How do you treat a rash caused by chicken mites?

Treatment of Chicken Mite Rash

The most effective treatment for a rash caused by chicken mites (Dermanyssus gallinae) is permethrin 5% cream applied to affected areas, combined with environmental control measures to eliminate the mite infestation.

Diagnosis and Clinical Presentation

• Chicken mite infestations typically present with:

  • Pruritic papular rash, often on exposed skin areas
  • Intense itching that worsens at night
  • Erythematous macules and papules with excoriation
  • Symptoms appearing after contact with birds (chickens, pigeons) or their nesting areas

• Key diagnostic clues:

  • History of exposure to birds, especially chickens or pigeons
  • Multiple people affected in the same environment
  • Itching that intensifies in the evening 1
  • Mites may be visible on clothing or bedding with careful inspection

Treatment Algorithm

First-Line Treatment:

1. Topical anti-parasitic treatment:

   • Permethrin 5% cream applied from neck down for 8-14 hours 2
   • Wash off after treatment period
   • May need to repeat after 7-10 days if symptoms persist

2. Symptomatic relief for itching:

   • Topical hydrocortisone 1% cream applied to affected areas up to 3-4 times daily 3
   • Oral antihistamines for severe itching 1
   • For severe cases with extensive inflammation, short-term oral corticosteroids may be needed 1

Environmental Control (Critical for Preventing Reinfestation):

1. Eliminate bird nests and roosting areas:

   • Remove nests near windows, attics, or other areas close to human habitation
   • Seal entry points to prevent birds from returning

2. Decontamination of environment:

   • Machine wash and dry all bedding, clothing, and fabrics at high temperatures (at least 120°F/49°C) 2
   • Items that cannot be washed should be removed from body contact for at least 72 hours 2
   • Thoroughly vacuum all potentially infested areas 2
   • Consider acaricide treatment of living spaces with appropriate insecticides (carbamates, organophosphates, or pyrethroids) 4
   • Repair cracks and crevices where mites might hide 4

Special Considerations

• For pregnant/lactating women:

  • Permethrin is considered safe and is the preferred treatment 2

• For severe or persistent cases:

  • Consider oral ivermectin at 200 μg/kg, repeated after 14 days 2
  • This is particularly useful when topical treatments have failed

• Follow-up:

  • Evaluate after 1 week to assess treatment response
  • Retreatment is indicated if symptoms persist after 14 days 2
  • Note that pruritus may persist for several weeks after successful treatment and is not necessarily an indication for retreatment

Prevention of Recurrence

• Maintain distance from bird habitats, especially chicken farms or areas with pigeon populations 4
• Regular cleaning and inspection of areas where birds might nest
• Proper ventilation of living spaces 4
• Seal windows and openings where birds might enter or nest near human habitation

Pitfalls and Caveats

• Chicken mite bites are often misdiagnosed as other skin conditions, leading to delayed appropriate treatment 1
• Without environmental control measures, reinfestation is likely to occur even with effective topical treatment
• Persistent symptoms despite appropriate treatment should prompt consideration of alternative diagnoses or ongoing exposure to the source of infestation