Tungiasis: How to Recognize It and Why It Matters

Faith Nyiahule
2 days ago
3 min read

What Is Tungiasis?

Tungiasis is a skin infection caused by the adult female sand flea called Tunga penetrans. It usually penetrates through the feet, where the embedded flea grows and lays eggs, causing inflammation, pain, itching, difficulty in walking, sleeping, and concentrating on tasks. Tungiasis affects humans and animals alike.

Tungiasis affects millions of people in vulnerable communities across South America, the Caribbean, and sub-Saharan Africa. People who live in houses with sandy floors or go barefoot in rural areas, remote villages, and some large cities are more likely to get tungiasis. Children aged 5-14 years and elderly people have a higher risk of infection. This condition causes severe pain, inflammation, disability, and social stigma, particularly among children, and can lead to long-term cognitive challenges. Although it has a widespread impact, tungiasis is still largely neglected in global public health agendas. ¹

How to Recognize Tungiasis

Tungiasis is usually recognised by visual inspection. It appears as a small white/yellow disc-like bump on the skin, with a small black dot at the center that darkens until it becomes completely black. The feet are the most common point of infection, but infestation can occur in all parts of the body. The lesion usually becomes itchy at first, then painful and swollen. They commonly appear around the nails, on the toes, and on the soles of the feet. This is a clear indication of recent infection. ²

Why Tungiasis Is a Public Health Concern

When Tungiasis is left untreated, it leads to more serious health issues, resulting from the swelling around the site of infection, which is worsened by bacterial superinfection. During the initial phase, oedema, pain, and itching are obvious. Itching leads to scratching of the lesion, which in turn causes bacterial superinfection. Large abscesses are sometimes common. The feet are the most common point of infection, but infestation can occur in all parts of the body. Fissures, ulcers, swelling of the lymph nodes, deformation and loss of nails, and tissue necrosis are more severe complications. These result in pain, disability, disfigurement, and mutilation of the feet, causing characteristic changes in the way people with tungiasis walk. It causes severe discomfort and social stigma, particularly among children, and can lead to long-term cognitive impairment. Tetanus has also been linked to tungiasis in unvaccinated individuals. In a study, 10% of tetanus cases were found to have tungiasis as their point of entry. Tungiasis has a widespread impact but has remained largely neglected in global public health agendas. ¹^,²^,³

Extremely low income is a major risk factor for tungiasis. This includes living in a house with a sandy floor, not washing feet regularly, and not using soap when washing. In some communities, infection is linked to ownership of animals such as pigs and dogs. A long-lasting reduction in tungiasis can only be achieved through an approach that involves behavior change to increase soap use in daily feet washing, wearing shoes, spraying floors with insecticide or sealing them, treating animal reservoirs where they are infected, and treating infected humans. Also, regularly applying a repellent with a coconut oil base can effectively prevent the fleas from penetrating the skin and significantly reduce symptoms within 8–10 weeks. Addressing tungiasis as a public health issue can improve health, mobility, and quality of life in affected communities. ²

Sources

Guidelines for the treatment of tungiasis - PAHO/WHO | Pan American Health Organization [Internet]. 2025 [cited 2026 Jan 22]. Available from: https://www.paho.org/en/documents/guidelines-treatment-tungiasis.
Tungiasis [Internet]. [cited 2026 Jan 22]. Available from:
https://www.who.int/news-room/fact-sheets/detail/tungiasis.
Thomas S. Life Cycle and Transmission of Tungiasis: A Parasitic Infection. Journal of Bacteriology & Parasitology [Internet]. 2022 [cited 2026 Jan 22]; 13(6):21–2. Available from: https://www.walshmedicalmedia.com/.

Assessed and Endorsed by the MedReport Medical Review Board