Wszy odzieżowe
Leczenie
Wszy odzieżowe (Pediculus humanus corporis) to pasożyty zewnętrzne bytujące głównie na ubraniach i pościeli, żywiące się krwią człowieka. Infestacja dotyczy szczególnie osób z ograniczonym dostępem do higieny, takich jak bezdomni czy osoby w warunkach przeludnienia. Podstawą leczenia jest poprawa higieny osobistej, obejmująca regularne mycie ciała (minimum raz w tygodniu), częstą zmianę odzieży oraz pranie odzieży i pościeli w temperaturze 54-60°C, suszenie w suszarce przez 20-30 minut oraz prasowanie, zwłaszcza szwów. W przypadku braku możliwości prania, alternatywą jest chemiczne czyszczenie lub szczelne przechowywanie odzieży przez 2 tygodnie. Leczenie farmakologiczne, choć nie zawsze konieczne, stosuje się w rozległych infestacjach lub gdy metody higieniczne są niewystarczające.
- Leczenie wszy odzieżowych (Pediculus humanus corporis)
- Podstawowe zasady higieny w leczeniu wszy odzieżowych
- Leczenie farmakologiczne wszy odzieżowych
- Iwermektyna w leczeniu wszy odzieżowych
- Leczenie świądu i objawów towarzyszących
- Zapobieganie inwazji wszy odzieżowych
- Skuteczność leczenia wszy odzieżowych
- Praktyczne aspekty leczenia wszy odzieżowych
Leczenie wszy odzieżowych (Pediculus humanus corporis)
Wszy odzieżowe (Pediculus humanus corporis) to pasożyty zewnętrzne, które w odróżnieniu od wszy głowowych czy łonowych, żyją głównie na ubraniach i pościeli, a nie bezpośrednio na skórze człowieka. Pasożyty te żywią się krwią, przychodząc na skórę jedynie w celu pobrania pokarmu. Wszy odzieżowe stanowią problem zdrowotny, szczególnie wśród osób z ograniczonym dostępem do urządzeń sanitarnych, bezdomnych oraz w warunkach przeludnienia i niedostatecznej higieny12.
Podstawowe zasady higieny w leczeniu wszy odzieżowych
Główną metodą eliminacji wszy odzieżowych jest poprawa higieny osobistej oraz dekontaminacja odzieży i pościeli. W przeciwieństwie do innych rodzajów wszawicy, leczenie farmakologiczne nie zawsze jest konieczne12. Podstawowe elementy postępowania obejmują:
- Regularne mycie ciała z użyciem mydła i ciepłej wody (przynajmniej raz w tygodniu)
- Częstą zmianę odzieży na czystą (co najmniej raz w tygodniu)
- Pranie odzieży, pościeli i ręczników w gorącej wodzie (minimum 54-60°C)
- Suszenie wypranej odzieży w suszarce na wysokiej temperaturze przez co najmniej 20-30 minut
- Prasowanie ubrań ze szczególnym uwzględnieniem szwów, gdzie najczęściej gromadzą się wszy i gnidy
Regularne stosowanie tych metod jest zazwyczaj wystarczające do całkowitego wyeliminowania wszy odzieżowych. W przypadku braku możliwości prania odzieży, alternatywne metody obejmują:
- Chemiczne czyszczenie (pranie na sucho) odzieży, której nie można prać w pralce
- Szczelne zamknięcie rzeczy, których nie można wyprać, w plastikowym worku na okres 2 tygodni
- Prasowanie odzieży gorącym żelazkiem, szczególnie wzdłuż szwów
Leczenie farmakologiczne wszy odzieżowych
W przypadku rozległej inwazji wszy odzieżowych lub gdy metody poprawy higieny nie są wystarczające, można zastosować leczenie farmakologiczne. Produkty lecznicze stosowane w leczeniu wszy odzieżowych są podobne do tych używanych przy wszawicy głowowej12.
