How does a doctor diagnose scabies?
Scabies is usually diagnosed just by looking at the rash, and by the story of itchy spots spreading around your body. A doctor will often be able to recognise the typical appearance of the scabies rash, although in the early stages it can resemble eczema.
Often, a doctor will find one or more mite tunnels (burrows) on the skin to confirm the diagnosis. Sometimes the doctor will rub some ink on the skin and then wipe it off. If there are burrows in that area of skin, the ink will move along the burrow under the skin. It will be visible as a line after the rest of the ink has been wiped away.
Could it be something else?
It is sometimes difficult to tell the difference between the rash caused by scabies and the rashes of some other skin conditions. For example, sometimes the itchiness on the hands and wrists is quite similar to eczema. Sometimes doctors will treat the itching with steroid creams, which work well in eczema but will not help scabies at all.
If itching and a rash develop in several people who live in the same home at about the same time then scabies is a likely cause.
Do I need to see a doctor?
If you are confident that you have scabies - you may have seen the tunnels (burrows) on your skin, or perhaps you have had it before - then you don't need to see your doctor. Treatments for scabies are available to buy from a pharmacy.
Further reading and references
Scabies; DermNet NZ
Strong M, Johnstone PW; Interventions for treating scabies. Cochrane Database Syst Rev. 2007 Jul 18(3):CD000320.
Gunning K, Pippitt K, Kiraly B, et al; Pediculosis and scabies: treatment update. Am Fam Physician. 2012 Sep 1586(6):535-41.
FitzGerald D, Grainger RJ, Reid A; Interventions for preventing the spread of infestation in close contacts of people with scabies. Cochrane Database Syst Rev. 2014 Feb 242:CD009943. doi: 10.1002/14651858.CD009943.pub2.
Engelman D, Kiang K, Chosidow O, et al; Toward the global control of human scabies: introducing the International Alliance for the Control of Scabies. PLoS Negl Trop Dis. 2013 Aug 87(8):e2167. doi: 10.1371/journal.pntd.0002167. eCollection 2013.
Scabies; NICE CKS, May 2016 (UK access only)
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