Scabies (kudis buta): symptoms, how it spreads, treatment and stopping it coming back

What is scabies (kudis buta)?

Scabies is a skin infestation by the mite Sarcoptes scabiei, which is too small to see with the naked eye. Female mites burrow into the top layer of skin to lay eggs. The intense itch is an allergic reaction to the mites, their eggs and their waste.

Scabies is common worldwide, with at least 200 million people affected at any time. In Malaysia, outbreaks are most often seen where people live closely together, such as large households, hostels, welfare homes and detention centres. In early 2026, for example, the Kelantan Health Department reported 279 cases among Orang Asli communities in Gua Musang since the start of 2025.

It is linked to crowding and close contact, not to being dirty. Anyone can get it.

How scabies spreads

• Prolonged skin-to-skin contact is the main route: sharing a bed, cuddling and caring for children, and sexual contact. A quick handshake or hug is unlikely to pass it on.
• Bedding, towels and clothes are a less common route, because mites survive only 2 to 3 days off the skin. They matter more with crusted scabies (see below).
• If it is your first time, symptoms take 2 to 6 weeks to appear, but you can pass it on during that time. If you have had scabies before, itching starts within 1 to 5 days.

Pets don’t spread human scabies. Animal mange is caused by a different mite, which may cause a brief itch in people but doesn’t settle in human skin.

Symptoms of scabies

• Intense itching, worst at night, and often several people in the home itching at once
• Burrows: short, thin, wavy grey or silvery lines
• a rash of small red bumps or blisters, and scratch marks

Where it appears in adults and older children: between the fingers, the wrists, elbows, armpit folds, around the nipples, the waist and belly button, the buttocks, and the penis and scrotum. The head and neck are usually spared.

In babies and young children, scabies can also affect the face, scalp, neck, palms and soles, and may cause small blisters. Itchy lumps (nodules) can last for weeks or months after treatment.

Crusted (Norwegian) scabies is a severe form with thick, crusted skin and huge numbers of mites. It is very contagious. It mainly affects older people, people with a weak immune system, and people with conditions that limit sensation or movement. It may itch surprisingly little, and needs a doctor’s care.

Complications

Scratching breaks the skin and lets bacteria in, causing impetigo (crusted sores), boils, cellulitis and, rarely, blood infection. Some of these bacteria can damage the kidneys. See a doctor if sores are spreading, weeping yellow fluid or very painful, or if you have a fever. You may need antibiotics as well as scabies treatment.

Scabies treatment (ubat kudis buta)

Under the Ministry of Health’s scabies guideline, the first choice for most people is permethrin 5% cream. Other options include benzyl benzoate lotion, sulphur ointment for young babies, and oral ivermectin tablets for some cases. A doctor will choose the right one, especially for babies, pregnant women and crusted scabies.

How to apply permethrin cream properly:

1. Apply it at bedtime to cool, dry skin, not straight after a hot bath.
2. Cover the whole body from the jawline down, not just the itchy areas: between the fingers and toes, under the nails, the armpits, the genitals, the buttocks and the soles of the feet. Ask someone to help with your back. For babies and young children, the doctor may also advise treating the face and scalp, avoiding the eyes and mouth.
3. Leave it on for 8 to 12 hours, usually overnight, then wash it off.
4. If you wash your hands during that time, apply more to your hands.
5. Repeat after 1 week to kill any mites that hatched from eggs.

Ask a pharmacist or doctor how much cream you need for everyone at home. Antihistamine tablets and a soothing moisturiser can help with the itch.

Home remedies (petua) such as soaking in salt water may soothe the skin for a while, but they don’t kill the mites. Scabies needs a scabies treatment.

Treat everyone at the same time

This is the most common reason scabies keeps coming back. Everyone in your household, your sexual partners and anyone else who has had prolonged skin contact with you in the past 2 months should be treated on the same day, even if they have no rash or itch. Remember, symptoms can take up to 6 weeks to appear.

In hostels, schools and care homes, the District Health Office can help organise treatment for everyone at once.

Cleaning bedding, clothes and the home

On the day you start treatment:

• Wash bedding, towels and clothes used in the past 3 days in hot water (above 50°C), and dry them in a hot dryer or in the sun.
• Items you can’t wash, such as soft toys or shoes, can be sealed in a plastic bag for at least 3 days, after which the mites die.
• Vacuum mattresses, sofas and carpets.

You don’t need to fumigate or spray insecticide around the home.

After treatment: the itch, and when to go back

• Itching often continues for 1 to 2 weeks, sometimes up to 4 weeks, after successful treatment, as the skin reacts to dead mites. This doesn’t mean you need more cream. Using it too often can irritate the skin.
• See your doctor again if new burrows or bumps appear, or the itch is no better after 2 to 4 weeks. The usual reasons treatment fails are missing parts of the body, not repeating after a week, or someone at home not being treated.
• School and work: children and adults can usually go back 24 hours after the first treatment.

For other causes of itchy skin, such as eczema, hives and fungal rashes, see our guide to itchy skin.

Where to get scabies treated

A GP can confirm scabies, prescribe enough treatment for the whole household, and treat any infected sores. Our directory lists GP clinics across Kuala Lumpur, Selangor and other states, including clinics open in the evening, when the itch is often worst.

Browse the clinic directory

Frequently asked questions