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Hospital
Address: The Hospital for Tropical
Diseases
2nd Floor Mortimer Market
Capper Street
Off Tottenham Court Road
London WC1E 6JB
Cutaneous Larva
Migrans
Website: www.thehtd.org Hospital for Tropical
www.uclh.nhs.uk Diseases, Infection Division
Written by: Dr Robin Bailey
Diana Phillips

First published: October 2008

Last review date: March 2014
Next review date: March 2016
Leaflet code: UCLH/MB/ID/HTD/CLM/1
© University College London Hospitals NHS Foundation Trust

Created by Medical Illustration RNTNEH 020 3456 5103 Unique Code: 29299
What is CLM?
Cutaneous larva migrans, or CLM, is a
parasitic skin infection. CLM is caused by
hookworm larvae that usually infect cats,
dogs and other animals.
The most common type of hookworm that
causes CLM is called Ancylostoma
braziliense which usually infects dogs. When
animals defecate on soil or sand the
hookworm eggs pass out with the faeces onto
the soil and eventually hatch into larvae.
Humans become infected when these larvae
penetrate the skin. This usually happens to
people who have been sunbathing on
contaminated sandy beaches or walking
over moist soil. CLM is commonly found in
those who have visited tourist beaches in the
Caribbean and South East Asia.
At the site of penetration red eruptions occur.
The larvae may then begin creeping,
causing two to three millimetres wide, worm-
like tracks. The tracks are slightly raised, red
or pink in colour and may itch intensely.
Once creeping has started the tracks can
advance from a few millimetres to a few
centimetres daily.If many larvae are involved
a series of loops and tracks may form.
Will it do me any harm? Will I have problems after taking
No. In dogs the larvae migrate to the gut but Ivermectin?
they cannot move beyond the skin in Several million people worldwide have been
humans and do not live for very long. treated with Ivermectin and few have had
any problems. Occasionally, people have
They typically migrate around the skin in the
area that they first invaded until they die. reported dizziness, drowsiness, nausea,
This process usually lasts for a week or two, bloating, diarrhoea, headache, muscle
but in some cases can take months. aches and allergic reactions. If you
experience drowsiness you should avoid
Will I infect anyone else? driving, operating machinery, and limit your
alcohol intake.
No. CLM cannot be passed from person to
person.
How can I treat it?
As mentioned above, CLM does not cause any
harm and the larvae eventually die without
treatment. The rash then heals spontaneously.
However the larvae can live for several months
and many people find the itchy rash irritating
and cosmetically unpleasant and so opt to
have it treated promptly.
We can treat your CLM with a tablet called
Ivermectin (given once only). The dosage is
weight-based (200mcg/kg) and we will
weigh you in the clinic. You should also
inform us if you are pregnant or
breastfeeding. There are alternatives to
taking Ivermectin.