What conditions can be mistaken for scabies?

You can develop scabies from skin-to-skin contact. While you can’t see the mites with the naked eye, the itchy rash can look like tiny bites or little bumps on the skin.

But there are lots of other conditions that can cause similar symptoms, including eczema and psoriasis. Knowing more about these conditions can help you identify the issue and get the right medical treatment.

Need a prescription or refill? You can get discreet and expert on-demand care in as little as 15 minutes. For $29, answer a few questions online and get a treatment plan from a US-licensed healthcare professional. Get started here.

What is scabies?

Scabies is very common, affecting around 400 million people worldwide each year. It spreads through direct skin contact. While it can affect anyone, it’s more common in places that can be overcrowded, particularly nursing homes, prisons, and child care centers.

The tiny mites that cause scabies — Sarcoptes scabiei — can lay eggs in the top layers of your skin. It can affect any part of your body, but it’s common on the wrists, genital areas, breasts, between the fingers, and along the belt line. The most common symptoms are:

• itching that may worsen at night
• tiny bumps that may appear in a line
• small blisters in the rash
• gray, white, or skin-colored burrow lines on the skin

If you’ve had direct contact with someone with scabies and start showing symptoms, you can assume you’ve also contracted it.

With treatment, it’s possible to cure the condition entirely, and it should go away completely within 4 weeks. But reinfection is very common. This is because it’s difficult to get rid of all of the mites, particularly if you live with others who have scabies.

It’s important to also treat everyone in the household who has come into contact with scabies to prevent reinfection.

The following conditions have some similar characteristics to scabies.

Eczema

Eczema is a very common skin condition, affecting over 31 million people in the United States alone. There are several different types of eczema, including:

• atopic dermatitis
• contact dermatitis
• seborrheic dermatitis

Eczema is also closely linked with other allergies, including food allergies, seasonal allergies like hay fever, and asthma. Certain things in the environment can trigger a reaction, especially harsh perfumes and soaps. Some foods can also be a trigger.

The most common symptoms of eczema include:

• dry skin
• itchiness
• rashes or inflamed patches of skin
• skin discoloration

Unlike scabies, eczema is considered a long-term (chronic) condition, and it’s unlikely that you’ll get rid of it completely, even with proper treatment. Another key difference is the cause: Eczema is likely due to underlying genetic factors, while parasites cause scabies.

Psoriasis

Psoriasis is a common condition where your body makes skin cells too quickly, leading to a buildup. It’s an autoimmune condition. This means it’s caused by your immune system mistakenly attacking healthy skin cells, which is why they’re made quicker than usual.

This leads to symptoms, including:

• scaly patches of skin known as plaques
• itching or pain
• raised patches
• silvery-white patches on lighter skin
• darkened purple or brown patches on dark skin tones

The key difference between psoriasis and scabies is what the rash looks like. Psoriasis causes scaly plaques, while scabies is more likely to lead to small bumps and blisters.

Shingles

Shingles is a viral infection caused by the same virus that causes chickenpox. Symptoms of shingles often appear in stages and may involve a painful rash that affects one side of your body. This rash usually turns into blisters filled with fluid.

Differently from scabies, you’ll likely experience other symptoms with shingles, including:

• fever
• chills
• headaches
• an upset stomach

A key feature of shingles is that the rash only affects one side of your body.

Hives

Hives are itchy, raised rashes on your skin that may mimic scabies. They’re usually caused by an allergic reaction or a reaction to something in your environment. They may also occur due to stress.

In contrast to shingles, hives can happen anywhere on your body and may affect large areas at any one time. The rash generally won’t look like small bites.

Chigger bites

Chiggers are tiny insects that sometimes bite humans. Like scabies, this can cause a raised, itchy rash. They usually affect the following areas:

• lower legs
• ankles
• behind the knees
• armpits
• groin

You might notice chigger bites after spending time in long grass or forests.

Unlike scabies, chigger bites are not contagious, and symptoms generally go away on their own with the aid of over-the-counter medications. Scabies, however, requires prescribed creams.

How to tell what you have

The best way to tell what condition is affecting you is by asking a healthcare professional. But there are certain things you can consider to give you an idea of what your rash might be:

• If you have burrow marks, blisters, or tiny bumps that look like insect bits, it’s likely scabies-related.
• If you’ve recently had contact with someone with scabies, it’s likely scabies-related.
• If you have allergies or asthma, it’s likely to be eczema-related.
• If your rash is in the form of a scaly plaque, it could be psoriasis.
• If the rash is only on one side of your body and you also have a fever, you may have shingles.
• If the rash goes away on its own, it could be chigger bites
• If you’ve recently come into contact with common allergens like pollen or a new laundry detergent, it could be hives.

Doctors can usually diagnose scabies just by looking at you and your rash. They might also take a small skin sample and look at it under a microscope to see the small mites that cause it. Once you have a diagnosis, you can begin treatment.

Online care services, including Optum Perks Online Care, may make getting treatment easier. With these services, you can submit an online form answering a few questions about your symptoms, and a US-licensed healthcare professional will respond soon after to prescribe a treatment plan.

Scabies treatment

Even if you don’t have symptoms, if someone you live with or a recent sexual partner has scabies, it’s important to seek treatment, as it can take several weeks for symptoms to appear.

You can typically treat scabies by applying a medicated cream or lotion to the entire body from the neck down. These creams are only available on prescription. Examples include:

• permethrin (Elimite)
• crotamiton (Crotan)
• spinosad (Natroba)

If these treatments don’t work, a doctor may prescribe oral ivermectin (Stromectol).

If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.

Summary

Scabies is a condition caused by tiny mites on your skin. It causes symptoms like a rash and severe itching. But people can mistake several other conditions for scabies.

Eczema, for example, also causes itching and a rash. But the rash might look slightly different, and it’s usually due to a reaction to things in the environment or foods. Psoriasis can cause an itchy rash, but the rash looks more like scaly plaques.

Knowing what condition is affecting you can help you get the right treatment as quickly as possible. You can usually treat scabies with prescription medicated creams.

Download the free Optum Perks Discount Card to save up to 80% on many prescription medications. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.