Doctor's Notes on Lice (Head Lice, Body Lice, Pubic Lice)
Lice are gray-white or reddish-brown organisms about 2 mm to 3 mm in length. There are three major types of lice infestations in people: head lice, body lice, and pubic lice. Head lice can cause signs and symptoms of intense itching or a tickling feeling from the movement of hair. You may be able to see the lice and/or lice eggs (nits) attached to hairs by a sticky substance they secrete. Signs and symptoms of body lice include intense itching, red bumps on the skin, and thick and/or dark skin, usually near the waist or groin. Body lice do not live on the body or attach to skin or hair. They are often found in bedsheets or clothing and are larger than other lice. Signs and symptoms of pubic lice include intense itching in the genital area, lice crawling in the area or clinging to hair, and lice eggs attached to hairs. Almost all lice are visible without magnification.
Head lice feed on the blood from a human scalp, body lice feed on the skin and then detach themselves and live in bedding or clothing, and pubic lice live and feed in the groin area. They cause the signs and symptoms related to lice by their localized bites (blood meal) and debris (feces) on the skin. Rarely, body lice have caused epidemics of typhus and relapsing fever due to poor hygiene during wars, for example.
What Is the Treatment for Lice?
Treatment for lice is mainly with antiparasitic agents:
- Piperonyl butoxide
- Benzyl alcohol
- Isopropyl myristate
Usually, the antiparasitic can be purchased over the counter as lotions and/or shampoos. Because of resistance to some antiparasitics by lice, your doctor can suggest the best treatment for your infested area. Some people require more than one treatment. Additional treatment involves manually removing nits (lice eggs) from hair shafts, usually by repeated combing and hair brushing. Diphenhydramine can reduce itching.
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ScabiesScabies is a skin condition that causes severe itching. Scabies lesions on the skin may look like pimples, and the skin may also be red. Treatment involves washing all clothing and bed linens, vacuuming rugs and furniture, and applying a prescription cream to kill the mites.
Sexually Transmitted Diseases (STDs)Sexually transmitted diseases (STDs) are among the most common infectious diseases in the United States. STDs can be spread through any type of sexual activity involving the sex organs, the anus or mouth, or through contact with blood during sexual activity. Examples of STDs include, chancroid, chlamydia, gonorrhea, granuloma inguinale, lymphogranuloma venereum, syphilis, genital herpes, genital warts, hepatitis B, trichomoniasis, pubic lice (crabs), and scabies.Treatment is generally with antibiotics; however, some STDs that go untreated can lead to death.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.