What can be mistaken for scabies?

Many skin conditions can look like scabies, but require completely different treatments. If you’re unsure what you’re dealing with, getting the right diagnosis early can make all the difference.

Medically reviewed by:
Dr. Eric Howell
Dermatologist

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Scabies is often confused with other skin conditions such as eczema, dermatitis, or allergic reactions because they can cause similar symptoms like itching, redness, and rashes. However, these conditions are treated very differently and misdiagnosing them can delay the right care or make symptoms worse.

Not sure if it’s scabies or something else?

mom and son taking a photos for a scabies photo consultation

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What are some rashes that look like scabies?

Dr. Howell explains that because many common skin conditions can often look very similar, it can be difficult to tell them apart on your own, and in most cases, a dermatologist is needed to make an accurate diagnosis.

The comparison table below highlights their similarities and differences, but if you’re unsure what you’re dealing with, an online dermatologist can assess your symptoms and provide a clear diagnosis from the comfort of your own home.

what skin conditions look similar to scabies

Scabies rash

Scabies is a highly contagious skin infection and can spread quickly through direct skin-to-skin contact in a family, child care group, school class or nursing home.

Due to their highly contagious nature, doctors often recommend treatment for the entire family or contact groups to eliminate the mite.

Symptoms: The primary symptoms of scabies include intense itching and a pimple-like skin rash. The itching is often worse at night.
Treatment: Topical creams such as permethrin, crotamiton, sulfur ointment, benzyl benzoate or ivermectin tablets².

Hand foot and mouth disease (HFMD)

Hand, Foot, and Mouth Disease (HFMD) is a contagious viral infection commonly affecting children and characterized by sores in the mouth and a rash on the hands and feet. The infection is usually caused by a virus and spreads through direct contact with the virus from sneezing, coughing, or fecal contamination.

Symptoms: Appearance of painful red blisters on the tongue, gums, inside of the cheeks, the palms, soles, and buttocks, fever, sore throat, and feeling unwell.
Treatment: HFMD typically resolves on its own within 7 to 10 days, and treatments focus on relieving symptoms through hydration, rest, and over-the-counter pain relievers such as acetaminophen or ibuprofen³.

Impetigo

Impetigo is a highly contagious bacterial skin infection that is spread through direct skin to skin contact or by sharing personal items with a person that is infected. Impetigo most commonly affects young children, though it can occur at any age. It’s usually caused by either Staphylococcus aureus or Streptococcus pyogenes bacteria.

Symptoms: Red sores that quickly rupture, ooze for a few days and then form a yellowish-brown crust.
Treatment: Treatment typically involves antibiotic ointments or oral antibiotics to eliminate the bacteria⁴.

Herpes simplex

Herpes is a viral infection caused by two types of viruses: herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). HSV-1 primarily causes oral herpes, which is characterized by cold sores around the mouth and on the face. HSV-2 typically causes genital herpes, leading to sores and blisters in the genital area. Both types of herpes are highly contagious and can be transmitted through direct contact with an infected person’s skin or body fluids.

Symptoms: Painful blisters or ulcers at the site of infection, fever, body aches.
Treatment: Antiviral medications can help speed up healing and reduce the severity of episodes⁵.

Bedbug bites

The two main species of bedbugs that feed on human blood are Cimex lectularius and Cimex hemipterus. They usually bite at night and although their bites are not initially felt, they can turn into itchy welts. These insects reside in environments where people sleep or rest, such as beds, couches, and other furniture and although they are usually not passed through skin-to-skin contact, they can be transported via personal belongings, potentially leading to infestations in new areas.

Symptoms: Small, red, itchy bumps/rash, typically in a line or grouped together.
Treatment: Focus on relieving itching with antihistamines or corticosteroid creams and eradicating the bedbugs from home environments⁶.

Chickenpox (Varicella)

Varicella, commonly known as chickenpox, is a highly contagious viral infection caused by the varicella-zoster virus.The infection spreads through direct contact with the rash or through the air when an infected person coughs or sneezes. It primarily affects children and is characterized by an itchy, red rash that develops into fluid-filled blisters that eventually scab over. Other symptoms may include fever, tiredness, loss of appetite, and headache. Chickenpox is usually mild in children but can be more severe in adults.