Preparaty zawierające permetrynę
Permetryna jest syntetycznym związkiem opartym na naturalnych permetrynach o działaniu owadobójczym. Jest to lek pierwszego wyboru w leczeniu wszawicy12:
- Permetryna 1% (np. Nix) – stosowana jako lotion lub szampon
- Permetryna 5% krem (np. Elimite) – używana w cięższych przypadkach, szczególnie przy współistniejącej wszawicy głowowej lub łonowej
Permetrynę aplikuje się na całe ciało, pozostawiając na 8-10 godzin, a następnie spłukując. Zabieg należy powtórzyć po 7-9 dniach, aby wyeliminować wszy, które mogły wylęgnąć się z jaj niezniszczonych podczas pierwszej aplikacji56.
Inne preparaty przeciwwszawicze
W przypadku nieskuteczności permetryny lub w określonych sytuacjach klinicznych można zastosować12:
- Malation 0,5% (np. Ovide) – lotion owadobójczy o wysokiej skuteczności zarówno wobec dorosłych wszy, jak i ich jaj. Należy stosować przez 8-12 godzin, a następnie spłukać.
- Benzyl alkohol 5% – działający przez zablokowanie dróg oddechowych pasożytów i wywołanie ich uduszenia.
- Spinosad 0,9% – powodujący nadmierną aktywację układu nerwowego pasożytów, prowadzącą do paraliżu i śmierci.
- Pyretryny z butoksydem piperonylu – naturalne ekstrakty z kwiatów chryzantemy o działaniu owadobójczym.
Warto zaznaczyć, że lindane (1% szampon i lotion), kiedyś powszechnie stosowany w leczeniu wszawicy, nie jest obecnie zalecany jako lek pierwszego wyboru ze względu na potencjalną neurotoksyczność12.
Iwermektyna w leczeniu wszy odzieżowych
W trudnych przypadkach lub przy braku odpowiedzi na standardowe leczenie, można rozważyć zastosowanie iwermektyny1:
- Iwermektyna miejscowa 0,5% – stosowana w formie lotion, działająca poprzez wiązanie z kanałami chlorkowymi bramkowanymi glutaminianem w komórkach nerwowych i mięśniowych bezkręgowców.
- Iwermektyna doustna – podawana w dawce 200 mcg/kg masy ciała, z powtórzeniem po 7-14 dniach. Badania wykazały skuteczność tej metody w przypadku inwazji wszy odzieżowych u bezdomnych mężczyzn.
Leczenie świądu i objawów towarzyszących
Wszawica odzieżowa często wiąże się z intensywnym świądem, który może utrzymywać się nawet po eliminacji pasożytów. W celu łagodzenia świądu można zastosować12:
- Leki przeciwhistaminowe (np. difenhydramina) – zmniejszające reakcję alergiczną i świąd
- Kortykosteroidy miejscowe (np. hydrokortyton) – redukujące stan zapalny i świąd
- Antybiotyki ogólnoustrojowe – w przypadku wtórnych zakażeń bakteryjnych spowodowanych drapaniem
Zapobieganie inwazji wszy odzieżowych
Profilaktyka wszawicy odzieżowej koncentruje się na utrzymaniu odpowiedniej higieny osobistej i otoczenia12:
- Regularne mycie całego ciała (co najmniej raz w tygodniu)
- Częsta zmiana odzieży, bielizny i pościeli
- Regularne pranie odzieży i pościeli w wysokiej temperaturze
- Unikanie dzielenia się odzieżą, ręcznikami czy pościelą z osobami zainfekowanymi
- Sprawdzanie szwów odzieży używanej lub otrzymanej z drugiej ręki przed wprowadzeniem jej do domu
W przypadku dużych skupisk ludności (np. schroniska dla bezdomnych, obozy dla uchodźców) może być konieczne zastosowanie środków owadobójczych w otoczeniu, a także edukacja mieszkańców w zakresie higieny i prania odzieży12.
Leczenie osób z kontaktu
Osoby będące w bliskim kontakcie z osobą zainfekowaną wszami odzieżowymi również powinny być poddane kontroli i w razie potrzeby leczeniu. Zaleca się jednoczesne leczenie wszystkich domowników i bliskich kontaktów, aby zapobiec ponownej infestacji12.
