How is a skin mite treated? - briefly
Topical acaricides—commonly 5 % permethrin cream or sulfur ointment—are applied to the affected skin to eradicate the mites. Oral antihistamines or corticosteroids reduce itching, and washing clothing and bedding eliminates sources of reinfestation.
How is a skin mite treated? - in detail
Effective management of a skin‑mite infestation requires accurate diagnosis, appropriate pharmacotherapy, and environmental control.
The diagnostic process begins with a thorough history of itching, especially nocturnal exacerbation, and a physical examination for characteristic burrows or papules. Confirmation may involve skin scrapings examined under a microscope to identify the mite or its eggs.
Pharmacologic therapy centers on scabicidal agents. The first‑line topical preparation is 5 % permethrin cream, applied to the entire body from the neck down (or to the entire surface in infants) and left for eight to fourteen hours before washing off. A second application after 24 hours eliminates newly hatched organisms. Alternative topicals include 10 % benzyl benzoate, 1 % crotamiton, or sulfur ointment (5 % in petroleum). Oral ivermectin, 200 µg/kg as a single dose, is recommended for adults, children over fifteen kilograms, and individuals unable to tolerate topical treatment. A repeat dose after 7–14 days addresses any surviving larvae.
Special populations require adjusted regimens. Pregnant or lactating patients may receive topical permethrin, which is classified as safe; oral ivermectin is generally avoided. Infants younger than two months can be treated with sulfur ointment or diluted benzyl benzoate under medical supervision.
Adjunct measures reduce reinfestation risk. All household linens, clothing, and towels should be machine‑washed at 60 °C or sealed in plastic bags for at least 72 hours. Non‑washable items may be exposed to high heat or dry‑cleaned. Close contacts receive prophylactic treatment simultaneously, even if asymptomatic, to interrupt transmission chains.
Symptomatic relief includes antihistamines for pruritus and low‑potency corticosteroid creams to control inflammation. Persistent itching after clearance of the mites may indicate a post‑infestation hypersensitivity reaction; short‑course antihistamines or topical steroids are appropriate.
Follow‑up evaluation, typically one to two weeks after therapy, confirms resolution of lesions and absence of new burrows. Failure to respond prompts reassessment of diagnosis, potential drug resistance, or inadequate application technique, and may necessitate alternative agents or extended treatment courses.