Symptoms: Blister-like rash, itching, tiredness, sore throat, headaches and fever
Treatment: Chickenpox generally resolves on its own, but acyclovir can be prescribed to minimize symptoms. Treatments include rest, hydration, and medications like acetaminophen for fever and calamine lotion or antihistamines for itching⁷.

Not sure if it’s scabies or something else?

Consult a dermatologist

Molluscum contagiosum (water warts)

Molluscum contagiosum is a common viral infection of the skin caused by the molluscum contagiosum virus, a member of the poxvirus family and it spreads through direct skin-to-skin contact or by touching contaminated objects, such as towels or clothing. It primarily affects children but can also occur in adults, particularly those with weakened immune systems. The infection is characterized by small, painless, pearl-like bumps on the skin that may become itchy or sore. These bumps often have a dimple in the center and can appear anywhere on the body.

Symptoms: Painless, firm, round bumps with a dimple in the center.
Treatment: YCANTH (cantharidin) topical solution⁸, oral cimetidine⁹, podophyllotoxin, potassium hydroxide, salicylic acid, benzoyl peroxide, and tretinoin can be used as home treatments and must be applied to each lesion¹¹.

Folliculitis

Folliculitis is a common skin condition characterized by inflammation of the hair follicles. This can occur anywhere on the skin where hair grows, including the scalp, face, and limbs. The inflammation is typically caused by a bacterial or fungal infection, and it can result in red, swollen bumps that may look like pimples, often with a hair in the center. These bumps can be itchy and sometimes painful. When the bumps rupture, they may release pus or blood. Frequent causes include irritation from shaving, tight clothing, or an existing skin condition.

Symptoms: Red, swollen bumps that may have pus, itchy or burning skin.
Treatment: Mild cases often resolve on their own, while more severe infections may need medications such as itraconazole, fluconazole, topical mupirocin, clindamycin, oral antibiotics, ivermectin or oral metronidazole¹².

Eczema (Atopic Dermatitis)

Eczema is a chronic, inflammatory skin condition characterized by itchy, red, and dry skin, often leading to flaking or scaling. It is typically caused by genetic and environmental factors and can be exacerbated by irritants, allergens, and stress.

Symptoms: Itchy, red patches on the skin, dryness, and possible oozing or crusting.
Treatment: Managing eczema involves moisturizing regularly, avoiding known irritants, and using topical corticosteroids or calcineurin inhibitors to control symptoms. Severe cases may require systemic treatments¹³.

Hives (Urticaria)

Hives (also known as urticaria), is a skin reaction characterized by the sudden appearance of itchy, raised, red or skin-colored welts on the skin. These welts often come and go over a period, sometimes moving around the body. Hives are commonly triggered by allergies to medications, foods, insect stings, or other substances. Other causes can include infections, stress, and exposure to extreme temperatures. The condition may be acute, lasting less than six weeks, or chronic, persisting for longer periods.

Symptoms: Red, itchy welts on the skin, which may merge to form larger swollen areas.
Treatment: Treatment includes antihistamines to reduce itching and swelling. Severe cases may require corticosteroids¹⁴.

Psoriasis

Psoriasis is a chronic autoimmune condition that affects the skin, causing rapid skin cell turnover. This results in thick, red, scaly patches that can be itchy and sometimes painful. The exact cause of psoriasis is not fully understood, but it is thought to involve the immune system. Triggers for psoriasis outbreaks can include stress, infections, certain medications, and skin injuries.

Symptoms: Red patches of skin covered with thick, silvery scales, dry skin that may crack and bleed.
Treatment: Treatments include topical treatments, phototherapy, and systemic medications to reduce cell turnover and inflammation¹⁵.

Not sure if it’s scabies or something else?

Consult a dermatologist

Learn more about scabies

What do scabies look like?

Scabies typically appear as a skin rash composed of small red bumps and blisters. Scabies is also characterized by the presence of burrow tracks: tiny, irregular, raised lines on the skin where the mites have tunneled. These tiny lines may be very difficult to see due to scratching or inflammation. The intense itching associated with scabies is often worse at night and can be very uncomfortable.

