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Pediculosis (Lice)

Kaelen C. Dunican, PharmD and Cynthia Jeremiah, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • A contagious parasitic infection caused by ectoparasitic blood-feeding insects (lice)

  • Two species of lice infest humans:

    • Pediculus humanus has two subspecies: the head louse (var. ca...

DIAGNOSIS

HISTORY

  • Pruritus is common, often worse at night.

  • Often associated with “outbreak” in school settings

  • Investigate contacts of infected individuals.

PHYSICAL EXAM

  • Diagnosis is confirmed by visuali...

TREATMENT

MEDICATION

Permethrin (over the counter [OTC]), synergized pyrethrin (OTC), spinosad (Rx), benzyl alcohol (Rx), malathion (Rx), and topical ivermectin (Rx) are all effective for head lice (1)...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Children may return to school after completing topical treatment, even if nits remain in place. No-nit policies are unnecessary. 

Patient Monitoring

Drug resistance...

REFERENCES

1
Devore CD, Schutze GE. Head lice. Pediatrics.  2015;135(5):e1355–e1365. [View Abstract on OvidMedline]
2
Burgess IF. Current treatments for pediculosis capitis. Curr Opin Infect Dis. ...

ADDITIONAL READING

SEE ALSO

Arthropod Bites and Stings; Scabies 

CODES

ICD10

  • B85.0 Pediculosis due to Pediculus humanus capitis

  • B85.1 Pediculosis due to Pediculus humanus corporis

  • B85.3 Phthiriasis

  • B85.2 Pediculosis, unspecified

  • B85.4 Mixed pediculosis and phthiriasis

ICD9

CLINICAL PEARLS

  • School-based no-nit policies are not necessary because empty nits may remain on hair shafts for months after successful eradication.

  • Proper product application is essential; improper pr...

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