Pediculosis

Pediculosis refers to an infestation of lice – flat, wingless insects that live on humans and may cause symptoms such as itch. Pediculosis capitis (head lice) is most common in children. Patients generally present with intense itching on the scalp. Lice may be identified visually, and nits or eggs will be visible along the hair shaft. Nits are firmly rooted to the hair and are not easily slid along the shaft. Treatment is with 1% permethrin lotion, ivermectin lotion, isopropyl myristate, and others. All treatments must be reapplied after 1 week because they cannot kill the eggs. Lice and nits should be physically removed from the hair as much as possible.  Some children may require cutting or shaving the hair to allow for easier treatment. Pediculosis corporis (body lice) do not actually live on the skin or hair, but live in the seams of clothing and only move to the skin to bite for food. The lice may live in clothing for up to a month between meals, so infected clothing must be treated with high heat and not simply placed aside. Washing clothing and placing them in a hot dryer for 30 minutes or ironing is effective treatment. Pediculosis pubis (crab lice) are seen in pubic hair and less often in the thicker hairs on the chest, axilla, and eyelashes. They are spread through close physical contact, most commonly sexual. Treatment is as with head lice; sexual partners should be treated as well. Eyelashes can be treated with petrolatum twice daily for 8 days.