise Janssen

Medical content writer

Drs. Elise Janssen completed her MSc. in Medicine at the Free University, Amsterdam. She is currently training as a family physician at Amsterdam UmC. For Easly, she writes medical blogs and reviews medical texts.

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