Treating a hookworm inoculation rash

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Home>Using helminths>Treating a hookworm inoculation rash

Stopping the itch

After self-inoculation with hookworm larvae, the bandage/dressing should be left in place for a minimum of four hours and, ideally, for twelve. If the larvaeThe active immature form of an insect, or an animal such as a helminth, which develops from an egg and eventually transforms again into its adult state. are applied in the morning, the bandage/dressing can be removed before going to bed at night, making it easier to treat the itch and thus prevent sleep being lost as a result of discomfort during the night. Although some people prefer to inoculate just before going to bed because they can sleep through the itching.

If the resulting rash is itchy, this can be treated after removal of the bandage/dressing.

Gold star tip - use an electric hair dryer!

An electric hair dryer provides the gold standard treatment for a hookwormA helminth that lives in the small intestine. Necator americanus (NA) is the only hookworm species used in helminthic therapy. Its microscopic larvae are applied periodically to the skin. itch. Hot air is directed from the dryer at the centre of the rash and held up to the point of feeling momentary pain. This will usually stop the itch completely for a number of hours, but one does need to be careful not to cause a burn! More details here.

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The hairdryer trick works a treat. I ended up sleeping with mine beside the bed for a couple of days. [1]

Other approaches

Topical products containing 2% diphenhydramine hydrochloride are very effective and are available in several forms. An alcohol-based version may perform marginally better than a cream, but whichever form is used, diphenhydramine is ideal because it works as an antihistamine as well as a local anaesthetic. Available in both the US and UK - from Amazon, Ebay and other outlets and may also be available in other countries.

A maximum strength (1%) hydrocortisone cream is another treatment option for the itch, e.g.

Any topical allergy or itch treatment - such as vaginal itch relief creams - should work to varying degrees, and other treatments that have been reported to work include the following.

  • Calamine lotion One individual says this gives him at least two hours relief, and someone else, who had tried Benadryl lotion, prednisolone, cortisone cream, “some sort of anti/itch numbing spray” and oral antihistamines, has claimed that calamine lotion beats them all. [2]

Other creams found to be helpful include the following.

Several essential oils have been reported to help, including magnolia oil [4], sandalwood oil [5] and lavender oil. Two drops of the latter applied on a bandage calmed one user’s itch almost immediately and allowed her to forget about the rash completely! [6]

Others have reported success with a variety of substances, including honey, natural pawpaw cream, sea or salt water and even toothpaste!

One person says that she finds the best way to deal with the itch is not to touch the rash at all with fingers, creams or clothes, etc., as any friction over the area increases the itch. So, while it’s hard to achieve, she finds that just keeping the rash covered and restraining her urge to touch it is what works best for her. Another agrees about covering the rash.

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I use hydrocortisone cream and a gauze wrap (very snug) over the top. The snugness helps dampen the itch and prevents you from scratching it in your sleep! [7]

Someone else has found it helpful to go a step further and apply pressure to the rash using an elastic bandage.

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... using a tensor bandage around the site; the pressure/tension seems to help lessen the itchiness. (I have bees, and this really helps a lot for stings on arms/legs but a bit less effective for the inoculationThe introduction of an infectious agent into an organism. [http://helminthictherapywiki.org/wiki/index.php/Helminth_inoculation Helminth inoculation] itch.) [8]

A few others have reported getting up to half a day’s relief from the itch after giving their rash several hearty slaps. In one case this is done after applying hydrocortisone cream.



An ice pack has been found to provide effective relief by some people.

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My husband used the ice pack - on for about 1/2 hour before going to bed each night helped enough that he wasn't kept awake by the itching. It also helped decrease the swelling around the inoculationThe introduction of an infectious agent into an organism. [http://helminthictherapywiki.org/wiki/index.php/Helminth_inoculation Helminth inoculation] rash. During the day, he would just put on the ice pack for 15- 30 min, whenever he had a chance and it seemed to make it better for an hour or so at a time. [9]
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Icing it for 15 minutes took care of it. [10]

Managing an angry, weeping rash

Once there are pronounced yellow heads or blisters at the points of entry, scrubbing away everything that stands above the skin surface can bring remarkably swift relief from the itching and help reduce the possibility of swelling. This is probably because the scrubbing removes the debris left behind by the larvaeThe active immature form of an insect, or an animal such as a helminth, which develops from an egg and eventually transforms again into its adult state. when they entered the skin, thus taking away what the immune system was reacting to.

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After removing the bandage (12 hours), I recommend rubbing a pumice stone over the area with some force to remove the discarded larvaThe active immature form of an insect, or an animal such as a helminth, which develops from an egg and eventually transforms again into its adult state. skins that cause irritation. Since I began doing this, the length and severity of my skin reaction has decreased noticeably. [11]
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I pretty much just rip the skin off now as soon as the blistering starts. Not elegant, but it does seem to help it clear up sooner and relieves the itching. [12]

A rough towel, loofah, or surgical nail brush may remove the heads, but a pumice stone can be even more effective. [13] One hookwormA helminth that lives in the small intestine. Necator americanus (NA) is the only hookworm species used in helminthic therapy. Its microscopic larvae are applied periodically to the skin. host uses a men's pocket hair comb to scrape/rake repeatedly across the area, with the long edge of the comb aligned in parallel to the direction of movement. Another uses her fingernails [14] and one brave helminthophile pours table salt onto the rash and scours this with a paper towel, [15] although someone else who tried this commented that it "Burns like the dickens for a while!" [16]

One self-treaterSomeone who treats their own disease or condition without medical supervision. has found that following up the scrubbing with a clay poutice and/or lavender essential oil provides even more benefit.

