How can a mite located under the skin be completely removed? - briefly
Complete removal demands a dermatologist‑performed excision, typically using a sterile punch biopsy or small incision under local anesthesia to extract the mite and surrounding tissue. Topical acaricides are ineffective because the parasite lives beneath the epidermis.
How can a mite located under the skin be completely removed? - in detail
Removing a mite that has burrowed beneath the epidermis requires a systematic approach: accurate diagnosis, targeted pharmacotherapy, and, when necessary, physical extraction.
First, confirm the infestation. Dermatological examination should include dermoscopy or skin scraping to obtain specimens for microscopic identification. In ambiguous cases, a punch biopsy provides histological evidence and determines the species involved.
Second, select an appropriate anti‑acarian regimen. For most common subcutaneous mites, oral ivermectin is the drug of choice. Standard dosing is 200 µg/kg administered once, repeated after 24 hours if the parasite persists. Alternative oral agents include albendazole (400 mg twice daily for three days) and benzimidazoles, which are effective against certain larval forms. Topical treatments such as sulfur ointment (5–10 %) or benzyl benzoate (25 %) can be applied to the affected area twice daily for a week, supporting systemic therapy.
Third, address lesions that contain live organisms or residual cysts. Options include:
- Surgical excision: Under local anesthesia, excise the nodule, ensuring complete removal of the mite and surrounding tissue.
- Cryotherapy: Apply liquid nitrogen to freeze the lesion, killing the parasite and reducing inflammation.
- Laser ablation: Use a pulsed dye or CO₂ laser to vaporize the burrow and eradicate the mite.
After treatment, monitor the site weekly for at least six weeks. Persistent erythema, itching, or new nodules indicate treatment failure and warrant repeat dosing or alternative medication. Document all interventions and educate the patient on hygiene measures—regular washing of clothing and bedding at 60 °C, avoidance of shared towels, and environmental decontamination—to prevent reinfestation.
In summary, complete eradication of a subdermal mite follows a three‑step protocol: confirm the infestation, administer systemic and/or topical acaricides, and, if required, perform physical removal of residual lesions, followed by diligent follow‑up.