Pediculosis (Lice)
Symptoms
Head lice cause itching of the scalp, especially at the nape and behind ears. Inspection reveals live lice or ova (nits) attached to hair shafts. Body lice create itchy red bumps on the trunk and seams of clothing may harbor insects. Pubic lice produce intense itching in the groin and can infest eyelashes. Scratching leads to excoriations and secondary infection.
Cause
Pediculosis results from infestation with Pediculus humanus capitis (head), Pediculus humanus corporis (body), or Pthirus pubis (pubic). Transmission occurs via direct contact, shared combs, hats, bedding, or sexual activity in the case of pubic lice. Lice feed on blood several times daily, injecting saliva that causes itching. Poor hygiene and crowded conditions favor body‑louse infestation. Nits hatch in about 7‑10 days, perpetuating the cycle without treatment.
Treatment
Topical pediculicides such as permethrin 1% or pyrethrin are applied to affected areas and repeated after one week. Nit combing removes eggs and improves cure rates. Oral ivermectin is useful for resistant cases or heavy infestations. Washing clothing and bedding in hot water or sealing items prevents reinfestation. Sexual partners of patients with pubic lice should be treated concurrently.
Dr. Beth Schulz-Butulis
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