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Lice and Scabies: Treatment Update.
Karen Gunning1, Bernadette Kiraly2, Karly Pippitt2
1University of Utah College of Pharmacy, Salt Lake City, UT, USA.
American Family Physician
|May 16, 2019
Summary
Pediculosis and scabies are common ectoparasitic infections. Effective treatments include permethrin, but counseling on proper diagnosis and therapy is crucial for managing these conditions.
Area of Science:
- Dermatology
- Parasitology
- Public Health
Background:
- Pediculosis (lice) and scabies are common ectoparasitic infestations.
- Pruritus is the primary symptom for both conditions.
- Diagnosis relies on identifying live parasites, not just nits or eggs.
Purpose of the Study:
- To review current understanding and management of pediculosis and scabies.
- To highlight diagnostic criteria and treatment recommendations.
- To emphasize the importance of patient counseling.
Main Methods:
- Literature review of diagnostic methods for lice and scabies.
- Analysis of first-line and alternative pharmacologic treatments.
- Evaluation of environmental and public health recommendations.
Main Results:
- Live lice visualization confirms pediculosis; nits alone do not.
- "No-nit" policies are discouraged.
- Permethrin 1% is the first-line treatment for pediculosis; permethrin 5% for scabies.
- Noninsecticidal agents show promise for pediculosis.
- Pubic lice warrant STI screening; body lice suggest poor hygiene or crowded conditions.
- Scabies presents with a characteristic rash, potentially vesicular in infants.
Conclusions:
- Accurate diagnosis and appropriate use of therapies are essential for controlling lice and scabies.
- Extensive environmental decontamination is unnecessary for pediculosis.
- Counseling is key to effective management and reducing disease burden.
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