Body lice are usually seen in people who are living in overcrowded, unsanitary conditions or in people with very poor health habits. The lice live in the parts of the body that have hair, while their eggs live in clothing. Lice usually spread through contaminated bed linens or clothing. Scabies are not associated with poor health habits, and spread from one person to another though skin contact.
Treatment for Body Lice
The treatment for body lice must include treating the infection along with preventing the same infection from happening again, as explained by Dean Morrell, M.D., Director of Pediatric and Adolescent Dermatology at the University of North Carolina in "Tintinalli's Emergency Medicine: A Comprehensive Study Guide." Physicians recommend people use permethrin because it kills both the lice and the eggs. A medication called lindane can be used, but it does not kill the eggs. People who have severe itching may need a corticosteroid applied to the skin or an antihistamine in liquid or pill form.
Prevent Reinfestation of Body Lice
Dr. Morrell writes in "Tintinalli's Emergency Medicine" that everyone in close contact with the person who has body lice must be examined. This may include family members, roommates, classmates, adults and children at day care centers, and health care workers. The family must, therefore, notify the day care center and/or the school. Bed linens, hats and clothing must be washed in hot water or thrown out if they are infested with eggs. After washing, the clothing must be in the dryer on the high heat temperature and then, all seams should be ironed. There must be a thorough vacuuming of all chairs, sofas and carpets.
Treatment for Scabies
Adults and older children can use permethrin or lindane, covering their whole body from the neck downwards, leaving it on for eight to 14 hours before washing it off, and reapplying seven days later. People may use sulfur in petrolatum, but they must use it for three days. Physicians sometimes prescribe ivermectin when there is an epidemic or when people do not get better with permethrin or lindane, writes James Dinulos, M.D., Assistant Professor of Medicine and Pediatrics at the Dartmouth-Hitchcock Clinic in "The Merck Manual for Healthcare Professionals." Young children and infants need permethrin on their head and neck, carefully avoiding the eyes and mouth. Parents should put mittens on the infant so permethrin does not get in the mouth. Close contacts must be examined, and bed linens and clothing must be washed.
Precautions About Lindane
Dr. Dinulos writes in "The Merck Manual for Healthcare Professionals" that parents should not use lindane on children younger than two years old because it is toxic to the nervous system. For this same reason, people with seizure disorders should not use lindane. More precautions about lindane are written in "Current Diagnosis & Treatment: Emergency Medicine" by Ben Chlapek, D.O., of the Department of Emergency Medicine at Scott and White Memorial Hospital. Dr. Chlapek advises that children younger than 10 years old, the elderly, those with an impaired immune system, pregnant women and women who are breastfeeding should not use this medication because it can be toxic to the nerves.
References
- "Current Diagnosis & Treatment: Emergency Medicine"; C. Keith Stone, M.D., Roger Humphries, M.D.; 2008
- The Merck Manual for Healthcare Professionals: Scabies
- "Tintinalli's Emergency Medicine: A Comprehensive Study Guide"; Judith Tintinalli, M.D., Gabor Kelen, M.D. et al.; 2004