Skuteczność leczenia wszy odzieżowych
Prawidłowo prowadzone leczenie wszy odzieżowych jest bardzo skuteczne. Przy zastosowaniu odpowiednich metod higieny i dekontaminacji odzieży oraz, w razie potrzeby, leczenia farmakologicznego, wskaźnik wyleczenia przekracza 90%12.
Jeśli infestacja wszy odzieżowych nawraca, należy sprawdzić, czy wszystkie zalecane środki higieny są prawidłowo stosowane. Szczególną uwagę należy zwrócić na dekontaminację odzieży, pościeli i innych tkanin, które mogą stanowić rezerwuar pasożytów12.
Problem oporności na leki przeciwwszawicze
W ostatnich latach odnotowano wzrost oporności wszy na niektóre substancje owadobójcze, w tym permetrynę i pyretryny. W przypadku nieskuteczności standardowego leczenia, zaleca się rotację środków przeciwwszawiczych, aby spowolnić rozwój oporności12.
Badania wskazują, że średnia częstość występowania oporności wszy na pyretroidy wynosi globalnie około 77%, a w niektórych krajach osiąga nawet 100%. W takich przypadkach leczenie kombinowane lub zastosowanie alternatywnych środków przeciwwszawiczych może być konieczne1.
Praktyczne aspekty leczenia wszy odzieżowych
Leczenie wszy odzieżowych wymaga kompleksowego podejścia, obejmującego zarówno eliminację pasożytów z ciała pacjenta, jak i z jego odzieży, pościeli oraz otoczenia. W większości przypadków poprawa higieny osobistej i odpowiednie postępowanie z odzieżą są wystarczające do wyleczenia infestacji12.
Należy pamiętać, że w przeciwieństwie do innych rodzajów wszawicy, w przypadku wszy odzieżowych kluczowe znaczenie ma dekontaminacja odzieży i pościeli, a nie tylko leczenie samego pacjenta. Brak odpowiedniego postępowania z odzieżą może prowadzić do nawrotów infestacji, nawet przy prawidłowym leczeniu farmakologicznym12.
Warto również zauważyć, że wszy odzieżowe mogą być wektorami dla chorób takich jak dur wysypkowy, gorączka okopowa i gorączka powrotna. W związku z tym skuteczne leczenie wszawicy odzieżowej ma znaczenie nie tylko dla komfortu pacjenta, ale także dla zdrowia publicznego1.
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Materiały źródłowe
- #1 About Body Lice | Lice | CDChttps://www.cdc.gov/lice/about/body-lice.html
The only treatment is to improve hygiene and access to clean clothes. […] Improved hygiene and access to regular changes of clean clothes is the only treatment needed for body lice infestations; however, in some cases peduculicides are recommended. […] You can treat a body lice infestation by improving personal hygiene. Bathe and change into clean clothes at least once a week. Wash clothing, bedding, and towels used by the person infested with lice using hot water (at least 130F) and machine dry using the hot cycle. […] Pediculicide, a medicine that can kill lice, is sometimes used for treatment. If prescribed a pediculicide, apply it exactly as directed on the bottle or by your healthcare provider. However, a pediculicide is generally not necessary if hygiene is maintained and items are machine washed appropriately at least once a week.
- #1 Body Lice (Pediculosis): Symptoms, Treatment & Preventionhttps://my.clevelandclinic.org/health/diseases/17919-body-lice
Bathe with soap and water and wash and dry fabric items on the hottest possible settings to get rid of body lice. […] Most people successfully get rid of body lice infestations by regularly bathing with soap and warm water and washing their clothes. Try to bathe daily until you no longer see body lice or nits on your body, clothes, bedding or other fabric items, like towels. […] To prevent body lice from coming back, try to bathe and wash your clothing, bedding and other fabric items at least once a week. […] Wash your clothing, bedding and any other fabrics that have been in contact with the body lice in hot water (at least 129 degrees Fahrenheit or 54 degrees Celsius). […] You can also help kill nits and body lice by ironing your clothing. […] Many people recover without medication, focusing on keeping their bodies, clothing and bedding clean and free of lice. But if you cant regularly bathe or wash your clothes, your healthcare provider may suggest medications, including: Oral antiparasite medication, like ivermectin tablets.
