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American Family Physician Jan 2004Pediculosis and scabies are caused by ectoparasites; patients usually present with itching. Head and pubic lice infestations are diagnosed by the visualization of... (Review)
Review
Pediculosis and scabies are caused by ectoparasites; patients usually present with itching. Head and pubic lice infestations are diagnosed by the visualization of insects or viable nits (eggs). Primary treatment is topically administered 1 percent permethrin. Malathion is one alternative for treatment failures. The importance of environmental measures to prevent infestation is a matter of controversy. Pubic lice are treated the same as head lice, but this finding should prompt evaluation for other sexually transmitted diseases. Body lice infestation should be suspected when symptoms of generalized itching occur in persons who do not change or wash their clothing or bedding regularly; lice may be found in the seams of their clothing. Topically administered permethrin may help to eradicate body lice, but personal hygiene measures are essential for successful treatment. Classic scabies in adults can be recognized by a pruritic, papular rash with excoriations; in infants, small children, and the immunocompromised, the rash may include vesicles, pustules, or nodules. Primary treatment for scabies is permethrin cream and environmental measures are important to prevent recurrent infestation. Generalized crusted scabies is best treated with oral ivermectin.
Topics: Humans; Lice Infestations; Scabies
PubMed: 14765774
DOI: No ID Found -
BMJ Clinical Evidence Jan 2009Head lice can only be diagnosed by finding live lice, as eggs take 7 days to hatch and may appear viable for weeks after death of the egg. Infestation may be more likely... (Review)
Review
INTRODUCTION
Head lice can only be diagnosed by finding live lice, as eggs take 7 days to hatch and may appear viable for weeks after death of the egg. Infestation may be more likely in school children, with risks increased in children with more siblings, longer hair, and of lower socioeconomic group.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for head lice? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2008 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 15 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: dimeticone, herbal and essential oils, insecticide combinations, lindane, malathion, mechanical removal by combing ('bug busting'), oral trimethoprim-sulfamethoxazone (co-trimoxazole, TMP-SMX), permethrin, phenothrin, and pyrethrum.
Topics: Administration, Oral; Animals; Humans; Lice Infestations; Malathion; Pediculus; Permethrin; Scalp Dermatoses; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination
PubMed: 19445766
DOI: No ID Found -
Parasitology Research May 2021Head lice (Pediculus humanus capitis) are worldwide obligate human ectoparasites, with high implications in pediatrics. In Europe, first-line topical neurotoxic...
Head lice (Pediculus humanus capitis) are worldwide obligate human ectoparasites, with high implications in pediatrics. In Europe, first-line topical neurotoxic insecticidal therapeutic strategies are being replaced by topical physically acting agents as the first-choice treatment. Safety of the active ingredients and high efficacy in a one-time single-dose treatment with a brief treatment application time are key issues for consumer use and effective compliance. The aim of this study was to assess the in vitro efficacy of a newly developed squalane and dimethicone-based pediculicidal formula, against motile head lice and eggs after 2 and 5 min immersion in the product, as well as its skin tolerance and acceptability under dermatological and pediatric expert control in children with atopic skin. The results indicate that at both time points, 100% mortality rate of head lice crawling stages and late-stage eggs was achieved. The formula was well tolerated and suitable for children with atopic skin from 12 months of age. Showing high in vitro efficacy and good skin acceptability, this solution is presented as a new safe alternative therapy for treatment of head lice infestations.
Topics: Animals; Child, Preschool; Dimethylpolysiloxanes; Europe; Female; Humans; Infant; Insecticides; Lice Infestations; Male; Pediculus; Skin; Squalene
PubMed: 33797611
DOI: 10.1007/s00436-021-07113-y -
American Family Physician Sep 2012Pediculosis and scabies are caused by ectoparasites. Pruritus is the most common presenting symptom. Head and pubic lice infestations are diagnosed by visualization of... (Review)
Review
Pediculosis and scabies are caused by ectoparasites. Pruritus is the most common presenting symptom. Head and pubic lice infestations are diagnosed by visualization of live lice. Finding nits (louse egg shells) alone indicates a historical infestation. A "no nit" policy for schools and day care centers no longer is recommended because nits can persist after successful treatment with no risk of transmission. First-line pharmacologic treatment of pediculosis is permethrin 1% lotion or shampoo. Multiple novel treatments have shown limited evidence of effectiveness superior to permethrin. Wet combing is an effective nonpharmacologic treatment option. Finding pubic lice should prompt an evaluation for other sexually transmitted infections. Body lice infestation should be suspected when a patient with poor hygiene presents with pruritus. Washing affected clothing and bedding is essential if lice infestation is found, but no other environmental decontamination is necessary. Scabies in adults is recognized as a pruritic, papular rash with excoriations in a typical distribution pattern. In infants, children, and immunocompromised adults, the rash also can be vesicular, pustular, or nodular. First-line treatment of scabies is topical permethrin 5% cream. Clothing and bedding of persons with scabies should be washed in hot water and dried in a hot dryer.
