What is Delusional Parasitosis?

Phobias and delusions can be mild to serious psychological disorders that should normally be treated by the medical community.

Theirs is often a misunderstanding between the two terms: Phobia and delusion when it comes to the excessive fear of arthropods like spiders and insects.

Difference between Phobia and Delusion

“Entomophobia” refers to an irrational fear of real arthropods. Here, the fear involves a real stimulus for any insect or spider, encountered in everyday activities. For example, seeing a spider might trigger this intense fear. However, the good news is that entomophobia is easily curable with no much effect on the person other than limiting the person’s everyday activities.

On the contrary, there’s a much more serious condition called delusions of Parasitosis (DOP). It causes a severe and unbearable reaction to a virtual (not real) infestation. In general, delusions are mistaken beliefs and in this case the person wrongly believes that they are infested with an insect or mite or that they are being repeatedly bitten.


Delusional Parasitosis is a false belief that one is being infested by insects such as lice, mites, fleas, worms, spiders, bacteria, or other organisms.


Medically, Delusional Parasitosis, or Ekbom’s Syndrome is a relatively rare disorder wherein affectants have a delusional belief of being infested or attacked by parasites.

The sufferer of delusional Parasitosis reports parasites in or over the skin, in the stomach or bowels, around or inside body openings, and may also include a belief that the insects infest their home, environs or clothing.

A person with such belief may approach several doctors and other professionals asking for the cure for the supposed infestation. They will often bring small particles, dust, skin flakes and other material for the doctor to inspect. Since the material may be carried in a matchbox or an envelope, the presentation of sample materials has come to be known as the “matchbox sign.”

Another cause of this disorder can be the stimulant drug abuse, especially cocaine and methamphetamine. For instance, excessive cocaine use can lead to a syndrome “cocaine bugs” where the affected person believes he has, or feels parasites crawling under the skin. Chronic methamphetamine abusers are often called ‘tweakers’ because they pick at their skin. These conditions are associated with high fevers and extreme alcohol withdrawal sometimes, often associated with visual hallucinations of insects.

Sufferers of these conditions may self-mutilate and scratch themselves to the point where they can cause serious skin damage and bleeding, especially if they are delirious or intoxicated.

Signs of DOP

  • believes to have bites or skin lesions on their body from unseen causes
  • in addition to personal infestation, believes that home or workplace are “infested”,
  • reports having resorted to self-treatment with insecticides or other harsh chemicals
  • has fear for others to get infested leading to self-imposed isolation
  • has multiple, unsatisfactory contacts with the medical or pest control community
  • can cause abandoned home because of the “infestation”
  • reports that “bugs” are unseen or disappear after capture
  • submits elaborately wrapped samples, often with very detailed collection information
  • submits samples of body tissue or swabs.

Treatment of DOP

  • Psychiatric therapy
  • Antipsychotic drugs, sometimes

Delusional Parasitosis treatment is best coordinated between a psychiatrist and a skin specialist or dermatologist. The dermatologist does a thorough evaluation of the sufferer’s body to make sure that there are no actual parasites. After this, the sufferer is referred to a psychiatrist so that their delusion can be treated. Besides this, antipsychotic drugs like Risperidone and haloperidol can be very effective. While people often refuse to accept psychiatric treatment and instead visit many different doctors in a useless search for a cure that will eliminate the parasites they imagine.

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