Scabies is a contagious skin infestation caused by the microscopic mite Sarcoptes scabiei var. hominis. The answer to whether you can get scabies in your vagina is yes, indirectly, as the infestation heavily targets the skin of the entire genital area. Scabies is easily spread through prolonged, direct skin-to-skin contact, making it a common concern in intimate settings.
What Scabies Is and How It Affects the Genital Area
Scabies is caused by the female mite, which burrows into the stratum corneum, the outermost layer of the skin, where it lives and deposits eggs. The rash and intense itching are the body’s allergic reaction to the mites, their eggs, and their waste products. The genital area is a common site for this infestation because the mites prefer warm, moist skin folds.
The mite does not typically burrow into the mucous membranes lining the internal vaginal canal. Instead, it targets the surrounding skin of the vulva, the inner thighs, the groin, and the perianal area. Infestation of the external genitalia is classified as genital scabies and is transmissible through sexual contact.
Identifying the Signs of Scabies
The most characteristic symptom of scabies is intense itching, which often becomes worse at night or after a warm shower. This nocturnal intensification is a strong indicator of an active infestation. In the genital region, the infestation can manifest as small, raised, red or brown bumps, sometimes resembling pimples or hives.
A variant called nodular scabies often presents as hard, persistent, reddish-brown lumps specifically in the groin, armpits, and on the vulva or penis. Though difficult to spot, the mites create tiny, grayish-white, S-shaped lines or tracks where they have burrowed just beneath the skin surface. These symptoms can easily be mistaken for other conditions, such as eczema or other sexually transmitted infections, making a medical diagnosis necessary. Scratching the affected areas can lead to skin breakdown, which increases the risk of developing secondary bacterial skin infections.
Medical Treatment for Scabies
Effective treatment requires a prescription from a healthcare provider to ensure the complete elimination of the mites and their eggs. The standard first-line treatment is topical permethrin 5% cream, which kills both the mites and their eggs. The cream must be applied to the entire body from the neck down, left on for 8 to 14 hours, and then washed off.
A second application is required seven days after the first to eliminate any mites that hatched from eggs that survived the initial treatment. For cases where topical treatment fails, or for more severe infestations like crusted scabies, oral ivermectin may be prescribed. Ivermectin is typically taken in two doses, separated by one to two weeks, and is often recommended to be taken with food to increase its effectiveness.
The intense itching may continue for two to four weeks even after all the mites have been killed. This lingering symptom, known as post-scabietic pruritus, is due to the persistent allergic reaction to dead mite remains in the skin. Antihistamines or topical corticosteroids may be used to manage this discomfort while the skin heals. Simultaneously treating all household members and close physical contacts, including sexual partners, is required to prevent reinfestation.
Stopping Transmission and Preventing Return
Scabies is predominantly transmitted through prolonged skin-to-skin contact, which includes sexual intimacy. For classic scabies, a contact time of at least ten minutes is often necessary for transmission. To prevent the spread and recurrence of the infestation, environmental cleaning must be performed at the same time as the medical treatment. All clothing, bedding, and towels used by the infested person and close contacts within the 72 hours before treatment should be machine-washed.
Environmental Cleaning
- Wash items in hot water, at a temperature exceeding 50°C (122°F).
- Dry items on high heat for at least 10 minutes to kill the mites and their eggs.
- Seal items that cannot be washed (such as stuffed toys or delicate fabrics) in a plastic bag for a minimum of 72 hours, as the mites cannot survive long without human contact.
Avoiding close physical contact with others until after the second treatment application is completed helps ensure the transmission cycle is broken.