Topics: Antiparasitic Agents; Bedding and Linens; Clothing; Drug Combinations; Evidence-Based Medicine; Humans; Insecticides; Ivermectin; Laundering; Lice Infestations; Macrolides; Permethrin; Pruritus; Pyrethrins; Scabies; Sexually Transmitted Diseases
PubMed: 23062045
DOI: No ID Found -
International Journal of Dermatology Mar 2021Head louse infestations continue to be a concern of public health in most countries, including the most developed ones. The present recommendations are intended to... (Review)
Review
Head louse infestations continue to be a concern of public health in most countries, including the most developed ones. The present recommendations are intended to inform and stress the role and impact of the different authorities, institutions, industry, and the public in the control of head lice in order to reduce the prevalence of this parasite. We encourage health authorities to pursue more effective methods to correctly identify such infestations, and evaluate existing and new pediculicides, medical devices, louse repellents, and louse- and nit-removal remedies. Pediculicides and medical devices must have verifiable claims in the instructions for use and should be tested periodically to document current levels of resistance by lice to the active ingredients and to the formulated products. Where the prevalence of lice is claimed to be epidemic, children should be periodically evaluated objectively to document the actual level of prevalence. Continuing education for health providers and the general population promises to correct misinformation regarding the biology, prevention, and management of lice. Parents should regularly inspect their children for head lice and treat as necessary. Health authorities are encouraged to eliminate policies and practices that rely upon school exclusion as a means to reduce incidence and prevalence, e.g., the 'no-nit' policy which lacks scientific justification, and are counterproductive to the health and welfare of children.
Topics: Animals; Child; Humans; Lice Infestations; Pediculus; Prevalence; Public Health; Scalp Dermatoses; Schools
PubMed: 32767380
DOI: 10.1111/ijd.15096 -
Journal of Biology 2009Although most epidemic human infectious diseases are caused by recently introduced pathogens, cospeciation of parasite and host is commonplace for endemic infections.... (Review)
Review
Although most epidemic human infectious diseases are caused by recently introduced pathogens, cospeciation of parasite and host is commonplace for endemic infections. Occasional host infidelity, however, provides the endemic parasite with an opportunity to survive the potential extinction of its host. Such infidelity may account for the survival of certain types of human lice, and it is currently exemplified by viruses such as HIV.
Topics: Animals; Biological Evolution; Hominidae; Host-Parasite Interactions; Humans; Lice Infestations; Phthiraptera; Primate Diseases; Time Factors
PubMed: 19232074
DOI: 10.1186/jbiol114 -
Family Practice Feb 2016Health providers need to know which measures to take and children to prioritize in order to decrease costs associated with head lice infestations.
BACKGROUND
Health providers need to know which measures to take and children to prioritize in order to decrease costs associated with head lice infestations.
OBJECTIVE
Our aim was to determine the most important predictors for head lice and identify the major drivers of an infestation outbreak in a low-prevalence area.
METHODS
The study was based on three datasets of head lice prevalence (retrospective, point prevalence and prospective approach) from primary school children (ages 6-12) at 12 schools in Oslo, Norway. The tested predictors were siblings with lice, individual and household characteristics as well as class and school affiliation. Self-reported monthly incidences (prospective approach) of head lice were used to evaluate infestation dynamics.
RESULTS
Infested siblings strongly increased the odds of head lice infestation of school children (odds ratio 36, 26 and 7 in the three datasets) whereas having short hair halved the odds. Household characteristics were of minor importance, and class affiliation proved more important than school affiliation. Having head lice in one school term increased the odds of an infestation in the next, but this effect diminished over time. About 97% of all self-reported infestations were noted in two consecutive months or less.
CONCLUSIONS
With the exception of hair length, we have found that individual and household characteristics are of minor importance to predict head lice infestations in a low-prevalence country and that unnoticed transmissions in school classes and families are likely to be the major driver upon outbreaks.
Topics: Animals; Child; Disease Outbreaks; Family Characteristics; Female; Humans; Incidence; Lice Infestations; Logistic Models; Male; Multilevel Analysis; Norway; Odds Ratio; Pediculus; Peer Group; Prevalence; Prospective Studies; Retrospective Studies; Risk Factors; Scalp Dermatoses; Schools; Siblings; Socioeconomic Factors; Surveys and Questionnaires
PubMed: 26511728
DOI: 10.1093/fampra/cmv081 -
The Korean Journal of Parasitology Oct 2019Head-lice infestation, pediculosis capitis, remains a public-health burden in many countries. The widely used first-line pediculicides and alternative treatments are...