- #1 Lice – Diagnosis and treatment – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/lice/diagnosis-treatment/drc-20374404
A health care provider may diagnose body lice if they find eggs or crawling lice in clothing seams or on bedding. You can see a body louse on skin if it crawls there to feed. […] If you have body lice, first bathe with soap and water. After bathing, apply permethrin (Nix) to the affected areas before bedtime and then shower in the morning. Repeat this treatment nine days after the first application. […] Also take other measures to get rid of body lice. Wash clothing and bedding with hot, soapy water at least 130 F (54 C) and dry them at high heat for at least 20 minutes. Vacuum the floors and furniture. And seal unwashable items in an airtight bag for two weeks.
- #1 Pediculosis and Scabies: A Treatment Update | AAFPhttps://www.aafp.org/pubs/afp/issues/2012/0915/p535.html
First-line pharmacologic treatment of pediculosis is permethrin 1% lotion or shampoo. […] Permethrin 1% lotion (Nix) is first-line treatment for pediculosis, except in places with known permethrin resistance. […] A key to formulating an effective treatment regimen is recognizing that available treatments destroy lice, but do not reliably destroy eggs. […] Resistance to permethrin and pyrethrin/piperonyl butoxide can be significant in various communities, necessitating the use of malathion, which has maintained relatively low resistance because of limited use in the United States. […] In 2009, the first prescription suffocation treatment, a nonovicidal benzyl alcohol 5% lotion (Ulesfia), was approved by the FDA. […] In early 2011, the FDA approved a pediculicidal topical suspension agent, spinosad 0.9% (Natroba), which provokes hyperexcitation and eventual death by paralysis.
- #1 Pediculosis and Pthiriasis (Lice Infestation) Medication: Antiparasitic Agentshttps://emedicine.medscape.com/article/225013-medication
The goal of therapy is to eliminate lice and eggs. Chemical pediculicides are the mainstay of pharmacotherapy. With most medications, treatment should be repeated in 7-10 days (the time needed for the eggs to hatch) because nits are less effectively killed than adults. […] Treatment options include pyrethrins with piperonyl butoxide (A-200, Pronto, RC, Rid, Triple X), permethrin 1% lotion (NIX), permethrin 5% (approved to treat scabies but occasionally used to treat lice; Actin, Elimite), malathion 0.5% (Ovide), lindane 1% shampoo and lotion, ivermectin 0.5% lotion (Sklice), spinosad 0.9% (Natroba), benzyl alcohol 5% lotion (Ulesfia), isopropyl myristate (Resultz), dimethicone (LiceMD Pesticide Free, NYDA) and a mineral oil-based shampoo (Nix Ultra shampoo). […] Resistance to pediculicides has increased over recent years. Therapeutic agents can be rotated to slow the emergence of resistance.
- #1 Pediculosis Corporis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK482148/
Lindane is not recommended for first-line treatment due to some potentially serious reactions including neurotoxicity and seizures. In some settings, such as refugee camps with large numbers of people, environmental application of chemical insecticides may be needed to prevent the spread of body lice and louse-borne infections.
- #1 Management and Treatment of Human Licehttps://pmc.ncbi.nlm.nih.gov/articles/PMC4978820/
In clinical trials, oral ivermectin, given twice at a 7-day interval, may be more effective or as efficacious as topical 0.5% malathion lotion. […] Symbiotic treatment remains promising and it would be interesting to evaluate the effectiveness of other drugs alone or in combination on lice by targeting their endosymbiont bacterium. […] The effectiveness of this combination has also been confirmed in naturally infected dogs with Dirofilaria immitis. […] Thus, we conclude that the synergistic effect is one of the most effective means of lice treatment and also prevents reemergence and resistance.
- #1 Body Lice (Pediculosis): Symptoms, Treatment & Preventionhttps://my.clevelandclinic.org/health/diseases/17919-body-lice
Your healthcare provider should discuss how to use these treatments and any possible side effects. […] Try not to scratch your body lice bites. […] There are many over-the-counter (OTC) products that can help stop body lice bites from itching or causing pain, including: Antihistamines: Histamine is a chemical created by your immune system. […] Hydrocortisone: Hydrocortisone is a corticosteroid. It relieves itching and swelling. […] You can prevent body lice infestations by bathing and washing your clothing, bedding and other personal items at least once a week. […] Most people with body lice recover without medication. […] It may take up to two weeks for your body lice infestation to go away. […] Body lice are itchy and annoying insects. In most cases, body lice are fairly harmless and dont require medicines for treatment. Bathing and properly washing your clothing and bedding in hot water should kill body lice and their nits.
