If you have psoriasis, it’s easy to assume every itchy, flaky patch is another psoriasis flare-up. But scabies — an infestation caused by microscopic mites — can sometimes look similar. If you have both at once, sorting out what’s causing your symptoms can be even harder.

“Has anyone ever been misdiagnosed with scabies versus psoriasis?” asked a member of MyPsoriasisTeam. “I know it’s psoriasis because I have had many confirmations. So now I am being treated for both.”

Knowing which skin conditions can mimic psoriasis can help you ask your doctor the right questions and discuss whether you need testing. Here’s how psoriasis and scabies differ.

🗳️ Have you been diagnosed with scabies while living with psoriasis?

Yes, I’ve been diagnosed with it.

No, I was assessed but don’t have it.

No, and I haven’t been assessed for it.

Not sure/doesn’t apply

Thanks! You've successfully submitted your vote.

Sign up to view the results!

Continue with Facebook

Continue with Google

Continue with Email

By joining, you accept our Terms of Use, and acknowledge our collection, sharing, and use of your data in accordance with our Health Data and Privacy policies.

Already a member? Log In

Psoriasis vs. Scabies: Symptoms

Symptoms of psoriasis and scabies can vary. Here, we’ll discuss the differences between these two conditions.

Itchy Skin

Both psoriasis and scabies can lead to itchy skin lesions. However, some people with psoriasis don’t experience itching, whereas scabies often causes intense itching, especially at night.

Appearance

Scabies and psoriasis usually look different. Psoriasis usually appears as well-defined, discolored patches or plaques with scales on top. On darker skin, plaques may look purple, brown, or gray, while on lighter skin, they may look pink or red with silvery-white scales.

Scabies usually causes very itchy small bumps. Some people also develop thin, wavy lines called burrows, which form where mites tunnel into the skin. These burrows can be hard to see, and the scabies rash doesn’t always appear in a straight line.

Rupioid Psoriasis and Crusted Scabies

Even with these differences, psoriasis and scabies can sometimes be confused with each other. This may be especially true when comparing rupioid psoriasis and crusted scabies.

Rupioid psoriasis is a rare form of psoriasis. It causes thick, crusted, cone-shaped plaques that contain keratin, a protein found in the skin.

Crusted scabies, also called Norwegian scabies, is a severe form that causes thick, crusted patches on the skin. These patches can sometimes look similar to rupioid psoriasis.

Research on rupioid psoriasis is limited because the condition is rare. However, one case report, which describes a single person’s medical case, reported crusted scabies that had been mistaken for psoriasis.

Other Differences Between Psoriasis and Scabies

Several differences between these two skin conditions can help healthcare providers tell them apart. See a dermatologist or another healthcare provider for a proper diagnosis and treatment plan.

Psoriasis Involves the Immune System, and Scabies Is Caused by a Mite

Researchers don’t know the exact cause of psoriasis, but it’s considered an immune-mediated disease in which an overactive immune system causes skin cells to grow faster than usual. Genetics, along with certain environmental factors, play a role in who develops psoriasis. Factors that may trigger or worsen psoriasis include:

• Some infections
• Alcohol use
• Smoking
• Exposure to certain types of weather
• Certain medications

Importantly, psoriasis is not contagious, meaning it can’t be spread from person to person.

Scabies, on the other hand, is caused by a tiny mite called Sarcoptes scabiei, also known as the human itch mite. A mite can burrow into the skin and lay eggs, leading to an itchy rash.

Scabies usually spreads through prolonged skin-to-skin contact with someone who has it. Less often, scabies can spread through clothing, towels, or bedding used by someone who has it. This type of spread is more likely with crusted scabies, which can involve a much larger number of mites.

Different Factors Raise the Risks of Psoriasis and Scabies

Some people are more likely to develop psoriasis. The condition has a genetic component, so having one or both parents with psoriasis increases your risk. Smoking is also linked to a higher risk of psoriasis.

The risk factors for scabies are different. Anyone can get scabies, but people who have frequent or prolonged skin-to-skin contact with others may have a higher risk. Scabies can spread more easily in crowded settings where close contact is common, including childcare centers and nursing homes.

People with weakened immune systems may be at higher risk of developing crusted scabies. Some medications for psoriasis affect the immune system and can increase the risk of certain infections. However, there isn’t enough research to know whether psoriasis medications specifically raise the risk of getting scabies.

Psoriasis and Scabies Require Different Treatments

Psoriasis and scabies require different treatments because they have different causes. Your healthcare provider can recommend treatment based on your diagnosis, symptoms, and other health factors.

Treating Psoriasis

There’s no cure for psoriasis, but several treatments can help manage symptoms and reduce inflammation. Treatment depends on factors such as the type and severity of psoriasis. Options may include:

• Topical treatments, including corticosteroids and vitamin D analogs
• Anti-inflammatory medications
• Moisturizers
• Phototherapy (treatment with ultraviolet light)
• Oral or injected medications that suppress the immune system
• Retinoids
• Biologic medications that target specific parts of the immune system

Treating Scabies and Preventing Reinfestation

Treating scabies involves medication that kills the mites. Your healthcare provider might prescribe one of several topical treatments, such as permethrin cream. The right treatment depends on the severity of the scabies infestation and factors such as your age and overall health.

For many topical treatments, you apply the medication to the skin and wash it off after the recommended amount of time. You may need to repeat the treatment.

Your healthcare provider may also prescribe oral ivermectin in some cases. The U.S. Food and Drug Administration (FDA) hasn’t approved ivermectin specifically for scabies, so using it is considered off-label.

Family members and others who have had close contact with someone diagnosed with scabies may need treatment, even if they don’t have symptoms. Treating close contacts at the same time can help prevent scabies from spreading or coming back.

To help prevent the spread or return of scabies, wash clothing, bedding, and towels used during the three days before treatment in hot water and dry them on a hot setting. Items that can’t be washed can be sealed in a plastic bag for several days.

Visit a Healthcare Provider for a Diagnosis

If you have a new, persistent, or very itchy skin rash, talk with your healthcare provider. If the cause isn’t clear, they may recommend additional testing.

Psoriasis can usually be diagnosed by examining your skin, scalp, and nails. Sometimes, a healthcare provider may take a small skin sample, called a biopsy, to examine under a microscope.

Scabies is also often diagnosed by examining the skin and symptoms. If testing is needed, a healthcare provider may scrape a small amount of skin and examine it under a microscope for scabies mites or eggs.