Scabies Rash on Black Skin: Symptoms and Treatment - Verywell Health

Scabies is a skin condition that can affect anyone in crowded spaces like hospitals, care facilities, and daycare centers.

Scabies is caused by mites called Sarcoptes scabiei (which are not the same as mange, the mites that pets can catch), and is not related to cleanliness.

As mites burrow into the skin, the skin reacts with bumps. On lighter skin, scabies lesions can appear pink or red. On darker skin, scabies can appear differently.

This article provides an overview of what scabies looks like on darker skin, scabies symptoms, when to get medical attention, diagnosing scabies, and how to treat scabies.

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Scabies Rash on Darker Skin

Scabies rash can appear red or pink on lighter skin, and the rashes are often easy to spot. On darker skin, there can also be inflammation and redness, with colors ranging from pink to violet. However, rashes on darker skin most often appear skin-colored or only slightly lighter. This can make closer examination necessary.

Scabies Symptoms

For new infections, scabies symptoms can take a month to six weeks to appear. For people who've had scabies before, symptoms can appear in a day or two. Symptoms of scabies can include:

  • A rash that can look pimply: On darker skin, scabies lesions can look only slightly lighter, but in lighter areas like the inner arm or palm, they can be brown or black.
  • Burrows: Burrows are short lines (about 1 centimeter in length) where mites crawl into the skin. This manifests as a small bumpy line punctuated with a tiny dark bump. On darker skin, burrows might have to be felt or viewed with a dermatoscope, a small handheld device doctors look through to see clearly.
  • Intense itching: An itch that can be intense enough to keep people awake at night is another symptom of scabies.

Areas where scabies first appears include between fingers and toes, on the palms, soles, ankles, wrists, elbows, or navel (belly button), or around the nipples for women and genitals for men.

Scabies: Who's At Risk?

Anyone who lives or works in crowded spaces is at a higher risk of scabies. Scabies is not related to cleanliness, and it can even be present in hospitals and care facilities. People susceptible to scabies include:

  • Children and their parents
  • Sexually active young adults
  • Nursing home residents
  • Hospital patients

When to See a Healthcare Provider

Though scabies is treatable with pharmacist-recommended creams, a healthcare provider-recommended cream may prove more effective. Seek medical care if:

  • You have a rash that doesn't heal within weeks and doesn't respond to antihistamines or anti-itch creams
  • Your rash looks infected, blistered, or has pus
  • Your rash seems to spread, especially if it spreads rapidly
  • Itching doesn't respond to antihistamines or lotions

Scabies: When to Seek Emergency Care

Call a healthcare provider as soon as possible in the case of:

  • A painful, swelling, red, or warm rash
  • Red streaks from mite marks
  • Pus from lesions
  • Fever with a rash

Are There Tests to Diagnose Scabies?

To diagnose scabies, a healthcare provider may:

  • Examine the skin and look for burrows.
  • For darker skin, a healthcare professional might use a dermatoscope, a handheld device that helps with looking at skin imperfections more closely.
  • Ask if other family members or people in a patient's environment also have symptoms.
  • Rule out eczema or another skin infection.
  • Use an ink test, by which ink is rubbed on burrows and wiped off to see if some of it remains and falls into the burrows.
  • Perform a skin biopsy, by which a piece of skin is sampled to be viewed under a microscope.

How to Treat Scabies

Scabies can often be treated with a cream (usually Permethrin cream 5%). The cream is usually applied to cool, dry skin all over the body, except the head.

Other treatments that a person who has scabies might need include:

  • Taking antibiotics if there is an infection
  • Taking antihistamines for itch
  • Applying steroid creams for the itch
  • Using pramoxine lotion for the itch
  • Avoiding close contact with others until the treatment is complete
  • Washing linens and towels

It can take a month after treatment for scabies itching to completely disappear and at least a month for the blisters to heal.

Summary

Scabies is a rash caused by mites called Sarcoptes scabiei, and it occurs worldwide in places where people congregate in close spaces, such as hospitals, care facilities, and day cares. Scabies is not related to cleanliness.

On darker skin, scabies rashes may be only slightly lighter than skin color, which can make diagnosis challenging. Rashes on paler areas, like palms or inner arms, are often darker than the surrounding skin. Burrows, which is a term for the lines that result when mites burrow into the skin, can be observed with a dermatoscope or felt during an examination.

Treating scabies includes using a cream for one treatment or two treatments a week apart, washing all linens and towels, and making sure people in the surroundings are also treated.

A Word From Verywell

Scabies is a common condition found all over the world that can happen to anyone spending time in crowded living areas, including areas that are clean. Though it can be uncomfortable, the good news is that it normally only takes one treatment (or two one week apart) to get rid of the offending bugs for good. Ask your pharmacist or a healthcare professional which creams could be best for you and those with whom you live.

Frequently Asked Questions

  • Because scabies presents as a red rash, it is sometimes confused with several other conditions. Scabies rash can be misdiagnosed as rosacea, contact dermatitis, bullous pemphigoid, or eczema. Scabies can also be mistaken for an allergic rash or hives. Scabies lesions can be mistaken for bites from bedbugs, fleas, and midges.

  • Permethrin cream 5% is the most common treatment for scabies. The cream kills mites and eggs immediately. It might be necessary to take two or more treatments, each a week apart, to kill all mites and eggs.

  • Scabies usually starts between the fingers. Other common areas for scabies include the wrists, elbows, ankles, buttocks, penis, and nipples (for women). It can also appear around the navel.

By Neha Kashyap
Neha is a New York-based health journalist who has written for WebMD, ADDitude, HuffPost Life, and dailyRx News. Neha enjoys writing about mental health, elder care, innovative health care technologies, paying for health care, and simple measures that we all can take to work toward better health.

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