Scabies rashes can affect various parts of the body, such as:

Between the fingers
Wrist areas
Elbows
Armpits
Waistline
Buttocks
Male genital area
Umbilicus (belly button)
Soles of the feet in infants^{16 17}

Scabies symptoms

The symptoms of scabies may take 4-6 weeks to appear in individuals who have never been infested before, as this is the body’s reaction time to the mites. However, in people who have had scabies previously, symptoms may appear much sooner, typically within a few days of re-exposure.

Intense itching: The hallmark symptom of scabies is severe itching, which tends to get worse at night. The itching is caused by an allergic reaction to the presence of the mites.
Rash: Scabies typically leads to a rash that consists of tiny bumps that can look like pimples or knots under the skin. The rash commonly appears in the webs between the fingers, on the wrists, elbows, armpits, waist, buttocks, genital area, and the backs of the knees.
Burrows: One of the distinguishing features of scabies is the appearance of burrows. These are tiny, irregular tracks made up of tiny blisters or bumps on the skin. Burrows are most commonly found on the hands, feet, wrists, and between the fingers and toes.
Infection: Due to scratching, the affected areas may become secondary infected with bacteria, leading to complications like impetigo.
Crusts: In severe cases, such as with Norwegian scabies (crusted scabies), thick crusts and scales may form on the skin that contain thousands of mites and eggs¹⁸.

What should I do if I suspect I have scabies?

If you suspect that you have scabies, it is important to take the following steps to manage the condition and prevent its spread.

Consult an online dermatologist immediately for diagnosis and treatment.
Start treatment promptly and treat all close contacts simultaneously, regardless of symptoms.
Wash all recently used clothing, bedding, and towels in hot water and dry on high heat. Seal non-washable items in a plastic bag for at least 72 hours to kill any mites.
Avoid direct skin contact with others until treatment is effective, typically 24 hours after application.
Monitor your symptoms post-treatment; itching may persist for a few weeks due to an allergic reaction, but new burrows or rashes may require re-treatment.
Schedule a follow-up with your dermatologist if symptoms persist or new ones appear to ensure complete eradication of the mites.

Scabies treatment

Dr. Howell says there are several medications available for treating scabies depending on the severity of the infestation, the patient’s medical history, and other factors. In some cases, doctors may recommend using both oral and topical treatments to increase efficacy, particularly in the case of severe or crusted scabies (also called Norwegian scabies). This approach can help ensure that the treatment penetrates thick crusts and reaches all mites.

Topical creams for scabies

Permethrin cream (5%): This is the most commonly prescribed medication for scabies in children and adults. It’s applied over the entire body from the neck down and left on for about 8-14 hours before being washed off. It’s safe for adults, children, and the elderly but is usually not recommended for infants under two months of age¹⁹.
Spinosad liquid (0.9%): this is a newer treatment (typically used to treat head lice) approved to treat scabies in children as young as 4 years of age²⁰.
Crotamiton cream or lotion (10%): Crotamiton is another topical agent used to treat scabies, known for its anti-pruritic (anti-itching) properties. It is applied once daily for two consecutive days²¹.
Sulfur ointment (5-10%): This is one of the oldest scabies treatments and is particularly used for infants, pregnant women, and nursing mothers. It’s less commonly used today but can be effective, especially in resistant cases. It is applied nightly for three to six nights²².
Benzyl benzoate (25%): Applied to the body, avoiding the face, benzyl benzoate is left on the skin for 24 hours before being washed off. It may be reapplied for a second 24-hour period if necessary²³.
Lindane lotion (1%): Due to potential neurotoxicity, lindane is usually reserved for patients who cannot tolerate other treatments or when treatment with other agents has failed. Lindane is applied once and washed off after eight hours. It is not recommended for pregnant women, the elderly, or children²⁴.

Oral medications for scabies

Ivermectin: This is an oral medication that can be used in cases where topical treatment is impractical (such as with mentally or physically disabled patients) or when infestation is crusted and severe. It’s typically given as a single dose and may be repeated in one to two weeks if necessary. Ivermectin is not approved for use in children weighing less than 15 kg or in pregnant women.

Frequently asked questions about scabies and scabies treatment

Dr. Eric Howell, board-certified dermatologist answers common questions people have about what can be mistaken for scabies and how to treat scabies.

Can you get rid of scabies in 24 hours?

