Brief Answer:
There can be many parasites

Detailed Answer:
Hi
Thanks for your query.

Many parasites can be black in colour and survive on skin. Only way to know is a microbiological examination of the skin scraping. It may be demodex mite or some similar infestation. Topical creams may not be very helpful.

Since its a small parasite and is passing out of urine and poop also, I am guessing that you are getting it from drinking water. You may check by boiling your drinking water. If some organisms can be seen in it after boiling then its the cause and you will need to drink cleaner water in future.

Hope it helps. Let me know if I can assist you further.
Dr Vaishalee

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Brief Answer:
You lost weight because infestation is draining you out

Detailed Answer:
Hi again

I know having an infestation inside body is scary, especially after you lost so much weight.

But if you are able to find source of infestation, it can be cleared. You simply try drinking bottled water for some days and see if it clears the infestation. You can also ask for doctor to prescribe oral anti-parasitic medication like albendazole or mebendazole. It is a very safe medicine and is routine prescribed where parasitic infestations are common. It can even be given to children.

To apply on skin, I think Lindane lotion (gamma-BHC) would be better alternative then permethrin. Only take precaution not to apply it on face or near eyes and mouth.

Increasing immunity by regular exercise also helps. Also take healthy nutritious well cooked food, preferably vegetarian only. Avoid non-vegetarian foods as they may harboring parasites. Take more of milk and milk products like cheese, butter etc to gain weight.

Regards
Dr Vaishalee

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