Removing the heads will leave shallow craters which may weep, sometimes quite profusely, for a few days. However, the fluid released is just exudateCells and fluid that seep out of blood vessels during inflammation., or serous drainageClear, thin, watery plasma released during the inflammatory stage of wound healing.. It is very unlikely to be suppurationPuss formed as a result of bacterial infection..

There have been no reports to date of infections taking hold at inoculationThe introduction of an infectious agent into an organism. [http://helminthictherapywiki.org/wiki/index.php/Helminth_inoculation Helminth inoculation] sites, even when the skin is broken, and this may be because the heightened immune activity around the rash defeats any opportunistic bacteria. There should therefore be no need for the use of antibacterial preparations, but keeping the site covered with a thick, absorbent dressing will help prevent staining of one's clothes. Panty liners are excellent for this purpose.

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I cut panty liners into 2 or 3 sections depending on the size of the rash, and keep replacing these till the rash dries up. The waterproof backing prevents any liquid seeping through to one's clothes. [17]
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I've bought small tight athletic socks and cut the toe end off to create a "sleeve", inside of which I put very thin sanitary pads to absorb the liquid. [18]

Dickinson's Witch Hazel, dabbed on with cotton balls has provided soothing relief for the rash and a 75% reduction in swelling, itching and weeping within approximately half an hour. [19]

Some people have applied the homeopathic remedy, graphites, to their oozing rash, and this can be purchased as a cream, e.g., Nelsons Graphites Cream 30g. However, there have been no reports as to how effective this might be in the case of a hookwormA helminth that lives in the small intestine. Necator americanus (NA) is the only hookworm species used in helminthic therapy. Its microscopic larvae are applied periodically to the skin. rash.

Someone else has advocated applying a bandage covered in normal table salt, claiming that this "makes all the liquid come out really fast, and helps dry the scabs real soon." [20]

Oral antihistamines - Which are safe for hookwormsA helminth that lives in the small intestine. Necator americanus (NA) is the only hookworm species used in helminthic therapy. Its microscopic larvae are applied periodically to the skin.?

Oral antihistamines may also help to relieve the itch but, unfortunately, some of these contain drugs that have anthelminthic properties. While it is unlikely that anything will harm hookwormsA helminth that lives in the small intestine. Necator americanus (NA) is the only hookworm species used in helminthic therapy. Its microscopic larvae are applied periodically to the skin. before they attach to the gut mucosa (towards the end of the third week, post inoculationThe introduction of an infectious agent into an organism. [http://helminthictherapywiki.org/wiki/index.php/Helminth_inoculation Helminth inoculation]) some of these drugs may harm mature hookwormsA helminth that lives in the small intestine. Necator americanus (NA) is the only hookworm species used in helminthic therapy. Its microscopic larvae are applied periodically to the skin..

The following guide is intended to help navigate the available antihistamines.

❌ Can kill hookwormsA helminth that lives in the small intestine. Necator americanus (NA) is the only hookworm species used in helminthic therapy. Its microscopic larvae are applied periodically to the skin.

⚡ May cause harm to hookwormsA helminth that lives in the small intestine. Necator americanus (NA) is the only hookworm species used in helminthic therapy. Its microscopic larvae are applied periodically to the skin.

These antihistamines are closely related to piperazine and so should be avoided:

  • Cetirizine (Zyrtec, Reactine)
  • Levocetrizine (Alcet, Allear, Curin, levcet, Seasonix, T-Day Syrup, Teczine, UVNIL, Vozet, Xaltec, Xozal, Xuzal, Xusal, Xyzal, Zilola, Zyxem)
  • Phenylephrine
  • Desloratadine (NeoClarityn, Claramax, Clarinex, Larinex, Aerius, Dazit, Azomyr, Deselex and Delot)
  • Acrivastine (Semprex-D in the US) may also be harmful to helminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths].

Some people have taken cetirizine or levocetirizine while on helminthic therapyThe reintroduction to the digestive tract of a controlled number of specially domesticated, mutualistic helminths (intestinal worms) in the form of microscopic eggs or larvae to reconstitute a depleted biome to treat and prevent chronic inflammation, autoimmune disease and other immunological disorders including allergy., sometimes for very long periods, without a noticeable loss of benefit from their worms. However others suspected that these drugs may have been responsible for adversely affecting or even killing their worms. So best to avoid them while on the therapy.

  • Promethazine (Phenergan, Promethegan, Romergan, Fargan, Farganesse, Prothiazine, Avomine, Atosil, Receptozine, Lergigan, and, in the UK, Sominex)
    Promethazine does not appear to kill helminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths], especially when administered by intramuscular injection. However, one helminth host has reported that this drug reduced his worm benefits when taken orally.

These oral antihistamine products all contain drugs with anthelminthic potential

✅ Probably safe for hookwormsA helminth that lives in the small intestine. Necator americanus (NA) is the only hookworm species used in helminthic therapy. Its microscopic larvae are applied periodically to the skin.

Antihistamines that appear to be safe for helminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths] are

  • Fexofenadine (Allegra, Fexidine, Telfast, Fastofen, Tilfur, Vifas, Telfexo, Allerfexo) -- least likely to cause drowsiness
  • Loratadine (Claritin)
  • Diphenhydramine -- most likely to cause drowsiness

Most Benadryl-branded products sold in the USA contain only diphenhydramine so are worm-safe e.g.

See also

SimpleHTLogo(18x18).gif Helminthic Therapy Wiki: documenting the science, management, experience and results of helminth replacement therapy.