No, you generally cannot get rid of scabies completely in 24 hours. Scabies treatment can kill the mites quickly, but symptoms such as itching and a rash may continue for several weeks after successful treatment because your skin can continue reacting to the mites and their waste. Treatment usually involves prescription medication, such as permethrin cream or oral ivermectin, and household members and close contacts may also need treatment to prevent reinfection. Clothing, bedding, and towels should also be washed or otherwise treated as recommended. If symptoms persist or new burrows or rashes appear after treatment, you should consult a healthcare professional, as this could indicate treatment failure, reinfection, or another skin condition that resembles scabies.

What rashes look like scabies?

Several rashes and skin conditions can resemble scabies because they may also cause itching, redness, bumps, or blisters. Conditions that can look like scabies include hand, foot and mouth disease, impetigo, herpes simplex, bedbug bites, chickenpox, molluscum contagiosum, folliculitis, eczema, hives, and psoriasis. Because these conditions require different treatments, a dermatologist can help determine the cause of a scabies-like rash.

How do I know if I have scabies?

According to Dr. Howell, it can be difficult to tell scabies apart from other skin conditions because many cause similar rashes and itching. A dermatologist can examine your skin and determine whether scabies or another condition is responsible. Seeking medical advice promptly is especially important because scabies and some conditions that resemble it can be contagious.

What are Norwegian scabies?

Norwegian scabies, also called crusted scabies, is a severe and highly contagious form of scabies involving a very large number of mites. It typically causes thick, crusted areas of skin containing numerous mites and eggs. Crusted scabies is more common in people with weakened immune systems and generally requires more intensive treatment than typical scabies.

What is the best treatment for scabies?

According to Dr. Howell, scabies is commonly treated with prescription permethrin cream, which is usually applied over most of the body and left on for several hours before being washed off. Oral ivermectin may also be prescribed, particularly when topical treatment is impractical or for certain severe or persistent cases. Close contacts and household members often need treatment at the same time to reduce the risk of reinfestation.

How do you get scabies?

According to Dr. Howell, scabies spreads primarily through prolonged, direct skin-to-skin contact with someone who has the infestation. Less commonly, mites can spread through contaminated clothing, towels, or bedding. Once transferred to a person, female mites burrow into the outer layer of the skin and lay eggs.

Is scabies contagious?

According to Dr. Howell, scabies is highly contagious and can spread readily where people have frequent or prolonged skin-to-skin contact, including households, childcare facilities, and nursing homes. Prompt diagnosis and appropriate treatment of affected people and their close contacts can help prevent further transmission.

What is similar to scabies?

Skin conditions such as eczema, dermatitis, and allergic reactions can be similar to scabies because they can cause itching, redness, and a rash. Other possible lookalikes include hives, psoriasis, folliculitis and several infectious skin conditions. It can be difficult to distinguish between them based on appearance alone.

What is the difference between scabies and impetigo?

According to Dr. Howell, the main difference is their cause: scabies is an infestation caused by the mite Sarcoptes scabiei, whereas impetigo is a bacterial skin infection. Both conditions can spread from person to person, but they require different treatments.

Can you use ivermectin for scabies?

Yes. Oral ivermectin can be used to treat scabies and may be particularly useful for crusted scabies or when topical treatment is unsuitable or unsuccessful. Because ivermectin does not reliably kill mite eggs, another dose is commonly given after an interval determined by a healthcare professional.

Does ivermectin kill scabies immediately?

According to Dr. Howell, ivermectin does not eliminate a scabies infestation immediately. It acts against the mites after being taken, but additional treatment is often needed because ivermectin has limited activity against mite eggs. Itching can also continue for several weeks after successful treatment and does not necessarily mean that live mites remain.

Can you use permethrin cream for scabies?

Yes. Permethrin cream is a commonly prescribed first-line treatment for scabies. It is typically applied to the skin as directed by a healthcare professional, often over the entire body from the neck down in adults, and left in place for approximately 8–14 hours before being washed off. A repeat application may be recommended.

Can you use benzyl benzoate for scabies?

Yes. Benzyl benzoate is a topical medication used to treat scabies and may be used as an alternative to other treatments such as permethrin. The appropriate formulation and application instructions can vary, so it should be used according to medical or local treatment guidance.

Can dogs and cats get scabies?

