Scabies burrows on the hands are tiny, narrow, wavy lines just under the skin’s surface, often found between the fingers, along the sides of fingers, or around the wrists and nails. They may look grayish, pale, or close to your natural skin color and can be hard to spot. Itching, often worse at night, may occur too, but a healthcare professional can assess the cause.
What do scabies burrows on the hands look like?
Scabies burrows are small tunnels made by the female scabies mite just beneath the outer layer of the skin. They often look like thin, crooked or wavy lines that may be slightly raised. Their color can range from grayish-white to a shade similar to the surrounding skin, so they may be difficult to notice.
A burrow may extend only a few millimeters or reach approximately 1 centimeter in length. Sometimes, a tiny bump or blister appears near one end. Other nearby skin changes can include small red or skin-colored bumps, scratch marks, and irritated patches. According to the Centers for Disease Control and Prevention (CDC), scabies mites create tiny burrows just beneath the skin, but these marks can be difficult to find.
Where do scabies burrows usually appear on the hands?
The hands are a common location for scabies because the mites often affect areas where the skin is thin or folded. The marks may be scattered rather than forming one obvious tunnel. They may also be difficult to recognize when inflammation or scratching changes the appearance of the skin.
- Between the fingers: The webbed skin between adjacent fingers is a common location for scabies burrows and an itchy rash.
- Along the sides of the fingers: Fine lines, small bumps, or irritated patches may develop along the sides of individual fingers.
- Around the fingernails: The skin near the nails can be affected, sometimes making the changes difficult to distinguish from irritation or damage caused by scratching.
- On the wrists: Small burrows or itchy bumps may appear around the wrist creases, sometimes extending beyond the hands.
- On the palms: The palms can be involved, particularly in infants and young children, whose skin changes may differ from those seen in adults.
The American Academy of Dermatology (AAD) identifies the spaces between the fingers and the areas around the nails as common places for scabies mites to burrow. However, the location of a mark alone cannot establish its cause.
What other symptoms may occur with hand burrows?
Scabies often causes itching because the body's immune system reacts to the mites and their eggs and waste. Itching may become more noticeable at night and can interfere with sleep. Some people develop a rash with small bumps, while others have burrows that are difficult to see or skin changes that resemble eczema.
- Persistent itching affecting the fingers, hands, or other areas of the body.
- Small, itchy bumps around the finger webs or wrist creases.
- Redness, irritation, or scratch marks where the skin has been rubbed or scratched.
- Small sores or scabs caused by repeated scratching.
- Similar itching or a new rash in people who have close physical contact, such as household members.
These are possible features rather than a checklist for identifying scabies. According to the Mayo Clinic, other skin conditions, including dermatitis and eczema, can also cause itching and small bumps. A healthcare professional considers the appearance of the skin alongside the person's history and other symptoms.
Why might scabies burrows be hard to see?
Not everyone with scabies has easily visible tunnels. The mites are microscopic, and a typical infestation may involve relatively few mites. Their burrows can be faint, especially when they are close to the natural skin color. Scratching and the resulting inflammation can also obscure the original lines, leaving bumps or irritated areas that are more noticeable than the burrows themselves.
Symptoms may not begin immediately after exposure. During a first infestation, itching and other skin changes can take several weeks to develop. A person can transmit scabies before noticeable symptoms appear. Therefore, the absence of visible burrows or itching does not necessarily exclude an infestation when there has been a relevant exposure.
What else can look like scabies burrows?
Several skin conditions can produce lines, bumps, or irritated areas on the hands. Their appearance may overlap with scabies, especially when the skin is dry, inflamed, or frequently washed.
- Hand eczema: Can cause itching, redness, dryness, scaling, and small blisters. These changes do not necessarily form true tunnels beneath the skin.
- Contact dermatitis: An inflammatory reaction to an irritating substance or an allergen can produce an itchy rash, particularly on areas exposed to the substance.
- Scratch marks or minor skin injuries: Small cuts and superficial lines can resemble burrows, particularly when the skin is irritated.
- Other itchy skin conditions: Insect bites and other causes of skin inflammation can produce clusters of bumps that resemble a scabies rash.
The distinction is not always obvious from appearance alone. A line that looks like a burrow is not proof of scabies, and a lack of obvious tunnels does not rule it out. Persistent or spreading symptoms warrant an examination rather than repeated attempts to identify the cause by comparing skin photographs.
How do healthcare professionals check for scabies burrows?
A healthcare professional usually examines the skin, paying attention to the finger webs, sides of the fingers, nail areas, wrists, and other commonly affected locations. They may ask when the itching started, whether it worsens at night, whether anyone in the household has similar symptoms, and whether there has been close contact with someone who has scabies.
When necessary, a clinician may use a magnifying device called a dermatoscope or collect a small skin scraping from a suspicious area for examination under a microscope. Finding a mite, its eggs, or its waste can confirm the infestation. However, a scraping does not always reveal the mite, so a negative result does not automatically exclude scabies. The Merck Manual Professional Edition describes skin examination and microscopic examination of burrow scrapings as methods used in diagnosis.
What should you do if scabies burrows are suspected?
Arrange an assessment with a healthcare professional when you notice persistent itching with possible burrows, especially if symptoms are spreading or close contacts have developed similar skin changes. Seek prompt care if scratching has led to increasing pain, pus, spreading redness, warmth, or other signs of a possible skin infection.
If scabies is diagnosed, treatment usually involves a prescribed medicine that kills the mites. The correct product and instructions depend on factors such as age and individual circumstances. Follow the treatment directions carefully, including how to cover the hands, finger webs, and areas around the nails. Treatment should not be limited to the visible lines because mites can be present in other areas of the skin.
Close contacts may need treatment at the same time, even if they have no symptoms. The CDC's scabies guidance also recommends washing recently used clothing, towels, and bedding with hot water and drying them on a hot cycle, or using appropriate alternatives for items that cannot be washed. These measures help reduce the chance of reinfestation.
Itching can continue for a few weeks after successful treatment because the skin may remain irritated. However, new burrows, persistent or worsening symptoms, or new symptoms in close contacts should be discussed with a healthcare professional. These changes may indicate that further assessment or additional treatment is needed.