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Sand Cream
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About the Author
Jenny Poole writes on weight loss and beauty products. She is currently writing about ZaZa at www.zsazsacreamuk.co.uk.
How do you treat sand fly bites on the skin? The creams doctors prescribed have all been ineffective.?
I was bitten by sand flies in Peru several months ago. The bites appear as red spots on my skin and are hideous and very itchy. I've tried several types of topical creams prescribed by doctors but have been ineffective. What are the alternatives? Will the spots and itchiness stay with me forever?
Deeply worried...
READ VERY CAREFULLY! This may be serious.
If you were truly bitten by Sandflies, your skin lesions are most likely signs of what is known as Cutaneous Leishmaniasis. Sandflies are vectors (careers) for a protozoan organism known as Leishmania donovanii that commonly infects animals like opossoms, ant-eaters, sloths, and rodents in the New World (The West, ie Europe and Americas) and foxes, jackals, wolves, and raccoons in the Old World (Asia). The organism lives in its "immature" form (called "promastigote") inside the female sandfly and when the fly bites the skin, the parasite enters the body and converts to the mature reproductive form known as the "amastigote".
The infection usually occurs on exposed areas of the skin such as hands, legs, or the face. They are usually painless, may cause itching, and become crusted and dry-looking over time. The parasitic infection is very slowly progressive and in some cases may resolve on its own over 6-8 weeks. In most cases, the infection becomes chronic, progressive, and may invade internal organs such as liver, spleen, and bone marrow and turn into a systemic infection known as kala-azar or "Black Fever." This form of the disease is deadly.
Definitive diagnosis can be made by taking a skin biopsy of the site and visualization of the parasite under the microscope, culturing the organism, or the use of advanced molecular biology techniques such as ELISA and PCR which identify Leishmania DNA. These are not readily available in most healthcare settings due to their cost and scarecity of this disease in urban settings in most of US regions.
The most effective and definitive treatments for Leishmaniasis are Pentostam (sodium stibogluconate) and Glucantime (meglumine antimonate). But these drugs may not be readily available since they are not used very often. Other more practical drugs are amphotericin B and pentamidine which are antifungal and anti-parasitic agents given in intravenous and intramuscular forms.
My suggestion to you is to be seen in the University Based healthcare setting and mention to them the fact that you were bitten by Sandflies. They may then decide to pursue measures for definitive diagnosis and treatment. I hope this helped.
- Dr. F. Trojan
- Keck School of Medicine, University of Southern California
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