- #1 Pubic and Body Lice | Doctorhttps://patient.info/doctor/pubic-and-body-lice-pro
Outbreaks require delousing of people with 1% permethrin dusting powder, basic sanitation and hygiene, changes of clean clothing, and sometimes shaving. […] Treating clothing with permethrin may prevent infestation. […] Treatments are very effective in killing nymphs and mature lice but less effective in killing eggs. […] Appropriate therapy produces a cure in more than 90% of cases. […] To prevent re-infestation, treat contacts of the patient at the same time as the patient.
- #1 Treatment of human lice – Wikipediahttps://en.wikipedia.org/wiki/Treatment_of_human_lice
The treatment of human lice is the removal of head lice parasites from human hair. However, there are a number of treatment modalities that can be employed with varying degrees of success. These methods include chemical treatments, natural products, combs, shaving, hot air, and silicone-based lotions. Treatment is recommended only after a clear diagnosis since all treatments have potential side effects. A common recommendation is to repeat treatment with a pediculicide at least once after 10 days, when all lice have hatched. If living lice are still present, the treatment is repeated using an anti-louse product with a different active ingredient. Prophylactic treatment with pediculicides is not recommended. […] Insecticides used for the treatment of head lice include lindane, malathion, carbaryl, pyrethrum, piperonyl butoxide, permethrin, phenothrin, bioallethrin, and spinosad. Many of the pediculicides in the market are either not fully effective or are ineffective when they are used according to the instructions. Resistance of head lice to insecticides such as lindane, malathion, phenothrin and permethrin has been reported. A 2021 systematic review and meta-analysis found that the mean frequency of pyrethroid resistance of lice was 77% globally, and even 100% in several countries. It concluded that treatment with current insecticides may not be effective and is likely the cause of increased levels of infestations.
- #1 Body lice (pediculosis)https://dermnetnz.org/topics/body-lice
Treating the body infested with lice is not usually necessary as the lice live on the clothing. […] If the infestation is widespread and covers much of the body, insecticides used in the treatment of head lice may also used in the treatment of body lice. […] Environmental measures are the focus of treating body louse infestations. […] Laundering of clothing and bed linens using hot washes is essential to killing body lice and their eggs on clothing. […] Hot washing and hot tumble-drying is effective in killing lice and eggs. […] Ironing with a hot iron is effective. […] Dry cleaning is also effective. […] Sometimes a topical insecticide spray can be applied to clothing, especially the seams. […] Regular hot washing of clothes and bathing has led to a decrease in incidence of body lice but during wartime and in some undeveloped countries the condition can still occur. […] Household contacts and close friends should also be educated about hygiene and how to launder clothing and linen to prevent the spread of body lice and reinfestation.
- #1 Management and Treatment of Human Licehttps://pmc.ncbi.nlm.nih.gov/articles/PMC4978820/
Of the three lice (head, body, and pubic louse) that infest humans, the body louse is the species involved in epidemics of louse-borne typhus, trench fever, and relapsing fever, but all the three cause pediculosis. […] Despite the introduction of other resources including cresol, naphthalene, sulfur, mercury, vinegar, petroleum, and insecticides, the numbers of lice infestation cases and resistance have increased. […] Today, the development of new treatment strategies such as symbiotic treatment and synergistic treatment (antibiotics + ivermectin) in vitro has proved effective and is promising. […] Thus, this review summarizes the management methods and various strategies used in treating these hematophagous parasites. […] Removing lice by hand or with a lice comb, heating infested clothing, and shaving the scalp were some of the oldest methods of controlling human lice.
