The main symptoms of scabies are:

• intense itching that is worse at night
• skin rash in the areas of the body where mites have burrowed

These symptoms are described in more detail below.

Intense itching

The main symptom of scabies is intense itching that is worse at night when the skin temperature is warmer. The itching may take between four to six weeks to develop because this is the length of time that it takes for the body to react to the absorption of mite droppings into the skin cells.

If you have had a previous infection, the symptoms will begin to show within one to two days. This is because your immune system will have learnt to react to a scabies infection.

Skin rash

The skin rash that is associated with a scabies infection is made up of tiny red insect bites or spots. If you scratch the rash, you may also develop crusty sores.

Burrow marks can be found anywhere on the body but, in adults, they often appear in the following areas:

• the folds of skin between the fingers and toes
• the wrists
• the elbows
• around breast nipples (in women)
• around the male genital area

The rash can also sometimes occur in the following areas:

• the underarm area (axillae) 
• around the waist
• the inside of the elbow
• the lower buttocks
• the lower legs
• the soles of the feet
• the knees
• the shoulder blades
• female genital area
• the nipples
• the groin
• around the ankles

Elderly people, young children and those with a low immune system (immunocompromised) may also develop a rash on their head and neck.

In infants and young children, burrow marks tend to appear at different locations on their body, including the:

• face
• head
• neck
• scalp
• palms of the hands
• soles of the feet

The scabies mites also leave small red blotches and silver coloured lines on the skin. These marks are caused by the mites burrowing into the skin.

Blisters and pustules (small blisters that contain pus) on the soles of the feet and palms are also a common characteristic of scabies in infants.