RTS - Headlice, Scabies Flashcards
What causes headlice?
caused by louse
- tiny grey/brown insects
they lay eggs at the base shaft of hair
- nits = empty white shells
What are the symptoms of headlice?
itchy scalp
- allergic reaction of the scalp to the saliva of the lice
What are the questions for headlice?
have lice been seen? - check via dry/wet combing presence of empty white shells - not an indicator of failed treatment is there itching - not always itching - can take up to 3 months for itching to develop
What are the detection methods for lice?
wet hair combing
- wash hair as normal, apply conditioner, untangle, use detection comb from the scalp to ends of hair, check for lice after each stroke, rinse and repeat
dry hair combing
- untangle hair, use detection comb from scalp to ends of hair, comb each section 3-4 times, check for lice by holding thumb to comb to trap lice, comb whole hair
What are differential diagnosis for headlice?
dandruff - itching and irritation all over the scalp - scalp is usually dry and flaky - skin debris is sometimes visible treatment = nizoral (ketoconazole)
seborrhoeic dermatitis
- affects other areas = face and napkin area
- infants can have large crust on scalp = cradle cap
What are practical measures for headlice?
do not need to stay home - children avoid scratching hair detection combing after eradication - wet combing 2-3 days after then 8-10 days after not associated with dirty hair
What are the treatment for headlice?
dimethicone 92% spray, 4% lotion and 4% gel isopropyl myristate cyclomethicone solution isopropyl myristate vamousse coconut, anise and ylang ylang spray - CAY = natural alternative permethrin - resistance has built up in the UK wet combing
How does dimethicone treatment work?
dimethicone - Hedrin
- over 2 years only
- reapply 7 days after to remove unhatched eggs, and kill remaining lice = lotion
- spray 92% - apply on dry hair, work through the hair, leave to dry naturally, leave on for 12 hours, rinse and comb
- lotion 4% - apply on dry hair, work through the hair, leave to dry naturally, leave on for 8 hours, rinse and comb
- gel 4% - apply on dry hair, work through the hair, leave to dry naturally, leave on for 15 mins, rinse and comb
How does isopropyl myristate work?
isopropyl myristate cyclomethicone solution
- over 2 years only
- reapply 7 days if any lice remain after checking
- full marks solution
- apply to dry scalp and leave for 10 minutes
- dissolves the outer coating, dehydrating and killing them but does not kill eggs so must comb through the hair
isopropyl myristate vamousse
- contains alcohol and is flammable
- lack of trial data on use
How does malathion work?
Prioderm, Suleo-M
- use for infants over 6 months
- okay for breastfeeding
- apply to dry hair, leave for 12 hours , comb through and wash
- reapply 7 days if any lice remain after checking
How does wet combing work?
uses bug busting comb and method
- removes lice without using lotion to kill them
- needs to be repeated at least 4 times every 4 days over 2 weeks
must be done on every family member
Why might there be treatment failure for headlice?
inadequate quantity of insecticide no live lice at time of treatment poor technique no repeat application - unhatched eggs hatch and reproduce resistance short contact time with insecticide re-infection by close contact
How does CAY work?
apply to dry hair and leave for 15 minutes
comb out the hair and wash
repeat after 7 days to remove hatched eggs
What are prescribing issues with headlice?
Malathion
Prioderm and Suleo-M should not be prescribed for asthmatics or small children as it contains alcohol
- fumes can precipitate asthma
- skin reactions can occur
What causes scabies and where is it found?
scaroptes scabies - parasite
- results in pruritic infection = scratching
takes place in the finger webs, sides of fingers and wrists
