Frequently Asked Questions

• Crusted scabies is a severe form of scabies that can occur in some persons who are immunocompromised (have a weak immune system), elderly, disabled, or debilitated. It is also called Norwegian scabies. Persons with crusted scabies have thick crusts of skin that contain large numbers of scabies mites and eggs
• Persons with crusted scabies are very contagious to other persons and can spread the infestation easily both by direct skin-to-skin contact and by contamination of items such as their clothing, bedding, and furniture.
• Persons with crusted scabies should receive quick and aggressive medical treatment for their infestation to prevent outbreaks of scabies.

Infestation is common, found worldwide, and affects people of all ethnic backgrounds and social classes. Because scabies spreads easily under crowded conditions where close body and skin contact is common, institutions such as nursing homes, extended-care facilities, childcare facilities, and prisons are often sites of scabies outbreaks. In  addition, household members and sexual partners of infested people are also at high risk.

• Scabies usually is spread by direct, prolonged, skin-to-skin contact with a person who has scabies. Contact generally must be prolonged; a quick handshake or hug usually will not spread scabies.
• Scabies is spread easily to sexual partners and household members. Scabies in adults frequently is sexually acquired. 
•  An infested person can spread scabies even if he or she has no symptoms.
• Household pets and other animals do not spread the human form of scabies.

• Itching. Itching is caused by an allergic reaction to the proteins and feces of the mite. Severe itching, especially at night, is the earliest and most common symptom of scabies.
• Rash. A pimple-like itchy rash is common and may affect much of the body or be limited to common sites such as between the fingers, wrist, elbow, armpit, penis, nipple, waist, buttocks, and belt-line. The head, face, neck, palms, and soles are often infested in infants and very young children, but usually not in adults and older children.
• Burrows. Tiny burrows are sometimes seen on the skin. These are caused by the female scabies mite tunneling just beneath the surface of the skin. Burrows appear as tiny raised and crooked grayish-white or skin-colored lines on the skin surface. Because mites are often few in numbers, these burrows may be difficult to find.

People with crusted scabies may not show the usual signs and symptoms of scabies such as the characteristic rash or itching.