What are the symptoms of scabies?
This is the main symptom of scabies. This is often severe and tends to be in one place at first (often the hands), and then spreads to other areas. The itch is generally worse at night and after a hot bath. You can itch all over, even with only a few mites, and even in the areas where the mites are not present.
These tunnels (burrows) may be seen on the skin as fine, dark, or silvery lines about 2-10 mm long. They most commonly occur in the loose skin between the fingers (the web spaces), the inner surface of the wrists, and the hands. However, they can occur on any part of the skin. You may not notice the burrows until a rash or itch develops.
The rash usually appears soon after the itch starts. It is typically a blotchy, lumpy red rash that can appear anywhere on the body. The rash is often most obvious on the inside of the thighs, parts of the tummy (abdomen) and buttocks, the armpits and around the nipples in women. The appearance of the rash is often typical. However, some people develop unusual rashes which may be confused with other skin conditions.
Scratching due to intense itching can cause minor skin damage. In some cases the damaged skin becomes infected by other germs (bacteria). This is a secondary skin infection. If skin becomes infected with bacteria it becomes red, inflamed, hot, and tender.
Aggravation of pre-existing skin conditions
Scabies can worsen the symptoms of other skin conditions, particularly itchy skin problems such as eczema, or problems such as psoriasis. Scabies can be more difficult to diagnose in these situations too.
Note: the itch and rash of scabies are due to a reaction (allergy) to the mites (or their saliva, poo (faeces) or eggs). Scabies symptoms usually take 2-6 weeks to occur after you are first infected. The itch and rash can develop on any part of the skin, away from where the mites are actually burrowing. This means that you are infectious and can spread scabies before you even know you have scabies.
What are the symptoms of recurring infection?
The itch and rash normally take 2-6 weeks to develop when you have a first scabies infection. However, if you have scabies and it is cleared with treatment, and then you catch it again, the symptoms may be slightly different. In such instances the rash and itching develop much more quickly - often within a day or two. This is because the first scabies infestation has already sensitised your immune system. It then reacts much more quickly with this second bout of scabies.
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)
I just want to write this for anyone who has recently been diagnosed with scabies and is feeling very hopeless. (I don't doubt that some of the people on here truly have been struggling with this for...elle33235
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