Scabies vs. Eczema: How to Tell These Common Skin Conditions Apart (With Photos)

Believe it or not, there’s a common skin condition where bugs crawl underneath your skin: scabies. With this skin infection, small mites (Sarcoptes scabiei) burrow into your skin and multiply, causing an intensely itchy rash. And because people usually don’t know about it, it’s often mistaken for other common rashes, like eczema. But unlike eczema, scabies is highly contagious and can cause outbreaks in places where people are close together. In many cases, if one family member gets scabies, the rest of the family does, too. Schools, nursing homes, and other institutions are also common outbreak centers. 

Being able to tell the difference between scabies and eczema can help you spot a scabies infection early. This way you get the right treatment immediately — and stop it from spreading to close contacts and other people in your household.

What do scabies and eczema rashes look like?

It can be hard to tell eczema and scabies rashes apart. But there are some clues that can help you tell the difference, including what they look like and where on the skin they happen. 

Scabies

Scabies usually cause tiny clusters of skin bumps. In fair skin, these look pinky-red. In darker skin tones, the rash is brown or violet. Sometimes you can see tiny lines where the mite burrows in the skin. In severe scabies, the rash can look scaly or crusty. 

Scabies can develop on any part of the body, but common locations include the:

• Hands and wrists

• Armpits 

• Belly button 

• Genitals 

• Face and scalp (in infants and children)

Here are some images of scabies so you can see what it typically looks like in different skin types  and body locations. 

Scabies causes tiny itchy bumps on the finger and in the web spaces of the hand.

The wrist is another common location for scabies, and the tiny bumps can form a line.

Scabies can cause larger violet and brown bumps (called nodules).

Scabies is common on the feet, and scratch marks are often visible.

Eczema

Eczema causes a skin rash that’s bumpy with scaly patches. The rash is usually pink-red in fair skin, and violet or brown in darker skin tones.

Like scabies, eczema can happen anywhere on the body. But it’s most common on the:

• Inside of the elbows, wrists, and hands

• Behind the knees 

• Around the neck 

• Face and scalp (more common in infants and children)

EXPERT PICKS: WHAT TO READ NEXT

• If you’re recovering from scabies: This step-by-step guide walks you through what to expect after treatment — including how long symptoms may last and ways to ease itching while your skin heals.

• Curious what eczema actually feels like? People experience eczema in different ways. Learn how symptoms can show up on the skin — and how they may change during a flare.

• If you’re still dealing with widespread itching: Explore the most common causes of itchy skin and what signs may point to dryness, allergies, or another condition.

• Eczema vs. psoriasis: These common conditions can both cause itchy rashes. Learn how to tell them apart (with photos).

Here are some pictures of what eczema typically looks like in different skin types and body locations.

In darker skin tones, eczema causes dark brown scaly patches, as seen here behind the knees.

In fair skin, eczema causes red patches on the insides of the elbows.

Eczema on darker skin can cause violet brown patches.

Eczema is common on hands.

What are the symptoms of eczema vs. scabies?

There are some key features that can help you tell the difference between scabies and eczema. Here are some specific symptoms to look for.  

Getting a diagnosis

A dermatologist or healthcare professional can usually tell the difference between eczema and scabies based on your symptoms and rash. They can also do a scabies prep, a quick test that takes a few skin scrapings that are examined under the microscope for scabies mites. 

How do you treat eczema vs. scabies?

Eczema and scabies have very different treatments, so it’s important to have the right diagnosis. Here’s an overview of how each condition is treated. 

Eczema treatment

There’s no cure for eczema. In many cases eczema is chronic, so long-term treatment is usually needed. Depending on how severe your eczema is, treatment may involve one (or more) of the following treatments: 

• Good skin care and frequent moisturization with emollients

• Prescription creams, like topical steroids (triamcinolone) or JAK inhibitors (Opzelura)  

• Pills that suppress the immune system, like steroids (prednisone) or cyclosporine

• Biologics, like Dupixent

• Light therapy, like narrowband UVB

Scabies treatment 

Unlike eczema, scabies can be cured with the right treatment. Standard treatment involves combining both topical treatments (creams) and pills to kill all the mites and keep them from multiplying:  

• Permethrin is the most common cream for scabies. You must apply the cream to your entire body and leave it on the skin for 8 to 10 hours before rinsing it off. For the best results, sometimes you need two treatments, 1 week apart. 

• Ivermectin is a pill that’s used off-label to kill the scabies mite. People usually take 2 doses 1 week apart. 

In addition to medications, here are some additional tips to make sure the scabies infection is completely treated and doesn’t come back: 

• Treat any close contacts (like people who live in the same house or sexual partners).

• Separate any clothing or sheets you came into contact with in an airtight container for 4 days (scabies can survive for up to 3 days on these). Another option is to wash fabrics in hot water and dry them in high heat. 

• It’s common to itch for up to 6 weeks after treatment (this is because residue from mites can linger on the skin). Skin moisturizers and antihistamines can help with the itch. 

• If you’re still itchy and developing new rashes, you could still have scabies. Your healthcare team can check your skin and see if you need more treatment. 

What happens if you don’t treat scabies?

You shouldn’t ignore scabies or leave it untreated. The mite infestation will only continue to worsen, which can lead to serious complications, like infection. It can also spread to other people you come into contact with.

Pictures of other rashes that can be mistaken for scabies

Scabies can look like other common skin rashes. Here are some pictures of other conditions that can be mistaken for scabies.

Contact dermatitis

Contact dermatitis is caused by an allergic reaction or an irritation to something that comes into contact with the skin. A common example is nickel. The rash is itchy, and it’s usually red, violet, or brown. Patches can look scaly or crusty. One key feature: It only develops on skin that comes into contact with the product.

Contact dermatitis can develop from exposure to nickel in a buckle.

Allergic contact dermatitis can happen on the eyelids.

Heat rash

Heat rash is also called miliaria or prickly heat. It happens when sweat glands are blocked. It’s most likely to develop in covered skin, when it’s hot and humid. Like with contact dermatitis, the rash only develops in specific areas of skin. In this case, areas of skin that are covered up. The rash causes pink, red, brown, or violet skin bumps. Sometimes, these can be fluid-filled with clear liquid, or less commonly, pus.

In darker skin tones, miliaria, or heat rash, causes many tiny light brown skin bumps.

In fair skin, heat rash causes pink-red bumps and patches.

Bug bites

Bug bites (like from mosquitoes or bedbugs) are itchy and can cause small red, violet, or brown skin bumps. Sometimes they can appear in clusters, too. And, they can also become crusty  with scratching. Unlike scabies, bug bites go away within a week without any treatment.

In darker skin tones, bug bites cause individual purple-brown skin bumps.

In light skin, bug bites cause many small pink bumps.

Hives

Hives can develop as a reaction to an allergy, an infection, medication, or certain foods. They cause smooth, raised skin patches that feel warm and itchy. They’re typically red in fair skin and skin-colored or violet in darker skin tones.

Hives cause red, raised patches in fair skin.

Hives in darker skin tones may not be as obvious.

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Written by:

Alina Goldenberg, MD, MAS, FAAD

Alina Goldenberg, MD, MAS, FAAD, is a board-certified dermatologist in private practice. She is also an assistant clinical professor in the Department of Internal Medicine at the University of California, Riverside School of Medicine.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. A pulmonologist and hospitalist, she practiced and taught clinical medicine at hospitals in London for a decade before entering a career in health education and technology.

Reviewed by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

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Images used with permission from VisualDx (www.visualdx.com).