How should skin mites in humans be treated? - briefly
Effective management combines topical acaricides (e.g., permethrin 5 % cream applied once daily for three days) and oral ivermectin 200 µg/kg as a single dose, repeated after one week if necessary. Close contacts should receive identical therapy, and clothing and bedding must be washed at ≥60 °C or sealed for two weeks.
How should skin mites in humans be treated? - in detail
Effective management of cutaneous mite infestations requires accurate diagnosis, selection of appropriate pharmacologic agents, and supportive care to prevent reinfestation.
Accurate identification of the specific mite species—such as Sarcoptes scabiei (causing scabies), Demodex folliculorum (associated with rosacea and blepharitis), or Dermatophagoides (triggering allergic dermatitis)—guides therapy. Diagnosis relies on clinical examination, dermoscopy, and, when necessary, skin scrapings examined under microscopy.
Pharmacologic treatment
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Scabies
- First‑line: topical 5 % permethrin cream applied overnight to the entire body, repeated after 7–10 days.
- Alternative: 25 % benzyl benzoate lotion or 10 % sulfur ointment for infants and pregnant women.
- Oral ivermectin (200 µg/kg) as a single dose, repeated after 7 days, for extensive disease or crusted scabies.
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Demodex‑related conditions
- Topical metronidazole 0.75 % gel or cream applied twice daily for 4–6 weeks.
- Oral tetracycline-class antibiotics (doxycycline 100 mg daily) for severe rosacea or blepharitis.
- Tea‑tree oil 5 % lotion may be used adjunctively, though evidence is limited.
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Allergic dermatitis from house dust mites
- Antihistamines (cetirizine 10 mg daily) to control pruritus.
- Topical corticosteroids of appropriate potency for acute inflammation.
- Immunomodulators such as topical calcineurin inhibitors for sensitive areas.
Supportive measures
- Wash all clothing, bedding, and towels in hot water (≥60 °C) and dry on high heat; non‑washable items should be sealed in plastic for at least 72 hours.
- Treat close contacts simultaneously to interrupt transmission.
- Maintain skin hydration with emollients to reduce barrier disruption and itching.
- Educate patients on avoiding scratching to prevent secondary bacterial infection; prescribe topical antibiotics (e.g., mupirocin) if infection occurs.
Follow‑up
- Re‑examine patients 2–4 weeks after treatment completion to confirm eradication; persistent lesions may indicate treatment failure or resistant strains, prompting repeat dosing or alternative agents.
- For immunocompromised individuals, schedule regular monitoring due to higher risk of severe manifestations.
By integrating precise diagnosis, evidence‑based medication regimens, and rigorous hygiene practices, clinicians can achieve complete resolution of mite‑related skin disorders and minimize recurrence.