LICE

Three different kinds of lice live on humans:

• Head lice are usually found in hair, most often on the back of the neck and behind the ears.
• Pubic lice, also called crabs, are usually found in the pubic area. But they may also be found on facial hair, on eyelashes, on eyebrows, in the armpits, on chest hair, and, rarely, on the scalp.
• Body lice live and lay eggs (nits) in the seams of clothing. The lice are on the body only when they feed.

Signs and symptoms of lice include:

• Intense itching.
• Tickling feeling from movement of hair.
• Lice on your scalp, body, clothing, or pubic or other body hair. Adult lice may be about the size of a sesame seed or slightly larger.
• Lice eggs (nits) on hair shafts. Nits resemble tiny pussy willow buds. Nits can be mistaken for dandruff, but unlike dandruff, they can’t be easily brushed out of hair.
• Small red bumps on the scalp, neck and shoulders.

DIAGNOSIS

During an examination, your doctor may examine you for lice using a magnifying lens and check for nits using a special light, called a Wood’s light, which makes the nits look pale blue.

Head lice

A diagnosis of head lice can be made after a live young or adult louse in the hair or on the scalp is found, or after one or more nits is seen on hair shafts located within 1/4 inch (6.4 millimeters) of the scalp.

Body lice

A diagnosis of body lice may be made if eggs or crawling lice are found in the seams of clothing or on bedding. It’s possible to see a body louse on skin if it crawls there to feed.

Pubic lice

Pubic lice are diagnosed when moving lice or nits are seen on hair in the pubic area or on other areas of coarse hair, such as chest hair, eyebrows or eyelashes.

RECOMMENDED MEDICATIONS

Use medications that treat lice only as directed. Applying too much can cause red, irritated skin.

Head lice

Treatment for head lice may involve:

• Over-the-counter products. Shampoos containing pyrethrin (Rid, others) or permethrin (Nix) are usually the first option used to combat lice infestations. These work best if you follow the directions very closely.
• Prescription medications. Malathion (Ovide) is a prescription medication that you apply to your hair and then rub into your hair and scalp. Malathion is flammable, so keep it away from heat sources such as hair dryers, electric curlers and cigarettes. If you’re pregnant or breast-feeding, talk to your doctor before using this product.
Benzyl alcohol lotion (Ulesfia) is a prescription treatment that you apply to the scalp and hair for 10 minutes and then rinse off with water.
Ivermectin lotion (Sklice) is a topical, single-dose treatment for head lice. You apply the lotion directly to dry hair and the scalp for 10 minutes and then rinse with water. Spinosad topical suspension (Natroba) is a newer prescription treatment for head lice. You apply the medication to dry hair and the scalp for 10 minutes and then rinse with water. Repeat the treatment after seven days only if live lice are still present. 
Finally, lindane is a prescription shampoo that’s sometimes prescribed when other measures fail.

Body lice

If you have body lice, you don’t need treatment. However, you must take the same self-care measures, such as treating clothing and other items, as you would for head lice. If self-care measures fail to get rid of the lice, your doctor might recommend trying one of the nonprescription or prescription treatments for head lice.

Pubic lice

Pubic lice can be treated with many of the same nonprescription and prescription treatments used for head lice.

Self-care important

Whether you use over-the-counter or prescription shampoo to kill lice, much of the treatment involves self-care steps you can take at home. These include making sure all the nits are removed and that all clothing, bedding, personal items and furniture are decontaminated. In most cases, killing lice on your body isn’t difficult. The challenge is getting rid of all the nits and avoiding contact with other lice at home or school.