- #2 Pediculosis Corporis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK482148/
Treatment of body lice does not usually require the use of a pediculicide because improvements in hygiene, including showering and laundering clothing in hot water at least 50 C, will most often eradicate the infestation. All clothing, bed linens, and towels should be washed in hot water and machine-dried on the hot cycle. […] Itching can be treated with topical corticosteroids and systemic antihistamines. Secondary skin infections are managed with appropriate systemic antibiotics. While pediculicides are not required to eradicate body lice infections, they are often used if body lice or nits are found on body hair or if there is a co-infection with head lice, pubic lice, or scabies. In these cases, pharmacologic treatment employs the same agents for pubic and head lice, most commonly permethrin cream applied to the entire body for 8 to 10 hours. Additional treatments include 5% benzyl alcohol lotion, 0.5% ivermectin lotion, 0.5% malathion lotion, 0.9% spinosad topical suspension, and 1% lindane shampoo.
- #2 Body Lice | MedlinePlushttps://medlineplus.gov/bodylice.html
The main treatment for body lice is to improve personal hygiene. That means regular showers and washing clothes, bedding, and towels at least once a week. Use hot water to wash the laundry, and dry it using the hot cycle of the dryer. Some people may also need a lice-killing medicine.
- #2 Pediculosis and Pthiriasis (Lice Infestation) Treatment & Management: Approach Considerations, Pesticides, Occlusive and Nonpesticide Therapyhttps://emedicine.medscape.com/article/225013-treatment
Use of a pediculicide is usually unnecessary with P humanus corporis infestation because the lice live on the clothing. Treatment of clothing and bed linens includes laundering in hot water, ironing with a hot iron, or drying in a hot dryer. Dry cleaning is also effective for killing lice and their nits on clothing. Education about hygiene and accessibility to laundering facilities are important in preventing the spread of body lice and re-infestation. […] Topical agents can be applied to clothing, especially the seams. Published data suggest that permethrin spray can help prevent body louse re-infestation. In cases of heavy pediculosis, treatment of the body with a pediculicide shampoo or lotion may be beneficial, especially if the patient also has confirmed or suspected concomitant head or pubic louse infestation. Oral ivermectin 12 mg given as 3 doses 7 days apart has also been shown to be effective in a cohort of homeless men. None of these agents is currently labeled or marketed for treatment of body lice in the United States.
- #2 AAD Reading Room | Eradicating Ectoparasites: Treatment Options and Tips for Successfully Diagnosing and Treating Lice and Scabies | MedPage Todayhttps://www.medpagetoday.com/reading-room/aad/general-dermatology/101773
A first-line pharmacologic treatment for pediculosis is permethrin 1% lotion or shampoo, which is the most-studied treatment option and is also safe for children older than two months of age as well as cost effective. […] The organophosphate cholinesterase inhibitor malathion lotion 0.5% was reintroduced in the United States in 1999 after being taken off the market twice because of problems related to prolonged application time, flammability, and odor. […] When compared with pyrethrins and permethrin, malathion was the most pediculicidal and ovicidal agent with the highest cure rates after a single application. […] Ivermectin is available as a prescription in lotion form 0.5% for the treatment of lice (off-label use for scabies). […] Oral ivermectin is an option for scabies and refractory head lice. […] After trials of two appropriately administered courses of permethrin, an alternative agent should be used.
- #2 Pediculosis and Pthiriasis (Lice Infestation) Medication: Antiparasitic Agentshttps://emedicine.medscape.com/article/225013-medication
Pyrethrins are first-line treatment in head, pubic, and severe body louse infestation. […] Permethrin is the drug of choice recommended by most authorities as the first line of treatment in head, pubic, and severe body louse infestation, especially for infants older than 2 months and small children. […] Malathion is approved by the FDA for the treatment of head lice. […] Topical ivermectin causes parasite death by selective, high-affinity binding to glutamate-gated chloride channels located in invertebrate nerve and muscle cells. […] Lindane stimulates the nervous system of parasites, causing seizures and death. […] Benzyl alcohol inhibits lice from closing their respiratory spiracles, allowing the lotion to obstruct the spiracles, which ultimately results in asphyxiation. […] Spinosad causes neuronal excitation in insects, followed by hyperexcitation, paralysis, and death.
