Lice and Scabies Flashcards
Explain the life cycle of lice.
male + female louse–>egg–>nymph–>adult louse
-female lice survive for 1-3 months and lay 5-10 eggs per day
-nymphs emerge after 6-10 days
-nymphs undergo 3 molts over 10 days
In which group of people do we most commonly see lice?
young children
What are the most probable routes of lice transmission?
head-to-head contact (vast majority of cases)
beds
towels
hats
combs/brushes
True or false: lice jump to a new host
false
they dont have wings
True or false: lice prefer dirty hair, thus excessive shampooing will help prevent your child from getting lice
false
clean or dirty hair, lice dont care
True or false: it is highly unlikely to get lice from your pet or on the back of couches
true
Differentiate between nits and lice.
nits:
-the eggs
-immobile (glued to one spot)
-typically laid closely to the scalp for warmth
-they do not wash out (shampoo or combs will do niche)
lice:
-living
-little bugs
What are the symptoms of lice?
it can vary from nothing to itching
-itching typically occurs behind the ears or back of neck
because
-the nits like the warmth in these spots
What was the original insecticide used for lice?
GBH/lindane (original Kwellada)
-agricultural chemical
Why was GBH/lindane (original Kwellada) taken off the market?
it was totally safe for head lice but people overused it for scabies
head lice: used as a shampoo for 8 minutes to kill lice
scabies: Kwellada needed for 8-12hrs from head to toe, some
people used for months on end which caused
neurological disorders
List off all the lice treatments. (that are currently available)
pyrethrins/pb
permethrin
Nyda
isopropyl myristate
anista/coconut oil
List off characteristics of the pyrethrins/pb treatment.
apply to dry hair
shampoo for 10 minutes
repeat in 7 days
removes nits
resistance is possible
Where do pyrethrins come from?
chrysantheum plant extract
What is the point of adding piperonyl butoxide to the pyrethrin treatment?
pb is a potency enhancer, it helps pyrethrins last longer or get into the bodies of lice better
True or false: GBH is safer than pyrethrin
false
What are the side effects of the pyrethrin treatment?
almost none, maybe some local reactions
Jeff says he never discusses any side effects
What is one of the popular pyrethrin/pb treatments?
R & C
R & C II Spray is an insecticide that is promoted to kill lice on furniture, bedding, mattresses, etc. What do we make of this product?
not needed in the vast majority of lice cases
lice do not want to live on spots like the couch
How is permethrin made?
it is a synthetic pyrethroid made in the lab
relative of pyrethrins
True or false: permethrin is not safe in children
false
very safe
List off characteristics of the permethrin treatment.
wash hair with regular shampoo
add creme rinse for 10 minutes
rinse out
repeats not needed (though it cant hurt to repeat)
nit removal
resistance is possible
What are the popular permethrin treatments?
Nix
Kwellada-P
What are the pediculosides?
permethrin
pyrethrins/pb
lindane
True or false: you should never use the word “pediculoside” when talking with a parent who needs lice treatment for their kid
true
this can scare the parent
What are the physical agents for lice treatment?
SH-206 (Jeff said it was ahead of its time, wont see it)
isopropyl myristate (10 min, nit pick, repeat in 7d)
coconut/anise oil (15min, nit pick, repeat in 9d, not behind counter)
dimethicone (10min+nit comb time, nit pick, re-apply prn)
True or false: the shampoo alone can get rid of nits
false
nit combing needed as well
Which physical agent is probably a solid option to pick?
Nyda (dimethicone)
List off some characteristics of Nyda.
contains dimethicone
penetrates lice/egg breathing system
death of lice and eggs within 58s
30 min of contact then start nit-combing with product still in hair
product will dry
then 8hr of contact
re-check in 8-10d
What are the directions for use of Nyda?
- spray all over hair (dry hair)
- massage until hair is completely wet then let sit for 30min
- comb hair with nit comb and leave the product on for 8hrs
- after 8hrs wash with any regular shampoo
What should be done if live lice are found in hair 24-48hrs after treatment?
we are suspecting insecticide resistance so try a different product
if its Nyda, try again
What are some of the popular “other” treatments?
bug-busting:
-no medicated shampoo, just lice comb every 3d
-failure is high
heat:
-you would have to set your hair on fire
-wont work
electrocution:
-unsure about efficacy
-supposed to be like bug zappers at a cabin
tea tree oil:
-we arent sure the concentration to give
dry-on-suffocation using lotion:
-probably the pre-cursor to Nyda
ivermectin
What are some things to expect with lice treatment?
the products arent that gross
the itch will stop in a few days
they work in ~10mins
kids can go back to school the next day
What are a few things you can do to clothes, bedding, hats, cloths, and toys for home control?
hot water and dry in the laundry machine
ironing
dry cleaning
freezer (complete overkill)
True or false: dipping a comb in vinegar will be enough to dissolve the glue on nits
false
you need the special combs
When are nits considered to be cosmetic?
when they are >1/2 inch from the scalp
True or false: body lice is not common in our part of the world
true
Which treatment is officially indicated for pubic lice?
pyrethrins/pb
the others are probably fine but the company didnt indicate it
What is suggested that you do if you have pubic lice?
shave
if shaved, no repeats of treatment are needed
What is scabies?
bug burrowing in the skin and laying eggs
What is the most common method of scabies transmission?
person-to-person contact
What is the treatment for scabies?
permethrin 5% dermal cream/lotion
head-to-toe
What is the main symptom of scabies?
itch
-the itch can persist for a few weeks after treatment
True or false: blind treatment of close contacts for scabies is not necessary
false
Which agent was probably the pre-cursor to many physical agents?
SH-206
-made up of essential oils, repeat every 2 days
Which physical agent is not behind the counter?
coconut/anise oil
Why should you not use a comb dipped in vinegar while using permethrin?
vinegar can neutralize the activity of permethrin
Where are scabies pre-dominantly found?
between fingers and on wrist
