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Bound by tradition: severe pediculosis capitis in a breastfeeding mother with religious headwear

Varun H1, Hanumanthaiah H C2, Adarshlata Singh1

  • 1Department of Dermatology, Venereology and Leprosy, Datta Meghe Institute of Higher Education and Health, Sawangi (Meghe), Wardha, India.

Skin Health and Disease
|November 28, 2025
PubMed

A 25-year-old breastfeeding woman from rural India presented with a 2-month history of intense scalp pruritus, formication and fever. Examination revealed a severe Pediculus humanus capitis infestation involving her scalp, face and religious headscarf, with extensive live lice, nits, pustules, excoriations, crusted papules and dermatopathic lymphadenopathy. Treatment with permethrin 1% lotion and weekly oral ivermectin for 4 weeks, in conjunction with broad-spectrum antibiotics and supportive care, resulted in near-complete eradication. This case represents one of the most severe presentations of pediculosis capitis documented, demonstrating how cultural practices can impede early detection and complicate management.

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