Identification and management of pediculosis

Currently, pediculosis affects 6-12 million persons in the United States each year, and this number continues to rise. Social stigma and persistent misconceptions complicate the implementation of appropriate management strategies. Diagnosis is made on the basis of finding nits (i.e., silvery-white eggs firmly attached to the hair shaft), concentrated on the crown, behind the ears, and at the nape of the neck. Transmission occurs by direct contact with an infested person or indirectly by contact with clothing, personal grooming articles, bedding, or upholstered furniture containing viable nits or lice. Although three chemical agents are currently available, permethrin 1.0% (Nix Creme Rinse) is the treatment of choice. Environmental treatment is also necessary for the eradication of the infestation. Health care personnel who come into contact with this population need to be well informed of the facts in order to disseminate accurate information for diagnosis and management.