eMedicine Specialties > Emergency Medicine > Infectious Diseases

Pediculosis: Follow-up

Author: Nelly Rubeiz, MD, Consulting Staff, Department of Dermatology, American University of Beirut Medical Center; Associate Professor, Department of Dermatology, American University of Beirut, Lebanon
Coauthor(s): Abdul-Ghani Kibbi, MD, Chairman and Professor, Department of Dermatology, American University of Beirut Medical Center, Lebanon
Contributor Information and Disclosures

Updated: May 5, 2009

Follow-up

Further Outpatient Care

  • Shaving of the scalp or body hair eradicates lice; however, this is not cosmetically acceptable for most patients.
  • Wet combing or application of diluted vinegar or commercial preparations of 8% formic acid may help in the removal of nits or at least make the combing easier. Plastic or the sturdier metal nit combs may be used.
  • Multiple lice suffocation agents have been advocated, but most have not been scientifically evaluated. These include Vaseline; petroleum jelly; oils; mayonnaise; and a dry-on, suffocation-based pediculicide lotion (DSP lotion).
  • Treatment of the patient's environment is important.
    • Fomites (clothes, towels, beddings, hats, children's stuffed animals) should be washed in hot water, machine-dried, ironed, or dry cleaned. Temperature exceeding 131°F (55°C) for more than 5 minutes kills eggs, nymphs, and mature lice.
    • Combs are hair brushes should be discarded, soaked in very hot water (>131°F or 55°C), or treated with pediculicides.

Deterrence/Prevention

  • All household members should be examined and treated at the same time if infested.
  • Safe sex practices may decrease the risk of STDs.

Complications

  • Persistent pruritus
  • Secondary bacterial infection

Prognosis

  • Pediculosis has more than a 90% cure rate with appropriate treatment.
  • Treatment failures are the result of improper application of pediculicides, noncompliance, reinfestation, or drug resistance.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Lindane (Kwell) should be properly used. Seizure may result from abnormal absorption and gross overuse of the product.

Special Concerns

  • Pubic lice in children may be an indication of sexual abuse.
 


More on Pediculosis

Overview: Pediculosis
Differential Diagnoses & Workup: Pediculosis
Treatment & Medication: Pediculosis
Follow-up: Pediculosis
Multimedia: Pediculosis
References
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References

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Further Reading

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Keywords

pediculosis, lice, lice infestation, Pediculus humanus capitis, head louse, head lice, Pediculus humanus corporis, body louse, body lice, Pthirus pubis, pubic louse, pubic lice, lice eggs, nits, typhus, trench fever, relapsing fever, cervical lymphadenopathy, conjunctivitis, human immunodeficiency virus, HIV, syphilis, gonorrhea, chlamydia, genital herpes, trichomonas

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Contributor Information and Disclosures

Author

Nelly Rubeiz, MD, Consulting Staff, Department of Dermatology, American University of Beirut Medical Center; Associate Professor, Department of Dermatology, American University of Beirut, Lebanon
Nelly Rubeiz, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Coauthor(s)

Abdul-Ghani Kibbi, MD, Chairman and Professor, Department of Dermatology, American University of Beirut Medical Center, Lebanon
Disclosure: none None None

Medical Editor

David A Peak, MD, Assistant Residency Director of Harvard Affiliated Emergency Medicine Residency, Attending Physician, Massachusetts General Hospital; Consulting Staff, Department of Hyperbaric Medicine, Massachusetts Eye and Ear Infirmary
David A Peak, MD is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, Society for Academic Emergency Medicine, and Undersea and Hyperbaric Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Jeter (Jay) Pritchard Taylor III, MD, Compliance Officer, Attending Physician, Emergency Medicine Residency, Department of Emergency Medicine, Palmetto Health Richland, University of South Carolina; Medical Director, Department of Emergency Medicine, Palmetto Health Baptist
Jeter (Jay) Pritchard Taylor III, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Pamela L Dyne, MD, Professor of Clinical Medicine/Emergency Medicine, David Geffen School of Medicine at UCLA; Attending Physician, Department of Emergency Medicine, Olive View-UCLA Medical Center
Pamela L Dyne, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

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