Can house dust mite-triggered atopic dermatitis be alleviated using acaricides?

House dust mite (HDM) allergens are the most important triggers for atopic dermatitis. Reducing exposure to these allergens may alleviate clinical symptoms. Chemicals with acaricidal activity have been used to treat upholstered furniture, carpets and bedding with the aim to reduce HDM allergen exposure. These chemicals, by reducing HDM, can decrease the concentration of mite allergens in dust but improvements in clinical symptoms are not always apparent. Clinical improvement is more likely to occur if bedding has been treated rather than carpets and upholstery. Future control strategies should be aimed at treating bedding. Permethrin is a very efficient killer of mites. It is used topically to treat scabies and head lice and is impregnated in bed nets to prevent mosquito bites. Even when applied to the skin in high concentrations, it has a very low toxicity in humans and other mammals. Permethrin-impregnated bedding may prove to be the best control method in the treatment of HDM allergen-triggered atopic conditions.