Your concern
Unbearable itching at night
Scabies: itching that explodes at night and affects several people in the same household.
Two elements together are worth more than any observed lesion: the itching worsens dramatically at night, and more than one person in the household is scratching. When these coincide, scabies comes among the first hypotheses even before looking at the skin.
It is caused by a microscopic mite that burrows through the superficial layers of the skin. The typical sites are revealing: the finger webs, wrists, elbows, armpits, waistline and genital area, while in adults the face is usually spared. What is visible is often mostly the result of scratching, which makes the picture less recognisable than expected.
It has nothing to do with hygiene — a misconception that delays many diagnoses and embarrasses patients. Two things must be said immediately because they change the outcome: all household members are treated at the same time, including those without symptoms, otherwise the cycle restarts; and itching can continue for weeks after successful treatment, because it is the reaction to what remains in the skin and not proof that the mite is still alive.
The whole household is treated, including those without symptoms
This is the mistake that makes most treatments fail, and it is not excessive caution. Weeks pass between infestation and the appearance of itching: a household member may already be carrying the mite without noticing and, if not treated alongside the others, returns the infestation to those who had recovered. For the same reason linen, bedding and towels are handled at the same time, following the advice given at the visit. Treating one person in a household of four almost always means having to do it again.
How it shows
- Intense itching, clearly worse at night
- Other people in the household with the same symptom
- Typical sites: finger webs, wrists, elbows, armpits, waistline, genitals
- Scratch lesions, excoriations and crusts
- Sometimes small linear burrows visible on the skin
- In adults the face is usually spared
How we proceed
- 1Visit: distribution of lesions, nocturnal pattern of itching, household context
- 2Confirmation of the picture, with dermatoscopy where useful
- 3Simultaneous treatment of the patient and all household members
- 4Advice on linen, bedding and shared items
- 5Follow-up: residual itching does not equal failure
Available treatments
- Dermatology visit
- Dermatoscopic diagnosis
- Treatment extended to household
- Scheduled follow-up
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Frequently asked questions
I did the treatment but it still itches: did it not work?+
In most cases it did work. The itching is the body's reaction to what the mite left in the skin, and that reaction subsides more slowly than the infestation: it can continue for weeks even though the parasite has already been eliminated. This matters, because the instinctive response — repeating the treatment alone — further irritates the skin and worsens the very symptom you want to remove. If itching persists or new lesions appear, return for a visit rather than starting over.
How is it caught?+
Through prolonged skin contact, far more than casual contact: living together, sharing a bed, close relationships. Transmission through linen and clothing is possible but plays a smaller role than direct contact. It has nothing to do with how clean the home or the person is, and dwelling on that only delays the visit out of embarrassment.
Do I have to throw away sheets and clothes?+
No. They are handled with a hot wash or by isolating them for the indicated period: the mite does not survive long away from human skin. Precise advice — which items, what temperature, for how many days — is given at the visit, because it depends on how many people are involved and how extensive the picture is.
Related reading
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