Delusional Parasitosis And Treatment!

Delusional Parasitosis (or delusions of Parasitosis or DOP) is a serious condition in which a person has a false belief of being infested by insects like, mites, lice, fleas, spiders, worms, bacteria or other organisms. Due to this belief, a person develops an unbearable reaction to a virtual (not real) infestation.


DOP is a wrong belief that makes a person wonder if they’re bitten by an insect or mite, but in reality, nothing of this sort has happened to them. In this condition, the sufferer is likely to believe that parasites are living in or on the skin, in their stomach or bowel, around or inside their body openings, or infesting on their surrounding environment, home or clothing.


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A person with this belief often approaches doctors and other medical professionals, asking them for the cure of the infestation. They suspect that even a smallest of the particles like dust, skin flakes or other materials may be the cause of the trouble. As the suspected material is carried in an envelope or a matchbox-sized object, the presentation of these samples are referred to as “matchbox signs”.

The stimulant drug abuse, especially methamphetamine and cocaine, is another frequent cause of DOP.  A person taking excessive cocaine may develop a false belief of being suffering from “cocaine bugs” and may feel the parasites are crawling on their skin. On the other hand, chronic methamphetamine abusers are termed as ‘tweakers’ because of their constant picking of skin. These conditions can further lead to extreme alcohol withdrawal, high fever, and visual hallucinations of insects living on one’s body.

In this condition, sufferers may harm their skin by excessive scratching to a point where they can seriously damage it to bleed or make vulnerable to other secondary infections.

Signs of DOP

In this condition, the suffering:

  • Tries to self-treat with insecticides or other harsh chemicals.
  • Believes to be bitten by unseen insects or mites.
  • Believes that their home is infested with insects or mites.
  • Begins to fear that others might get infected with the same disorder and keep themselves isolated.
  • Forms multiple, unsatisfactory contacts with the medical practitioners or pest control community.
  • Can abandon their home due to the fear of the “infestation”.
  • Reports of unseen bugs living on their body.
  • Submits wrapped samples and detailed information related to the believed infestation.
  • Submits samples of swabs or body tissues.


Treatment of DOP

Delusional Parasitosis treatment is best done in collaboration with a psychiatrist and a dermatologist. The dermatologist or skin specialist looks for a complete history of the sufferer’s body to ensure there is no presence of actual parasites. Once no parasitic signs are observed, the sufferer is further referred to a psychiatrist to treat their delusion.

The suffering is treated with antipsychotic drugs like Risperidone and haloperidol. Some patients refuse to go for psychiatric treatment and instead visit other doctors to seek proper treatment thinking the virtual parasites will be eliminated.

The secondary forms of delusional parasitosis are treated after the primary associated psychological or physical condition. The primary cause needs to be treated first as it caused other delusional disorders and schizophrenia. Earlier, pimozide was prescribed to treated typical antipsychotics. But now medicines like olanzapine or risperidone are considered as the first-line treatment for antipsychotics.

Initially, some sufferers are likely to reject the first-line treatment or diagnosis of delusional parasitosis by their medical professionals. So, it is a difficult task to convince them for the treatment. Sometimes it takes weeks to months or years to convince suffer to undergo certain treatment of DOP.

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