Head-lice infestation, pediculosis capitis, remains a public-health burden in many countries. The widely used first-line pediculicides and alternative treatments are often too costly for use in poor socio-economic settings. Ivermectin has been considered an alternate treatment for field practice. This study was composed of 2 parts, a cross-sectional survey and an intervention study. The main objectives were to determine the prevalence and potential factors associated with head-lice infestation, and to evaluate the effectiveness and safety of oral ivermectin administration. A community-based cross-sectional survey was conducted among 890 villagers in rural areas along Thai-Myanmar border. Females with infestations were eligible for the intervention study, and 181 participated in the intervention study. A post-treatment survey was conducted to assess acceptance of ivermectin as a treatment choice. Data analysis used descriptive statistics and a generalized-estimation-equation model adjusted for cluster effect. The study revealed the prevalence of head-lice infestation was 50% among females and only 3% among males. Age stratification showed a high prevalence among females aged <20 years, and among 50% of female school-children. The prevalence was persistent among those with a history of infestation. The major risk factors were residing in a setting with other infected cases, and sharing a hair comb. The study also confirmed that ivermectin was safe and effective for field-based practice. It was considered a preferable treatment option. In conclusion, behavior-change communication should be implemented to reduce the observed high prevalence of headlice infestation. Ivermectin may be an alternative choice for head-lice treatment, especially in remote areas.
Topics: Administration, Oral; Adolescent; Adult; Animals; Child; Female; Humans; Insecticides; Ivermectin; Lice Infestations; Male; Middle Aged; Pediculus; Rural Population; Thailand; Treatment Outcome; Young Adult
PubMed: 31715690
DOI: 10.3347/kjp.2019.57.5.499 -
Acta Dermatovenerologica Alpina,... Dec 2008Head lice infestation, or pediculosis capitis, caused by Pediculus humanus capitis, is a common health concern. In the US, where pediculosis capitis is the most... (Review)
Review
Head lice infestation, or pediculosis capitis, caused by Pediculus humanus capitis, is a common health concern. In the US, where pediculosis capitis is the most prevalent parasitic infestation of children, 6 to 12 million people are affected every year. Pediculosis capitis remains confined to the scalp. Scalp pruritus is the cardinal symptom, although patients with lice can be asymptomatic. Pruritus with impetiginization should prompt the physician to look for lice or viable nits. All close contacts should be examined. Treatment directed at killing the lice and the ova should be considered only if active lice or viable eggs are observed. The three fundamental effective treatment options for head lice are topical pediculicides, wet combing, and oral therapy. Spraying or fogging a home with insecticides or pediculicides is not recommended.
Topics: Animals; Child; Humans; Insecticides; Lice Infestations; Pediculus; Pyrethrins; Scalp Dermatoses
PubMed: 19104739
DOI: No ID Found -
Frontiers in Cellular and Infection... 2019is an obligate bloodsucking ectoparasite of human that includes two ecotypes, head louse and body louse, which differ slightly in morphology and biology, but have... (Review)
Review
is an obligate bloodsucking ectoparasite of human that includes two ecotypes, head louse and body louse, which differ slightly in morphology and biology, but have distinct ecologies. Phylogenetically, they are classified on six mitochondrial clades (A, B, C, D, E, and F), head louse encompasses the full genetic diversity of clades, while body louse belongs to clades A and D. Recent studies suggested that not only body louse, but also head louse can transmit disease, which warrants greater attention as a serious public health problem. The recent sequencing of body louse genome confirmed that has the smallest genome of any hemimetabolous insect reported to date, and also revealed numerous interesting characteristics in the nuclear and mitochondrial genomes. The transcriptome analyses showed that body and head lice were almost genetically identical. Indeed, the phenotypic flexibility associated with the emergence of body lice, is probably a result of regulatory changes, perhaps epigenetic in origin, triggered by environmental signals. Current lice control strategies have proven unsuccessful. For instance, ivermectin represents a relatively new and very promising pediculicide. However, ivermectin resistance in the field has begun to be reported. Therefore, novel opportunities for pest control strategies are needed. Our objective here is to review the current state of knowledge on the biology, epidemiology, phylogeny, disease-vector and control of this fascinating and very intimate human parasite.
Topics: Animals; Bacteria; Communicable Disease Control; Evolution, Molecular; Genome; Humans; Insect Vectors; Insecticide Resistance; Insecticides; Lice Infestations; Mitochondria; Pediculus; Phylogeny; Phylogeography
PubMed: 32039050
DOI: 10.3389/fcimb.2019.00474