Scabies Ink Test

A clinician gently rubs a washable, water-based marker over skin where scabies is suspected, then wipes it off with an alcohol swab. If a burrow is present, a thin wavy/dark line remains where the ink has settled in the tiny tunnel. The ink test helps locate burrows; diagnosis is made by a clinician and may be confirmed with a skin scraping test.

The Scabies Ink Test is used to help visualise scabies burrows under the skin. It doesn't have a window period in the same way as tests for infections like HIV or chlamydia. The test is performed when scabies is suspected, and the results are immediate. A Specialist Healthcare Professional can best advise you on whether this test is appropriate for your specific situation.

No. The ink test shows what is visible at the time of examination. Early infection, scratched/eczema-covered skin, or very few burrows can make the test negative even if scabies is present. (With a first infection, symptoms can take 2–6 weeks to appear.)

Scabies mites (Sarcoptes scabiei var. hominis) create tiny tunnels in the top skin layer (stratum corneum). Water-based ink briefly fills these tunnels and is retained when the surface ink is wiped away, outlining the burrow.

A positive (a clear ink-outlined burrow) is helpful and makes scabies more likely, but the test can miss cases—so a negative result does not rule out scabies. Clinicians often add skin scraping for microscopy, which confirms the diagnosis by finding a mite, egg or fecal pellet.

If you have an itch (often worse at night) with a new rash—especially in the finger webs, wrists, waistline, buttocks, breasts or genitals (and in children, also the scalp, palms, and soles)—book a clinical assessment. Your clinician will decide whether the ink test or another method is best.

Yes. A skin examination is usually required to assess the rash properly and decide on testing and treatment.

Yes. Clinicians may use skin scraping for microscopy (confirmation). In some specialist settings, PCR test may be used.

In the clinic, the result is immediate and explained face-to-face.

The ink test is a visual aid, not a lab test. We record one of the following:

• Burrow visualised with ink → scabies more likely; we may confirm with a skin scraping test.
• No burrow visualised → scabies not excluded; early disease or scratched/eczema skin can hide burrows.

If microscopy is done, results are reported as mite/egg/fecal pellets seen (confirmed) or not seen (does not rule out scabies). Final diagnosis follows IACS 2020 criteria.

Often we start treatment on clinical grounds rather than waiting for lab confirmation to reduce spread. If we do need to wait (e.g., for microscopy in special cases), try to avoid prolonged skin-to-skin contact and don’t share towels, bedding or clothing. If advised to treat, treat all household/close contacts at the same time.

We’ll agree on a plan. In the UK, permethrin 5% cream is first-line; oral ivermectin is used in certain situations (e.g., crusted scabies, outbreaks, or when topical treatment is impractical). Some alternatives exist if permethrin isn’t suitable. We’ll also advise:

• Treat all household/intimate contacts simultaneously.
• Laundry: wash clothes/towels/bedding used in the last 3 days at ≥60°C (or tumble-dry hot); items that can’t be washed can be sealed in a bag for 72 hours.

Itch can persist for 2–6 weeks after effective treatment—this doesn’t necessarily mean failure. Follow-up is arranged if symptoms persist.

Yes—please inform sexual partners, household members, and other close contacts so they can be assessed and treated at the same time. This limits further transmission and reinfestation.

For patients needing testing for official purposes, we will record your driving license or passport number and expiry date, which will be used to issue a certificate of testing.