These parasites will make your skin crawl

Published on Sunday, June 1, 2025

By: Gary Pettus, gpettus@umc.edu

If you were asked to complete the phrase “___ and ticks,” your choice would probably be “fleas.”

But this gives short shrift to scabies, an infestation which, regarding human suffering, pairs nicely with the tick.

Unlike the six-legged flea – an insect – adult ticks and scabies mites are eight-legged menaces that live on or in your skin, have similar life cycles, cause extreme itching and skin irritation, can bring on secondary infections, may cause rashes, can be spread through close contact, and, without quick and proper action, are difficult to conquer.

But they must be conquered, and for that, it’s useful to know their differences as well.

“Ticks are much more active in the summer months,” said Leslie Partridge, a dermatology-certified nurse practitioner at the University of Mississippi Medical Center.

Scabies, a contagious skin disease caused by the mite Sarcoptes scabiei var. hominis, is especially devastating in tropical regions, but the pestilence is growing worldwide, as stated during The World Congress of Pediatric Dermatology 2025 Annual Meeting in April.

Similarly, the number of illnesses carried by ticks, as reported to the Centers for Disease Control and Prevention, has more than doubled over the past two decades, The New York Times reported in May.

As for size, ticks are small – some smaller than others – but are relatively easy to spot. A single scabies mite, by contrast, is elusive to the naked human eye.

“Sarcoptes scabiei are microscopic,” said Amanda Brown, a family nurse practitioner in the UMMC Department of Dermatology. “The mite burrows into the upper layer of the skin causing a sensitivity reaction with intense itching, particularly at night. It could be the worst itch of your life.

“The rash can vary depending on the severity and length. Papules, or bumps, and sometimes burrows can be seen. The first infestation can take four to six weeks for sensitization, so carriers can be asymptomatic, initially.”

Scabies mites typically spare the scalp and face, unlike the Demodex mite, Brown said. 

Like ticks, scabies aren’t picky eaters. “Scabies can affect any human, regardless of age, race, gender or socioeconomic status,” Brown said. “Infestations are more likely to occur in shared or crowded living spaces such as long-term care facilities or shelters.” 

As for favorite dining spots, a scabies mite can be found in some of the tick’s regular haunts – including the waistline and genital area. It also burrows in the folds between your fingers and toes; the folds of the armpits or between the thighs; the bend of your wrists and knees; and under fingernails.

To prevent a scabies infestation, avoid direct, skin-to-skin contact with known infected individuals, Brown said.

“Wash linens and clothing in hot water and dry using a high-heat cycle for 60 minutes. For items that cannot be washed and dried, seal them in a plastic bag and store for two weeks. Vacuum the carpet, cushions and other fabric surfaces.

“When traveling, place luggage on a hard surface – avoid placing your personal items on beds, linens or carpet.”

Ticks are a mite easier to handle, often.

When outdoors, tick prevention requires the use of insect repellant with a 20-30% concentration of DEET, Partridge said. “You should wear long pants tucked into socks and long sleeves when walking through heavily-wooded and brushy areas with tall grass.

“Your clothing should be light-colored so that ticks can be spotted easily. After spending time in brushy areas, perform a full-body tick check – especially the armpits, behind the knees, the groin and along the waistline.

“You should also check your children and pets.” 

If you find a tick on your body, remove it with tweezers, Partridge said. “Gently grasp the tick as close to the skin as possible and pull upward with steady, even pressure; avoid twisting.

“Wash your hands and clean the site. Don’t try the old trick of applying Vaseline to smother the tick and especially don’t try to burn off the tick. This can cause burns to your skin, and the tick may not even detach.”

Heat can upset the tick, causing it to eject saliva and gut contents, raising the likelihood of disease transmission.

“I’ve had several patients present to the clinic for a ‘rapidly changing mole,’ but on exam it was found to be an engorged tick,” Partridge said.

“Each time, we were able to remove the ticks effectively, and none of the patients went on to develop symptoms that would warrant further treatment.

“It’s always a bit of a mixed reaction, though: a sigh of relief that they do not have a skin cancer, but surprise that they had a tick attached to their skin.”  

The Mississippi State Department of Health has a Mississippi tick surveillance program. You may send a photo or photos to MSDH for identification of a tick found in the state. Remove the tick first if it’s attached, take at least one photo of it and email photos along with details of where it was found and when.

For scabies, identification can be made by a health care provider, who can often diagnose the problem just by looking at it. The provider may also apply mineral oil to the rash and scrape away a small skin sample to be examined under a microscope.

Tick bites, too, can be painful and itchy but in many cases can go unnoticed, Partridge said.

“Redness and itching can occur at the attached site. Once the tick is full, it falls off the skin. Depending on the type of tick, this can occur rapidly – ‘feed and leave’ – or it can stay attached for several days.

“Infections caused by tick bites are rare.” But if a rash, headache, fever, or flu-like symptoms occur after a tick bite, see your health care provider.

Rocky Mountain Spotted Fever is a serious tick-borne illness seen in Mississippi, mostly in the summer, Partridge said. “The first symptoms of fever and headache usually begin within several days after the bite. Soon after, pink/red spots appear on the wrists and ankles, quickly spreading.”

Anyone with those symptoms, or who feels unwell after a tick bite or a suspected one, should see a health care provider as soon as possible or go to the Emergency Department, Partridge said.

“The tick needs to be attached to the skin for over 24 hours to transmit most diseases. So, it’s important to check your skin often after being outdoors.”

The scabies mite is even more tenacious than the tick. “It’s likely that the severe itching will prompt medical attention, but secondary infection from excessive scratching is possible,” Brown said.

“Scabies bites differ from insect bites, such as those from a mosquito. Insect bites will eventually calm down and resolve without treatment. The only way to get rid of scabies is with prescription treatment.

“The most common treatment for scabies is topical Permethrin 5% cream or oral Ivermectin. It is critical that two doses are administered a week apart.”

For an appointment with a dermatology provider, call 601-815-3374 or go online here.