Symptoms of first-time scabies infections may not appear for up to 2 months after the person has been infested by the mites (Centers for Disease Control, 2009m). Small vesicles or pimplelike bumps occur in the area where the female mite tunnels into the skin. A red rash around the primary lesion indicates the area where hatched adult mites are feeding. Areas of infestation itch intensely, especially at night. Favorite sites of infestation typically include the webs and sides of fingers, wrists, abdomen, genitals, buttocks, and female breasts.
Scabies is treated with a topical scabicide (lotion or cream product used to kill scabies) that is applied from the neck down to the toes. Several prescription scabicides are available; they are applied at bedtime and left on for 8 hours, then washed off with soap and water. A single application is usually effective, although some physicians advocate a second application 7-10 days later. It is recommended that all household members and close contacts of an infested person, including asymptomatic ones, be treated simultaneously. In addition, all clothing and bedding used by treated people should be washed in hot water or dry cleaned.