Preventing and Treating Sand Flea Bites

Introduction

Sand flea bites are small, red, raised, and itchy bumps on a person's skin caused by bites from sand fleas and tiny organisms found in the sand. Though most sand flea bites are harmless, some sand fleas can burrow into a person's skin leading to serious skin infections and diseases. The sand flea bites can be treated. Simple steps such as keeping legs and feet covered and using insect repellents can help prevent sand flea bites.

What Are Sand Flea Bites?

Tunga penetrans (the jigger or chigoe flea) are the true sand fleas. These are tiny and can bore holes into the person's skin. These fleas can cause tungiasis, a parasitic infection, or sand flea disease, leading to severe skin lesions (inflammation and wounds). The sand fleas are found in South America, Africa, Central America, West Indies, and the Caribbean. True sand fleas are rare in the United States. In places where true sand fleas are rare, people consider the bites from the tiny organisms (crustaceans, beach fleas) in the sand as sand flea bites. Most of these flea bites are harmless, though some could be harmful and dangerous. These bites could lead to red and itchy bumps on the skin, and the irritation resolves in a few days.

Who Is More Prone to Sand Flea Bites?

Sand fleas live in a humid environment; thus, anyone can get sand flea bites on the beach while wading in shallow water (warm) or playing in the sand. Sand flea disease (tungiasis) is found in people living in underdeveloped or poor regions and coastal areas and is the most common parasitic infection in these high-risk areas. Individuals spending much time barefoot on the sand (on beaches, dirt floors, or farms), young children, disabled people, and the elderly are at a greater risk of bites and infection. These fleas generally thrive during the dry seasons, and if a person travels to high-risk areas with sand fleas, they can carry true sand fleas and flea bites home.

What Happens in Sand Flea Bites?

When a true or chigoe sand flea bites, the female sand flea, penetrates (burrows) the person's skin and burrows into their flesh. The sand flea sucks the person's blood, grows, and swells up by 2,000 times. The sand fleas also lay eggs in the skin, falling out before hatching. The female sand fleas may live in the person's skin until they die (usually four to six weeks). Occasionally, sand flea bites occur on a person's feet or ankles. Sand flea bites can be seen between toes, on the heals, toenails, thighs, groin, hands, and genitals. It can cause itchy and irritated skin with raised and red bumps. Skin ulcers and open wounds can occur in serious infections that are painful and susceptible to other infections, such as tetanus or gangrene.

How to Prevent Sand Flea Bites?

Tips to prevent sand flea bites include the following.

1. Go to the Beach at the Right Time: One must avoid visiting the beach at dusk and dawn, as the sand fleas are most active when the temperature is cooler and are least active during the daytime. Early morning or late evening beach visits increase the risk of sand flea bites. Visiting the beach in the middle of the day is safer to prevent sand flea bites. In addition, one must avoid visiting the beach during rain, as such cool and moist conditions increase sand flea activity and the chance of flea bites. Windy weather also helps to minimize sand flea bites.

2. Apply Insect Repellents or Sprays: These topical insect repellants on the legs, feet, and ankles can minimize sand flea bites. Coconut oil and some natural essential oils also help to repel the sand fleas.

3. Keep Legs, Ankles, and Feet Covered: While on the beach, the risk of sand flea bites can be minimized by covering below the waist. Tight pants, covering socks, and close-toed shoes can do the trick and protect the person from sand fleas.

4. Avoid Sitting on the Sand: Using a blanket or towel while sitting on the sand can help protect from sand flea bites. Sitting directly on the sand makes the person an easy target for sand flea bites.

5. Keep Moving: If a person is in an area that has a high risk of sand fleas, the best option to prevent bites is to keep moving.

6. Wash Feet: After walking barefoot on a beach or sand, one must practice washing their legs and feet to prevent infections.

7. Talk to a Healthcare Provider: Consulting a doctor about the risk of traveling to a high-risk region can help to adjust the person's travel plans to prevent sand flea disease.

How Are Sand Flea Bites Treated?

Sand flea bites are itchy and uncomfortable. There are several treatment options to manage sand flea bites. The patients must resist the urge to scratch the area. Scratching the skin further irritates the skin and can even lead to infections. There are over-the-counter creams (usually Hydrocortisone or steroids) to reduce the itching and inflammation. Home remedies such as applying aloe vera gel and colloidal oatmeal baths also seem beneficial to cooling and soothing the skin and reducing itchiness. Seeking medical attention is necessary in case of severe sand flea bites, infections, and allergies.

To diagnose sand flea bites, the healthcare provider carefully examines the patient's skin and reviews their medical history, including allergies, infections, and skin diseases. In addition, the patient's description of contact with other people with skin lesions and travel to beaches, outdoor spaces, or regions where sand fleas are common helps confirm the diagnosis.

For mild sand flea bites, the following can help manage the symptoms.

• Antihistamine medications (oral or topical) relieve the symptoms such as itching.

• Cold packs.

• Calamine lotions and other skin creams to treat itchiness.

• Medications like corticosteroids reduce swelling and inflammation (oral or topical creams).

Individuals with ulcers or open wounds are treated with the following:

• Antibiotics (to reduce infection risk)

• Tetanus shot.

• Topical creams.

• Surgical removal of fleas from the skin.

In endemic areas where sand flea disease is common, surgical removal of the fleas from the skin is the standard treatment option. It is to be performed in a healthcare setting by a healthcare professional. The patients must avoid trying to remove the sand fleas from the skin alone. The procedure is difficult and painful. In addition, removing sand fleas can lead to further inflammation and superinfection in the skin if the parasite ruptures. After surgical sand flea removal, the wound is dressed. The patient's tetanus shot status is usually verified at the time, and a booster dose is given if needed for long-lasting protection.

Conclusion

There are several treatment options to manage the itchy and uncomfortable sand flea bites. However, preventing sand flea bites is always better. Simple measures such as avoiding the beach at dusk and dawn, keeping feet and legs covered, using insect repellents, washing feet, and avoiding sitting directly in the sand can help to prevent sand flea bites.