Crusted Scabies vs Scabies: Know the Differences

Crusted Scabies vs Scabies

Difference between Crusted Scabies and Scabies: Scabies, a typical skin mite infestation by Sarcoptes Scabiei, is characterised by intense itching and redness. Alternatively, Crusted Scabies also known as Norwegian scabies is the severe form of scabies with thick crusted lesions which harbour high numbers of mites and eggs. Crusted Scabies usually do not exhibit the characteristic pruritus associated with scabies and tend to occur in individuals that are immune-compromised. For successful elimination of infestation, aggressive methods such as oral drugs are often used along with topical treatments for treating Crusted Scabies.

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Difference between Crusted Scabies and Scabies

Scabies causes itching and a rash while in contrast, Crusted Scabies (Norwegian) have thick crusts which contain numerous mites and eggs’ this fact is common in people whose immune systems are compromised. The table below provides the differences between Crusted Scabies and Scabies.



Crusted Scabies

Causative Agent

Sarcoptes scabiei mite

Sarcoptes scabiei mite


Mild to moderate itching and rash

Severe infestation with thick, scaly crusts on skin


Small, red, itchy bumps

Thick, grey, crusted lesions on skin


Direct skin-to-skin contact

Prolonged, close contact is often necessary, but can also spread indirectly through contaminated items

Common Sites

Between fingers, wrists, elbows, and genitals

Scalp, hands, and soles of feet are common, but can occur on any part of the body

Contagious Period

Contagious throughout infestation

Highly contagious, especially due to the extensive mite burden in crusts


Topical scabicidal creams or oral medications

Requires more aggressive treatment, often involving hospitalisation and oral medications

Risk Groups

All age groups

Commonly seen in individuals with compromised immune systems or neurological disorders


Secondary bacterial infections due to scratching

Secondary bacterial infections are more common, and there is a higher risk of complications due to the extensive infestation


Clinical examination and sometimes microscopic examination of skin scrapings

Clinical examination, often supported by skin scrapings, biopsy, or imaging in severe cases

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What are Crusted Scabies?

Crusted Scabies, sometimes referred to as Norwegian Scabies, are a severe and extremely contagious form of Scabies in which a widespread infestation of the Sarcoptes Scabies mite causes the skin to thicken and crust. Immunocompromised people frequently experience it, and severe therapy is necessary to get rid of the infestation.

Causes of Crusted Scabies

  • Infestation: It begins with a Sarcoptes scabiei mite infestation, which is often spread by prolonged skin-to-skin contact with an infected individual.
  • Weakened Immune System: People who are immunocompromised, such as those who have HIV/AIDS, some cancers, or recently received an organ transplant, are more likely to get Crusted Scabies.
  • Underlying Diseases: Individuals who are bedridden or have certain neurological diseases, such as Parkinson's disease, may also be at a higher risk of getting Crusted Scabies.
  • Bad Personal Hygiene: Although Scabies can strike anyone, clean or dirty, living in close quarters and having inadequate personal hygiene might help the disease spread.
  • Age: Older people and those with impairments who might have trouble properly washing or scraping themselves are more likely to get Crusted Scabies.

Symptoms of Crusted Scabies 

  • Thick and Crusty Skin: The most characteristic sign is the skin's presence of thick, crusted lesions. These crusts can cover substantial portions of the body and have a greyish-white or yellowish appearance.
  • Severe Itching: Although itching is a frequent symptom of Scabies, in cases of Crusted Scabies, nerve damage from the significant infestation may make it less severe.
  • Skin Lesions and Scales: Affected skin areas may show scaling, peeling, and a variety of lesions, such as papules, nodules, and plaques, in addition to the thick crusts.
  • Skin Discoloration: Cramped Scabies can cause the skin to become discoloured, with red, brown, or greyish tones possible.
  • Foul Odour: Bacterial proliferation within the crusts of Scabies lesions can cause them to release a potent, disagreeable odour.

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What are Scabies?

