Scabies: symptoms, how it spreads, treatment and who to notify
Scabies is a skin infection caused by a microscopic mite. It causes intense itching that gets worse at night. It spreads through prolonged skin-to-skin contact, including during sex, and is cured with a treatment that must be used at the same time by the person affected, their partner and the people they live with.
What is scabies?
It is caused by the mite Sarcoptes scabiei, which digs small tunnels in the skin to lay its eggs. Away from the skin, the mite only survives 2 or 3 days.
Scabies symptoms
- Intense itching, especially at night.
- Small bumps, tiny blisters or thin lines on the skin, which are the burrows made by the mite.
- Common areas: between the fingers, wrists, elbows, armpits, waist, belly button, buttocks, genitals and around the nipples. In men, bumps on the penis and scrotum are typical.
If it is the first time, symptoms take between 2 and 6 weeks to appear, but you can already pass it on during that time. If you have had it before, they appear within 1 to 4 days.
How is scabies spread?
Through prolonged direct skin-to-skin contact: sleeping together, having sex or caring for someone. Less often, by sharing clothes, towels or bedding. A handshake or a quick hug rarely passes it on. Condoms do not protect, because it spreads through skin contact.
Diagnosis
The doctor usually diagnoses it from the symptoms and how the skin looks. Sometimes they use a dermatoscope or take a skin scraping to see the mite. If it appeared after sex, it is a good idea to get tested for other STIs too.
Scabies treatment
It is treated with permethrin cream, applied to the whole body from the neck down and left on for several hours, or with ivermectin tablets. It is usually repeated after 7 to 14 days. Always follow the instructions your doctor gives you.
Also:
- Everyone you live with and your sexual partners must be treated at the same time, even if they have no symptoms.
- Wash the clothes, towels and bedding from the last 3 days at 60 °C (140 °F) and dry them on a hot setting. Put anything that cannot be washed in a sealed bag for at least 72 hours.
How to tell your partner you have scabies
Telling them is essential: if your partner or the people you live with are not treated at the same time, the scabies comes back. Some tips:
- Be direct: it is a common infection, it is not caused by poor hygiene and it can be treated.
- Explain that they may have it even if they have no symptoms yet, because they take weeks to appear.
- Plan the treatment for the same day, along with washing the clothes.
If you cannot or do not want to tell them yourself, you have two options: ask for help at your healthcare center, where in some cases the staff notify contacts for you, or send an anonymous text message or email with STI notice, without your name or number appearing.
Who should you notify?
Your sexual partners and the people you have had close, prolonged contact with, such as those who live with you or share your bed, during the last month. All of them should be treated at the same time, even if they have no symptoms.
If you have been told you might have scabies
Even if you have no symptoms, see your doctor: close contacts are usually all treated at the same time, because the itching can take weeks to appear. Wash your bedding and towels and avoid skin-to-skin contact until you have finished treatment.
Frequently asked questions about scabies
How long is scabies contagious?
From the moment you get it, even before symptoms appear, until treatment is complete. That is why it is important to treat contacts even if they are not itchy.
Why am I still itching after treatment?
It is normal for the itching to last 2 to 4 weeks, because the skin keeps reacting to what is left of the mite. If it continues after that or new lesions appear, see your doctor again.
Can someone with good hygiene get scabies?
Yes. Scabies has nothing to do with hygiene: it is passed on through contact with another person who has it.
Other sexually transmitted infections
Syphilis · Gonorrhea · Genital herpes · HIV · Pubic lice (crabs) · HPV and genital warts · Chlamydia · Yeast infection (candidiasis) · Hepatitis A, B and C · Trichomoniasis · Mpox (monkeypox)
Sources: MedlinePlus: scabies; CDC: ectoparasitic infections treatment guidelines.Health information updated in October 2026. It does not replace advice from a healthcare professional.