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hile parasites are not considered a major problem for people in the United States, there are two types of similar organisms, which recently have caused virtual epidemics. These organisms – called ectoparasites – are lice and mites.
Infestations with lice (true insects) and mites (insect-like organisms) cause intensely itchy, annoying skin problems. Unless diagnosed and treated properly, these conditions can persist and eventually spread to family members, classmates, and friends.
Lice
Lice are small, wingless insects about one-eighth of an inch in length. They have been around for centuries and have flourished on both the rich and poor.
Associated with wars and disease in the Middle Ages, lice carry typhus, a disease which has been known to wipe out entire armies. They were extremely prevalent throughout the world until World War II, when DDT almost eradicated this annoying and dread pestilence. However, the ban on DDT as a hazardous substance, along with the increase in social contact and world travel, has contributed to a resurgence of louse infestation.
Today lice have become a major public health problem throughout the world. Aggravated by poor living conditions, lack of personal cleanliness, and overcrowding, this infestation has reached epidemic proportions. Lice are so common in Japan that pediculicides are distributed free in Japanese bathhouses.
The main symptoms of louse infestation – known technically as pediculosis – is a relentless, maddening itch caused by the saliva of the female louse.
There are three kinds of lice affecting three different body areas: head lice, pubic lice, and body lice. Although each type has a different shape, they all feed by biting the skin and sucking the blood.
The adult female louse lays eggs (nits), which she firmly attaches with a glue-like substance to hairs or to fibers of clothing. The eggs hatch in about ten days and reach maturity in about two weeks. Lice have a life span of about one month.
Head Lice
Except for the common cold, head lice is the most frequently occurring communicable disease among children in the United States. Head lice have become especially prevalent in recent years, particularly among school children in urban areas. They make their home in your hair, causing intense itching on your scalp, the back of your neck, and behind your ears, and, in severe cases, swollen lymph glands in your neck. For some reason, head lice are almost never seen in African-American people.
If you look closely, you can see the small, silvery egg cases attached to individual hair shafts. Usually these nits will be close to the scalp – no more than a half-inch from where the hair has emerged. Although they resemble dandruff, they are much more difficult to remove than dandruff flakes because of the sticky, cement-like substance the female louse secretes to attach the nits. Head lice are transmitted by direct contact, by personal items such as combs, brushes, and pillowcases, and through clothing such as hats, scarves, ribbons, and other head coverings. If one person in a family or classroom has head lice, there is a good possibility that others in the same home or class will have it, too.
If you have head lice, treatment is relatively simple and very effective. Kwell (the generic which is lindane), a prescription shampoo, will cure a case of head lice in five minutes. One shampoo for five minutes. That’s it! There are also non-prescription shampoos – RID, NIX, Pronto, Clear Lice Killing Shampoo – that work about as well.
After shampooing, you may still see eggs attached to the hair shafts, but these are now dead. To get rid of the unsightly but harmless dead nits, apply dilute vinegar (one-half vinegar and one-half water) to your scalp to loosen them and then back comb with a fine-tooth comb.
Lice that fall off the hair cannot survive longer than 2 or 3 days. Nits, however, can remain viable for up to two weeks off a human host.
To prevent the spread of lice, thoroughly wash all articles of clothing that are suspected of having nits or adult lice.
Pubic Lice (“Crab” Lice)
Pubic lice infestation – commonly called “crabs” – is a highly contagious, sexually transmitted disease. There has been a steady increase in its incidence, with about 2 million new cases a year. For some reason, “crabs” are more common in females between the ages of 15 and 19, and more common in males over the age of 20.
Usually you get pubic lice through sexual or other close physical contact, but they are also transmitted by just sharing a bed or wearing the clothes of an infested person, and even – rarely – from toilet seats!
The usual symptom of pubic lice is a maddening itch (especially at night), that scratching doesn’t relieve. Like head lice, the nits of pubic lice are usually glued in clusters to the short hair shafts and resemble the flakes of dandruff. Crabs usually set up housekeeping in the pubic region, but during warm, dark, and quiet periods, the adult female lice – along with their eggs – migrate to other short-haired areas of the body – the belly- button, chest, beard, and mustache in men, the armpits, and even the eyelashes. Never, however, to the scalp!
