Outdoor activities can be the best way to destress oneself and to enjoy the beauty of nature. Outdoor environment is certainly a thing that should not be taken for granted especially when it was hard to go outside during COVID-19. Even so, there are certain health conditions that can be caused by the outdoor environments. In this DoctorOnCall’s article, we will be learning about chigger bites that can be caused from being outdoors.
Chigger bites are due to infestation with the chigger larva. The larvae themselves are known with several names such as chiggers, red bugs and harvest mites. Typically, chiggers live in low grasses and shrubs in tropical, humid climates year round or mostly in summer and fall months in nontropical climates. Ironically, despite its name as such, it does not belong to the insect family. The chiggers belong to the specific family of mites called the trombiculidae and are considered as close relative to the arachnids which includes spiders and ticks.
The larval form of the chiggers is extremely small. It is so small that the average body diameter ranges between 1/150 to 1/120 inches. Due to the small sizes, it makes chiggers almost invisible to the naked eye. The way these chiggers affect humans is by attaching themselves to the clothes and migrating to the skin. From here, it will look for an optimal feeding site. It is worth noting that chiggers do not burrow into the skin as believed by many.
Chigger bites may be confused with bites from other small animals. Thus, how do you know if you have chigger bites? Chigger bites typically occur at sites on the body where clothing is worn tighter or in areas of skin folds. Common sites are on the lower legs, ankles, behind the knees, waistline, groin and the armpits area (axilla). Bites usually are not noticeable until 1-3 hours later as the mite secrete digestive enzyme that kills the skin cells. The dead skin cells form tubes known as stylostome which the larva used to obtain the digested tissue. The presence of the enzyme causes intense itching especially in the first 24-48 hours before it gradually subsides.
Chigger bites are usually diagnosed by doctors through health history and most often doctors will ask the patient’s recent history of being outdoors. Doctors will also take a close look on how the symptoms affect patients which includes the characteristics of the rash or bumps and location of where the skin lesion is most seen. For example, chigger bites are often seen on parts of the skin where clothes fit tightly and on the lower part of the body but if there are burrows, this may be a sign of mite bites instead. Due to the fact that flea, mite and chigger bites can be eerily similar, it may be difficult for the public and for you to know if it is really chigger bites. Thus, it is best to talk with a doctor to get an accurate diagnosis.
Getting the right diagnosis is important as the treatment will depend on the cause of the skin issues. Treatment includes removing the remaining chiggers and to alleviate symptoms. In general, doctors will clean the affected area with soap and water to remove the mites. Skin creams may be prescribed to kill the chiggers. Over-the-counter anti-itch cream such as calamine lotion or prescription of topical medication are used on the affected site to reduce itchiness and irritation. Doctors may also prescribe oral antihistamine to ease symptoms on top of topical medication. Patients might want to consider applying a cool compress or ice pack onto the area to reduce swelling and itching.
The best way to avoid chigger bites is to prevent it from happening in the first place. One of the easier ways is to use insect repellent, preferably containing DEET either to skin or clothing to steer away the chiggers. It is very important to read the labels on the insect repellent before using and to follow instructions. It is recommended to wear long sleeves and long pants when being outdoors. Clothing affected by the possible chiggers should be treated with permethrin. Permethrin can also be used on clothing for a few days before planning to be in the wild. It is advisable to wear tall boots and tucked pants or socks into the boots. Wearing a belt can also prevent chiggers from having direct access to skin. After being outdoors or in the infested area, clothes should be removed and soaked in hot water immediately. The person also should have a bath or shower with warm water and scrub their body with soap. The less time spent in the contaminated or infested area, the fewer chances for chiggers to get in touch with the person’s skin. Hence, some people will say the best way to avoid chigger bites is to simply avoid walking in long grass or bushes but of course this is not an ideal option for everyone.
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