What is the treatment for cutaneous larva migrans (CLM)?

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From the Guidelines

Cutaneous larvae migrans is best treated with ivermectin (200 mg/kg as a single dose) or albendazole (400 mg od for 3 days). When considering treatment options for cutaneous larvae migrans, it is essential to prioritize the most effective and recent evidence-based treatments. According to the study published in the Journal of Infection 1, ivermectin and albendazole are the recommended treatments for this condition. The key benefits of these treatments include:

  • Rapid resolution of symptoms
  • High efficacy in clearing the infection
  • Convenience of a single dose or short treatment course Some important considerations when treating cutaneous larvae migrans include:
  • The importance of prompt treatment to prevent prolonged symptoms and potential complications
  • The need for symptomatic relief with antihistamines or topical corticosteroids to manage itching and discomfort
  • The role of preventive measures, such as wearing shoes on beaches and avoiding direct skin contact with sand or soil in endemic areas, to reduce the risk of infection. It is crucial to note that the treatment regimen should be guided by the most recent and highest-quality evidence, and in this case, the study published in 2010 1 provides the best available guidance.

From the Research

Treatment Options for Cutaneous Larva Migrans

  • Various therapeutic modalities have been used to treat cutaneous larva migrans, including physical treatments, topical drugs, and systemic drugs 2.
  • Systemic drugs such as albendazole, ivermectin, and thiabendazole have been used to treat cutaneous larva migrans, with varying degrees of success 2, 3, 4, 5.

Efficacy of Albendazole

  • Albendazole has been shown to be effective in treating cutaneous larva migrans, with cure rates ranging from 46% to 100% 2, 4, 5, 6.
  • A therapeutic regimen of oral albendazole (400 mg daily for 7 days) has been shown to be effective in treating cutaneous larva migrans characterized by multiple and/or diffuse lesions, with no recurrences or side effects observed 2, 6.

Efficacy of Ivermectin

  • Ivermectin has been shown to be effective in treating cutaneous larva migrans, with cure rates ranging from 81% to 100% 4, 5.
  • A single 12-mg dose of ivermectin has been shown to be more effective than a single 400-mg dose of albendazole in treating cutaneous larva migrans 4.

Combination Therapy

  • Combination therapy with albendazole and ivermectin has been shown to be effective in treating cutaneous larva migrans, with complete resolution of lesions and no recurrence observed 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Albendazole: a new therapeutic regimen in cutaneous larva migrans.

International journal of dermatology, 1997

Research

A randomized trial of ivermectin versus albendazole for the treatment of cutaneous larva migrans.

The American journal of tropical medicine and hygiene, 1993

Research

Treatment of cutaneous larva migrans.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2000

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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