Scabies is a contagious skin infestation caused by the mite Sarcoptes scabiei. These minuscule mites burrow into the epidermis, where they multiply and lay eggs. Scabies are typified by a rash that resembles pimples and severe itching, particularly at night. Typically, it affects the buttocks, genitalia, armpits, hands, wrists, and elbows. The body's allergic response to the mites, their eggs, and their excrement causes itching and rash.

Causes of Scabies

  • Direct Skin-to-Skin Contact: Holding hands, giving hugs, or engaging in sexual activity with an infected individual is the most typical method that Scabies spread.
  • Household or Close Contact: Prolonged contact with clothing, towels, or bedding that has been infected can potentially spread Scabies. Transmission of the mites may occur if these objects are shared with an affected individual.
  • Densely Populated Areas: Scabies can spread quickly in places where people live in close quarters, including child care centres, nursing homes, or jails.
  • Sexual Interaction: Sexual contact with an infected person, especially in the vaginal area, can spread Scabies.

Symptoms of Scabies

  • Intense Itching: This is often the first symptom of Scabies and is usually more severe at night. The body's allergic response to the mites, their eggs, and their excrement is what causes the itching.
  • Skin Rash: Usually manifesting as tiny, raised lumps or blisters, a rash is a frequent symptom of Scabies. Though it can appear anywhere on the body, the mites' burrows are usually where the rash is located.
  • Burrows: On the skin, there may occasionally be thin, asymmetrical burrow tracks that resemble threads. The female mites dig these burrows when they burrow into the skin to deposit their eggs. They could show up as microscopic, elevated, skin-coloured, or greyish-white lines.
  • Secondary Infections: Breaks in the skin caused by scratching due to itching raise the possibility of bacterial infections. Additional symptoms including redness, swelling, and warmth around the affected area can be brought on by these secondary infections.
  • Itching All Over the Body: Scabies usually begin in one place on the body, but if treatment is not received, it may eventually spread to other areas. As the infestation spreads, the rash and itching could get worse.

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Similarities between Crusted Scabies and Scabies

  • Cause: Both Crusted Scabies and typical Scabies are caused by infestation with the Sarcoptes Scabies mite. The mites cause skin irritation and itching by burrowing into the skin, laying eggs, and causing an allergic reaction.
  • Transmission: Direct personal contact with an infected person is usually the means of spreading both types of Scabies. Prolonged skin-to-skin contact, sharing clothes or bedding, and sexual intercourse are a few examples of this.
  • Symptoms: Both normal and Crusted Scabies appear with extreme itching, especially at night, and a distinctive rash, though the intensity of symptoms varies. The rash may be accompanied by burrowing and manifest as tiny, elevated lumps, blisters, or lesions resembling pimples.

In conclusion, although the same mite causes both Scabies and Crusted Scabies, Crusted Scabies is a far more severe form of the infestation, as seen by thick skin crusts packed with numerous mites and eggs.

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What are Scabies?

The mite Sarcoptes scabiei is the source of the contagious skin infection known as Scabies. It usually manifests as a rash and severe itching in the regions where the mites have burrowed into the skin.

What are Crusted Scabies?

Crusted Scabies, sometimes referred to as Norwegian Scabies, is a severe case of Scabies in which there is an extensive mite invasion under the skin. Thick skin crusts containing thousands to millions of mites and their eggs are its defining feature.

How are Scabies transmitted?

Scabies are usually spread through prolonged, skin-to-skin contact with an infected person. It can also be transmitted through infested bedding, clothing, or furniture, although this is less common.

What are the symptoms of Scabies?

Common symptoms of Scabies include intense itching, especially at night, and a pimple-like rash.

How does Crusted Scabies differ from regular Scabies?

A more severe form of Scabies known as Crusted Scabies is defined by thick skin crusts that are packed with mites and eggs. It frequently affects those with compromised immune systems, and because the infection damages nerves, there may not be much itching at first.

Who is at risk of developing Crusted Scabies?

Crusted Scabies are more common in persons with compromised immune systems, such as the elderly, those living with HIV/AIDS, and those suffering from specific neurological disorders.