Dogs and cats can develop mite infestations similar to human scabies, including sarcoptic mange in dogs and certain forms of mange in cats. The mites affecting animals differ from the human-adapted scabies mite. Animal mites can occasionally cause temporary itching or skin irritation in people but generally cannot reproduce and maintain an ongoing infestation on human skin.

Is there an effective home treatment for scabies?

According to Dr. Howell, home remedies are not considered reliable treatments for eliminating scabies mites. Proven medical treatments, such as prescription permethrin or ivermectin when appropriate, are needed to treat the infestation. Measures at home, including laundering recently used clothing and bedding, can help prevent reinfestation, while treatments for itching may provide symptom relief.

How can I test myself for scabies?

According to Dr. Howell, self-diagnosing scabies is not recommended because several skin conditions can produce similar symptoms. Using the wrong treatment may also irritate the skin or delay appropriate care. A healthcare professional, particularly a dermatologist, can assess the rash and use appropriate diagnostic methods when necessary.

What looks like scabies but isn't scabies?

Eczema, hives, psoriasis, folliculitis, impetigo, bedbug bites, chickenpox, herpes simplex, molluscum contagiosum, and hand, foot and mouth disease can all produce skin symptoms that may be mistaken for scabies. Although they can look similar, their causes and treatments differ significantly, so an accurate diagnosis is important.

Is scabies an STD?

According to Dr. Howell, scabies is not classified as a sexually transmitted infection (STI). However, because it spreads through prolonged skin-to-skin contact, it can be transmitted during sexual activity. Sexual contact is only one possible route of transmission.

What is the difference between urticaria and scabies?

According to Dr. Howell, urticaria, or hives, typically causes raised, itchy welts and can be triggered by factors such as allergens, infections, medications, or other stimuli. Scabies is caused by mites that burrow into the outer layer of the skin, producing intense itching and a characteristic rash. Scabies itching is often particularly troublesome at night.

What is the difference between scabies and bed bugs?

According to Dr. Howell, scabies mites infest the skin and burrow into its outer layer, whereas bed bugs live in the environment and feed on people, usually while they sleep. Bed bug bites often occur on exposed skin and may appear in clusters or lines. Unlike scabies mites, bed bugs do not live or reproduce on the human body.

Is there a soap to kill scabies mites?

Ordinary soaps and laundry detergents are not treatments for scabies on the skin. Scabies requires an appropriate medication prescribed or recommended by a healthcare professional. To help prevent reinfestation, recently used clothing, towels, and bedding should be cleaned according to recommended laundering instructions, typically using hot washing and high-heat drying when the items permit it.

Does bleach kill scabies on the skin?

Bleach should never be applied to the skin to treat scabies, as it can cause significant irritation or chemical burns. Scabies on the body should instead be treated with proven medications such as permethrin or, when appropriate, oral ivermectin. For potentially contaminated clothing and bedding, laundering and high-heat drying according to scabies-control recommendations are generally sufficient; bleach is not required specifically to eliminate scabies mites.

Is there a spray for scabies?

Environmental sprays are generally not necessary for routine scabies because the mites usually do not survive for long away from human skin. The priority is treating affected people and close contacts as recommended and appropriately cleaning recently used clothing, towels, and bedding. Follow the advice of a healthcare professional for crusted scabies, where environmental contamination can be greater.

Can sunlight kill scabies on skin?

Sunlight does not kill scabies mites. If you are infected with scabies you need a prescription medication such as permethrin or another treatment recommended by a dermatologist.

Can Vaseline kill scabies?

No. Vaseline (petroleum jelly) does not kill scabies mites, you need a prescription medication to treat it. Vaseline is used to help moisturize dry or irritated skin.

Can scabies be transmitted from an animal to a person?

Human scabies is caused by the human-adapted mite Sarcoptes scabiei var. hominis, which does not normally establish an infestation on animals. Animals can carry related mites adapted to their own species, and contact with an infested animal can occasionally cause temporary itching or skin irritation in humans. However, these animal mites generally cannot reproduce on humans and therefore do not cause persistent human scabies.

How do you say scabies in Spanish?

Scabies is called "sarna" in Spanish and mites are called “acaros” in Spanish.
Lee este artículo en Español. Ronchas en la piel causadas por ácaros.

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