Got parasites? What you need to know about lice and scabies

Ok, I know you’ve been dreading this week’s post, but I promised you a post about the P word – PARASITES! If you have are a human who has any contact with other humans (especially kids), you should know about lice and scabies.

Remember when you were in grade school and the nurse lined you up in the hallways and used those very high-tech tongue depressors to methodically scan each fiber of hair on your head? Well, she was scanning for evidence of head lice which is just one form of parasite that is transmitted by human-to-human contact. In addition to head lice, there are also body lice and pubic lice.

All forms of lice lay eggs – head lice attach their eggs to the shaft of the hair, usually at the scalp; body lice leave their eggs on clothing; pubic lice usually lay their eggs deep in coarse hair, which is why they are also sometimes found in eyebrows, beard, chest and armpit areas. (I know this conversation isn’t fun, but the best prevention is education, so don’t stop reading).

Contrary to popular belief, animals like dogs and cats do not play a role in the infestation and transmission of lice. Head lice are spread via person-to-person contact; especially in school-age children because they are excessively close. It can also be transmitted via sharing headgear such as helmets and hats.

Body lice are usually associated with people living in close quarters who also have poor hygiene. They are not only spread from person to person but can also infest clothing, towels and bed linens. In the U.S., body lice are very uncommon due to regular bathing and laundering clothing.

Pubic lice, also known as “crabs,” are generally spread through sexual contact. A common misconception is that pubic lice can be transmitted via public toilet seats. Not true.

So, now that I’ve thoroughly freaked you out, I will fill you in on the signs and symptoms. Although they can be visible with the naked eye, the first presenting symptom is usually persistent itching. For head lice, the itching will occur in the scalp and more so at night when lice become more active. For body lice, the itching can occur anywhere on the body (except the head and genitals which would signify head lice or pubic lice respectively). Pubic lice cause intense itching in the groin and genital area. The itching may be accompanied by local redness and inflammation.

Treatment of lice infection varies based on the locale of the little suckers. Head lice can be treated with over-the-counter or prescription medication. You’ll want to make sure that a physician or school nurse confirms the diagnosis before you give any child medication. In addition, retreatment is usually suggested because any eggs that are laid during the initial treatment may not be killed by the medicine and therefore will infect the scalp once they hatch. Antihistamines, either topical or oral, can help the itching and make sleep less difficult. Examining and prophylactially treating close contacts of a person with lice is essential in ensuring complete elimination.

Other non-pharmacologic methods of eliminating head lice include washing hats, scarves, hoodies and other clothing on the hot cycle of your washing machine because five minutes of exposure to 130 degrees will kill the nits. Any items that cannot be laundered can be sealed in ziplock bags and stored away for two weeks before wearing again. Personal use items such as combs, brushes, razors can either be soaked in hot water (at least 130 degrees) or if possible, discarded. Finally, vacuuming and laundering bed linens will ensure complete annihilation of the lice and their eggs.

The best treatment for body lice is improving personal hygiene and regularly laundering bed linens and clothing. If medications are used, the guidelines are the same as for the treatment of head lice.

Pubic lice require treatment with medication. Some of the medicine for pubic lice can be highly toxic and therefore should be used with great caution and under the supervision of a professional. The same rules apply regarding laundry and personal hygiene. Of note, those diagnosed with pubic lice should also be tested for other sexually transmitted infections.

The other white meat version of parasitic infection is the dreaded scabies. This parasite is a mite that burrows under the skin and causes intense itching and a pimply rash. It usually goes for skin folds such as the webspaces between fingers, armpits, elbow creases, even the groin. As the mite crawl, it will create a raised, linear type irritation. Persistent scratching at the rash can cause local irritation and even sores.

Like lice, scabies is transmitted from prolonged skin-to-skin and sexual contact with an infected individual. Since the mites cannot live away from the human body for longer than three days, it is uncommon (though not impossible) for scabies to be transmitted via animals, swimming pools or toilet seats. Infestations usually occur in close living quarters or high-occupancy buildings such as nursing homes and prisons. Daycare and childcare facilities are also high risk for scabies outbreaks.

Once diagnosed by a professional, the treatment of scabies includes potentially toxic topical medication. The administration of these medicines should be done very carefully. The creams and shampoos need to be applied and removed in a particular manner, so the pharmacist’s instructions need to be followed closely to avoid complications.

Decontaminating household linens, clothing and personal items is essential, as is treating all close contacts and sexual partners of those infected with scabies. Also, as with lice, retreatment may be necessary if the rash and itching persists beyond two weeks after treatment.

When I sat down to compose this post, I was comfy in my sweats, sitting on my couch while my kiddies played nearby. Now, I find myself inadvertently scratching my head and in between my fingers, having definitely freaked myself out!

Now that we have reviewed all the vicious viruses, bacteria and parasites that human beings so kindly share this time of year, next week we can return to some lighter material that won’t send you scratching. Any questions or suggestions for posts are always welcome in my inbox!

Have a most pleasant and parasite-free weekend!

Alexis Hugelmeyer, D.O. is the wife of Michael, mother of Isabella, 5, and Lance, 2, and a family physician whose passion is hands-on manipulation for treatment and healing of any and every type of medical problem. She is administrative director of medical education and internship director at Peconic Bay Medical Center and also a private practitioner in Riverhead. A graduate of Villanova University and New York College of Osteopathic Medicine, she lives in Baiting Hollow.

Look for Dr. Mom every Saturday on Riverheadlocal.com

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