An infestation by the burrowing flea Tunga penetrans.  Commonly affects the feet, hands, elbows, and sometimes


  • A burrowing sand flea, Tunga penetrans

Risk factors

  • Travel to areas with T. penetrans
  • Walking bare feet
  • Living in same house with domestic animals such as pigs, dogs and rodents like rats

Clinical features

  • Punctum or ulceration, often described as a white patch with a black dot on affected area
  • There may be redness and swelling around affected site
  • A serosanguineous exudate may ooze from the central opening, and eggs may be seen with the naked eye
  • Lesions can be painful and very itchy


  • Tissue necrosis, suppuration, gangrene
  • Disability, disfigurement

Differential diagnosis

  • Cercarial dermatitis, scabies
  • Creeping eruption (ancylostoma species)
  • Tick or flea bite, myiasis


  • Clinical features are diagnostic



  • In many cases tungiasis will heal on its own as the burrowed flea dies within 2–5 weeks, and
    naturally sloughs off as the skin sheds

Surgical removal

  • Physical removal of the flea using sterile forceps, or needles, or safety pins

Medicine treatment and suffocation of flea

  • Apply benzyl benzoate 25% emulsion twice daily to the affected area for 6 days
  • Immerse affected area in potassium permanganate 0.05% once a day for 10 minutes
    for 10 days
  • Then follow with application of thickpetroleum jelly or 20% salicylated petrolleum jelly vaseline)
    daily for 7 days

If secondary bacterial infection

  • Take precautions to prevent secondary bacterial infections such as cellulitis, and tetanus


  • Spray the ground with insecticide such as malathion
  • Protect feet with socks and shoes
  • Dry laundry on a line instead of the ground
  • Do not share housing with animals. Animals such as goats, pigs, cows can all be infested with jiggers
  • Keep floors clean and dust free
  • Health education