How are subcutaneous mites treated in a human? - briefly
Treatment involves surgical extraction of the mite and surrounding tissue, followed by systemic antiparasitic medication (e.g., ivermectin) and, if needed, antibiotics to prevent secondary infection. Prompt diagnosis and complete removal are essential to avoid tissue damage and recurrence.
How are subcutaneous mites treated in a human? - in detail
Subcutaneous mite infestations in humans require a combination of accurate diagnosis, pharmacologic therapy, and, when necessary, minor surgical intervention.
Initial assessment includes a thorough skin examination, dermatoscopic inspection, and, if lesions are accessible, extraction of a mite or its burrow for microscopic identification. Laboratory confirmation guides the choice of medication and confirms the species involved, which influences the treatment regimen.
Pharmacologic options focus on agents with proven acaricidal activity:
- Ivermectin: oral dose of 200 µg/kg, repeated after 1–2 weeks to target newly hatched mites; effective against most Sarcoptes and Demodex species.
- Albendazole: 400 mg twice daily for 3 days; useful when ivermectin is contraindicated or as adjunct therapy.
- Permethrin 5 % cream: applied to the affected area for 8–12 hours, then washed off; repeat after 24 hours to cover the life cycle.
- Benzyl benzoate 25 % lotion: applied daily for 3 days, then weekly for a month; alternative for patients intolerant to other topical agents.
When lesions contain a large number of mites or form nodular cysts, incision and extraction may be performed under local anesthesia. The cavity is then irrigated with antiseptic solution and covered with a sterile dressing. Post‑procedural topical ivermectin or permethrin reduces the risk of residual infestation.
Adjunct measures include:
- Antihistamines for pruritus control.
- Topical corticosteroids to diminish inflammatory response, applied for a short course to avoid skin atrophy.
- Hygiene protocols: regular washing of clothing, bedding, and personal items at temperatures ≥ 60 °C; isolation of infested areas to prevent re‑exposure.
Follow‑up visits are scheduled at 2‑week intervals for the first month, then monthly for three months, to verify eradication and monitor for recurrence. Persistent symptoms after three treatment cycles warrant re‑evaluation for alternative diagnoses or resistant mite strains.
Effective management combines systemic and topical acaricides, targeted removal of entrenched mites, and strict environmental sanitation to achieve complete resolution.