The treatment for pubic lice is essentially the same as that for head lice. For lice and nits that have found their way to your eyelashes, apply Johnson’s Baby Shampoo or Vaseline with a Q-Tip two or three times daily. This should cure the condition in a few days.
Body Lice
Infestation with body lice is not very common in the United States. Unlike head and crab lice, body lice bite the skin but live in the seams of clothing. Treat the clothing, and the rash will disappear.
Scabies
Scabies is a common and contagious skin disease. It has infested humans for at least 2,500 years. Like lice, it has reached epidemic proportions in the United States. Although scabies is often associated with poverty and its crowded living conditions and poor hygiene, there has been a definite increase of the disease in the more affluent. Anybody and everybody can become infested with scabies. It has been estimated that more than 300 million cases of scabies occur worldwide every year.
A mite – a tiny creature, mistakenly referred to as an insect – causes scabies. This mite measures about one seventy-fifth of an inch in length, so small that it is barely visible to the naked eye. These tiny, eight-legged creatures burrow into the skin and spread from one individual to the next through personal and sexual contact. It may take a month before a newly infested person might notice the fierce itching that is so characteristic of scabies. Animals, principally dogs, carry a different form of scabies that they can pass on to humans to cause a similar condition.
Scabies is characterized by intense itching due to an allergy to the female mite and the eggs and feces she deposits underneath the upper layers of the skin. This itching becomes more intense at night, when the tiny organisms become more active, or when the person gets overheated or removes his or her clothing. Often the itching is so severe that it leads to nervousness and loss of sleep. And since the scratching often causes bleeding, an infested person may have bloodied sheets, pajamas, or underwear.
The scabies mite is most fond of attacking the webs of the fingers, the inner surfaces of the wrists, and the elbows. Other common areas where the mites set up housekeeping are the chest near the armpits, the area around the belly-button, the buttocks, the nipples, and the penis. As a rule, infestations above the neck are extremely rare, except in infants and young children where the palms, soles, wrists and buttocks are the most common areas involved.
Because scabies mimics several other itchy skin conditions, it often goes undiagnosed or misdiagnosed, particularly in nursing homes and extended care facilities where outbreaks may affect half or more of the patients. Various salves and lotions may alleviate your itching for a short period of time, but if scabies is the culprit, the mites will thrive and often cause secondary infection requiring antibiotic therapy.
Once the proper diagnosis has been established – and only a physician is capable of recognizing it – the cure is relatively simple. Elimite Cream or Kwell (lindane) Lotion, prescription medications, will cure almost all cases of scabies with only one or two applications. (Do not use Kwell Lotion more than twice and do not use it on children under the age of six.) In addition, wash or dry clean all contaminated clothing and linens. And, since scabies spreads so swiftly, it is vitally important that every person in the household and all sex partners of the person affected should be treated whether or not they have any symptoms.
So if you have persistent, widespread itching that occurs below the neck, that is more pronounced at night, and that is unrelieved by the usual simple baths and lotions, see your dermatologist. Fortunately, the nasty scabies mite succumbs to a swift and simple cure.
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For more information about lice and scabies, write to: National Pediculosis Association P.O. Box 149, Newton, MA 02161 800-446-4NPA; 617-449-6487 www.headlice.org www.aad.org or phone: 1-888-462-DERM x22 |
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| TREATING LICE |
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The following are a couple of good, over-the-counter treatments for head lice:
Rid Shampoo
Permethrin Lotion
Nix Creme Rinse or Mousse
Directions for use are on the labels.
To restore body and lustre to hair following scalp applications, follow with a mild shampoo.
If necessary, you can repeat this treatment, but do not exceed 2 applications within 24 hours.
To prevent reinfestation with lice, thoroughly wash all articles of clothing that are suspected of having nits or adult lice.
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| TREATING SCABIES |
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There are no over-the-counter remedies for scabies. If you suspect that you or members of your family have scabies, or if you have had any recent contact with someone who had scabies, see your dermatologist. He or she can make the diagnosis and prescribe the appropriate medication.
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