How should I treat a subcutaneous mite on the cheek? - briefly
Consult a dermatologist for a prescription topical acaricide (e.g., permethrin 5%) and, if necessary, oral ivermectin, while keeping the area clean and avoiding irritation.
How should I treat a subcutaneous mite on the cheek? - in detail
A subcutaneous mite infestation on the facial skin requires accurate diagnosis, prompt pharmacologic therapy, and diligent after‑care.
First, confirm the presence of the parasite. Dermatological examination should reveal a small, raised nodule or papule with a central punctum. Dermoscopy can display a moving organism or its burrow. If uncertainty remains, a skin biopsy or scraping examined under microscopy provides definitive identification.
Second, initiate treatment. The most effective systemic agent is ivermectin, administered orally at 200 µg/kg in a single dose, repeated after 7 days to cover the mite’s life cycle. For patients unable to take oral medication, topical ivermectin 1 % cream applied twice daily for 5 days is an alternative. In addition, a topical acaricide such as benzyl benzoate 25 % lotion or sulfur ointment can be applied to the lesion once daily for 3 days, then every other day for a week.
Third, manage local inflammation and prevent secondary infection. Clean the area with mild antiseptic solution (e.g., chlorhexidine 0.5 %). Apply a thin layer of a non‑steroidal anti‑inflammatory cream (e.g., diclofenac gel) to reduce swelling. If signs of bacterial infection appear—purulent discharge, increasing erythema—prescribe a short course of oral antibiotics targeting skin flora (e.g., cephalexin 500 mg QID for 5 days).
Fourth, monitor progress. Re‑examine the site after 10 days; the lesion should diminish in size, and no live mites should be visible. Persistent symptoms warrant repeat dosing of ivermectin or referral to a dermatologist for alternative interventions, such as cryotherapy or surgical excision of resistant nodules.
Finally, implement preventive measures. Advise regular washing of the face with gentle cleanser, avoidance of sharing towels or cosmetics, and thorough cleaning of bedding and clothing at temperatures above 60 °C. Periodic inspection of facial skin, especially after travel to endemic regions, helps detect early colonization.
Following this protocol maximizes eradication of the parasite, minimizes tissue damage, and reduces the likelihood of recurrence.