Rashes that look like scabies: Causes, symptoms, and treatment - Medical News Today

Scabies is a skin condition that occurs as the result of a mite known as Sarcoptes scabiei. The rash that results from scabies may appear similar to other skin conditions, such as psoriasis, eczema, or contact dermatitis.

In this article, we look at what a scabies rash looks like.

We also look at other rashes that are similar in appearance and their treatment options.

Scabies is a common condition that occurs as the result of an infestation of a microscopic skin mite called Sarcoptes scabiei. The mites burrow under the skin, causing intense itching and a rash.

The Centers for Disease Control and Prevention (CDC) describes the rash as pimple-like. On darker skin, the rash may be more difficult to see, but a person should be able to feel it.

According to DermNet, a scabies rash is varied in appearance, and may appear as:

  • pimple-like on the limbs and trunk
  • widespread or coin-shaped
  • small blisters
  • scales
  • lesions in the armpits, groin, navel, areolas, scrotum, buttocks, and along the penile shaft

The American Academy of Dermatology Association notes that the rash may cause small bumps that form a line.

The rash can affect many parts of the body, including the:

  • wrists
  • elbows
  • armpits
  • spaces between the fingers and toes
  • nipples
  • penis
  • waist
  • buttocks

A scabies rash causes intense itching that is normally worse at night.

The itchiness normally starts within 1–4 days in people who have had scabies before, but can take 2–6 weeks to appear in those that have not had scabies in the past.

Some people have a variant of scabies known as crusted scabies.

This occurs when thousands or even millions of mites infest the skin surface. People with crusted scabies have a scaly rash and the itchiness may not be present, or may be minimal. This type of scabies often occurs in people who are immunocompromised.

Other skin conditions may present similarly to scabies, some of which are discussed below.

Psoriasis is an autoimmune skin condition where the body makes new skin cells at a fast rate. This causes the cells to pile up on the skin surface, which results in scaly patches. Unlike scabies, psoriasis is not contagious.

In about 80–90% of people with psoriasis, plaques develop. This is called plaque psoriasis.

When this occurs, often there are raised patches that will have scales coated on top. Because of this, psoriasis can sometimes appear similar to crusted scabies.

The symptoms of plaque psoriasis include:

  • thick skin patches normally found on the elbows, scalp, knees, lower back, face, palms, and soles of the feet
  • silvery scales on the patches
  • plaques of different sizes

On lighter skin, psoriasis will be red or pink. On browner skin, psoriasis appears salmon-colored and the scales are silvery-white.

On dark skin, psoriasis patches are violet in color and the scales will appear gray.

Treatment

A variety of treatment options are available for psoriasis depending on the type of psoriasis present and its severity.

Topical treatments are the first line of treatment for mild psoriasis. A 2020 study found that topical treatments remain effective in treating mild psoriasis.

Topical treatments include:

  • Emollients: These include moisturizers and anti-itch creams.
  • Coal tar: Coal tar can help reduce the itchiness and flakiness of psoriasis as well as reduce the redness and swelling, and slow the growing skin cells.
  • Topical corticosteroids: This includes creams such as hydrocortisone. These help decrease the itchiness and inflammation.
  • Salicylic acid: Salicylic acid can help soften the scales and reduce swelling.
  • Topical retinoids: This is a synthetic form of vitamin A. The retinoid that can treat psoriasis is called tazarotene.

For moderate to severe psoriasis, a person may require phototherapy, systemic therapy, and biologics.

Eczema, or atopic dermatitis, describes a group of conditions that cause the skin to be itchy, inflamed, and irritated.

Atopic dermatitis is an inflammatory skin condition that is not contagious. It is more common in children, although it can affect people of all ages.

The symptoms of atopic dermatitis include:

  • itchiness, which can be severe
  • dry patches of skin that are red to dark brown in color
  • hardened or thickened skin
  • itching that can disrupt sleep

Treatment

Treatment of atopic dermatitis includes medications, skin care, and phototherapy.

A 2019 study found that NB-UVB phototherapy treatment was effective in treating atopic dermatitis.

Medication that may be prescribed includes:

  • steroids to reduce swelling and clear the rash
  • antibiotics to help prevent infections
  • antihistamines to reduce irritation

A dermatologist may recommend that a person:

  • avoids scratching the skin
  • uses a moisturizer
  • uses soap that is fragrance-free
  • applies lubricating ointments and moisturizers to damp skin after washing

A person can also try bleach baths. The National Eczema Association advises that a person uses regular, unconcentrated household bleach, which contains 5.25% sodium hypochlorite.

People should always consult a healthcare professional before trying a bleach bath.

Additionally, people should:

  • avoid using excessively cold or hot water
  • avoid adding any other ingredients to the bath
  • avoid soaking for longer than 15 minutes
  • avoid submerging the head and face

Learn how to use bleach baths safely here.

Contact dermatitis occurs when a substance comes into contact with the skin and causes irritation or an allergic reaction.

Irritant contact dermatitis can occur due to detergents, solvents, acids, and more.

When the substance causes an allergic reaction, this is called allergic contact dermatitis.

Symptoms of contact dermatitis include:

  • itchiness, which can be intense
  • rash
  • swelling
  • tender skin
  • dry and cracking skin
  • fluid-filled blisters
  • blisters that ooze, crust, and scale

Allergic contact dermatitis can also cause hives to appear.

Treatment

The treatment of contact dermatitis involves avoiding the trigger. A healthcare professional may also prescribe certain topical and oral medications, including:

  • strong corticosteroid cream to reduce inflammation
  • prednisone to suppress the immune reaction
  • antihistamines to control the itchiness

This is a reaction to insect bites. According to DermNet, the symptoms include itchy clusters of bumps.

Fleas and mites that live on pets are typically responsible.

The bumps commonly form on the legs, forearms, and face.

Treatment

Treatment will likely include:

  • topical steroid cream
  • antihistamines
  • antiseptic cream

This is a skin infection that develops in the hair follicles. It looks similar to acne.

It occurs when the hair follicles become damaged, and germs such as Staph aureus cause an infection.

Unlike with scabies, itching is not always present with folliculitis.

Treatment

Mild folliculitis should resolve itself without medical attention. A person can apply a warm compress to affected areas three to four times a day. Widespread folliculitis will often require treatment with a topical or oral antibiotic.

There are other conditions that also present similarly to scabies.

These include, but are not limited to:

  • Dermatitis herpetiformis: This is a rare, chronic condition that causes severely itchy blisters and raised lesions. They commonly appear on the scalp, lower back, buttocks, elbows, and knees. This skin condition occurs alongside celiac disease.
  • Prurigo nodularis: This is a skin condition that causes firm, itchy bumps. They typically begin on the lower arms and legs. They may occur as the result of scratching or picking.
  • Insect bites: Bites from mosquitoes, fleas, bed bugs, chiggers, and other mites, can look similar to scabies.

A person should seek medical advice if they notice any skin changes that persist.

People should also seek medical advice if they experience pain with the skin changes or any changes to the color or texture of the skin.

Scabies is a skin condition that occurs due to a mite infestation in the skin. The resulting rash and itchiness may be similar to rashes seen in:

  • atopic dermatitis
  • psoriasis
  • contact dermatitis
  • folliculitis
  • papular urticaria

Unlike scabies, the above skin conditions are not contagious.

Although treatment options are available, a person should seek the advice of a dermatologist or other healthcare professional.

Treatment options include medications, topical creams, and phototherapy. The treatment option will depend on the severity of each condition.

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