How Does Scabies Spread Between People?

Can Scabies Spread to Family Members?

Scabies is highly contagious. If one person in the household gets it, everyone is at risk. This is not an exaggeration.

How It Spreads

1. Direct skin contact (primary route) -- Prolonged skin-to-skin contact with an infected person, such as shaking hands, hugging, or sharing a bed. Note: It does not spread through the air like the flu -- it requires fairly close skin contact.
2. Indirect contact (also very common) -- Sharing items the infected person has used: towels, bath towels, bed sheets, duvet covers, pajamas, underwear. Scabies mites can survive on clothing and bedding for 2-3 days after leaving the body. Others who come into contact with these items during that period can become infected.
3. Sexual contact -- Scabies can be transmitted through sexual contact and is considered a sexually transmitted disease.

How It Spreads Within a Household

• Sharing a bed is the most common mode of household transmission, because prolonged skin contact makes it easiest for mites to crawl from the infected person to a healthy person.
• Households that share towels and clothing have a higher transmission risk.
• Scabies mites can ping-pong back and forth between family members -- you pass it to me, I pass it back to you later.

Why Does the Whole Family Need Treatment?

Scabies has an incubation period of 2-6 weeks. An infected person may already have mites reproducing before symptoms appear. That means:

• All household members living together should receive treatment, even if they have no symptoms.
• Don't wait for symptoms to appear -- by then, the mites may have already been passed back and forth several times.
• This is the "ping-pong effect" -- you get treated and cured, then get reinfected by an untreated family member, over and over.

How to Stop Household Spread

4. After diagnosis, the patient should sleep in a separate bed and not share bedding.
5. The patient's clothing, towels, bed sheets, and duvet covers should be changed daily and washed in water above 60 deg C (140 deg F).
6. Treat everyone in the household at the same time. Don't skip anyone.
7. After treatment is complete, thoroughly disinfect all clothing and bedding.