- #2 Head Lice Causes, Adult Symptoms, Treatment, Shampoo, Tablethttps://www.medicinenet.com/head_lice/article.htm
Benzyl alcohol 5% (Ulesfia): Benzyl alcohol is available in the U.S. as a 5% lotion. […] Spinosad (Natroba): Spinosad is derived from soil bacteria. […] Ivermectin (Sklice): Ivermectin is available as both a 0.5% lotion (which is FDA-approved for the treatment of lice) and as an oral medication (which is not approved in the U.S. for the treatment of lice). […] Lindane (Kwell): It is important to note that lindane 1% (Kwell) is no longer recommended as a treatment option for head lice due to its toxicity in children. […] Other treatments such as permethrin 5%, crotamiton 10%, and sulfamethoxazole-trimethoprim (Bactrim) are not currently approved by the FDA for use in the treatment of head lice. […] When using head lice medicine, as with any medicine, always follow the instructions provided.
- #2 Lice (Head, Body & Pubic)Treatment, Symptoms, Pictures, Home Remedieshttps://www.emedicinehealth.com/lice/article_em.htm
Body-lice infestation is a prominent public health problem in communities with large populations dealing with poverty, overcrowding, and poor personal hygiene. Reused mattresses and bed linens as well as communal beds are risk factors. […] The diagnosis of body lice involvement can be made by identifying lice or nits in clothing, bedding, or linens — especially in the seam regions. […] Anti-lice agents are usually not needed if clothing is thrown away and bed linens are thoroughly washed. […] Chemical insecticide sprays in the home are not effective and not recommended. […] Use over-the-counter antihistamines (such as diphenhydramine, [Benadryl]) for itching. […] Treat with anti-lice agents and repeat in seven to 10 days. […] Check all close contacts. Treat them only if lice or nits are found. […] Wash and dry all clothes and bed linens in hot cycles. […] The diagnosis is made by demonstration of the adult lice or nits. […] With appropriate home care or prescription medication, more than 90% of lice infestations can be cured.
- #2 Body lice | Better Health Channelhttps://www.betterhealth.vic.gov.au/health/conditionsandtreatments/body-lice
An increased level of personal hygiene with regular bathing or showering and regular laundering and changing of clothing is essential for control. […] To treat body lice: increase personal hygiene bathe or shower regularly (at least weekly) […] change and launder clothes, especially underwear, regularly (at least weekly), or throw away affected clothing […] wash clothing and bedding recently used by an infested person in hot water (greater than 70C). Tumble dry on hot, or iron clothes, with all seams turned outwards […] if items cannot be washed or dry cleaned, seal them in a white plastic bag for a month, or iron them, paying special attention to seams […] thoroughly vacuum mattresses, paying attention to seams and creases, and under buttons […] if prescribed, use an appropriate insecticide treatment (available from pharmacies)
- #2 Body lice (pediculosis)https://dermnetnz.org/topics/body-lice
Treating the body infested with lice is not usually necessary as the lice live on the clothing. […] If the infestation is widespread and covers much of the body, insecticides used in the treatment of head lice may also used in the treatment of body lice. […] Environmental measures are the focus of treating body louse infestations. […] Laundering of clothing and bed linens using hot washes is essential to killing body lice and their eggs on clothing. […] Hot washing and hot tumble-drying is effective in killing lice and eggs. […] Ironing with a hot iron is effective. […] Dry cleaning is also effective. […] Sometimes a topical insecticide spray can be applied to clothing, especially the seams. […] Regular hot washing of clothes and bathing has led to a decrease in incidence of body lice but during wartime and in some undeveloped countries the condition can still occur. […] Household contacts and close friends should also be educated about hygiene and how to launder clothing and linen to prevent the spread of body lice and reinfestation.
- #2 Pubic Lice (Crabs): Bites, Symptoms, Treatment & Preventionhttps://my.clevelandclinic.org/health/diseases/4522-pubic-lice-crabs
Pubic lice treatment usually involves special shampoos or creams to kill the lice. […] Treatment involves applying special creams or shampoos to the affected area, which kills the lice and their eggs. You can buy over-the-counter and get prescription medications. […] You treat pubic lice using a special shampoo or cream in the infested area. Using regular soap and hot water isnt effective in killing pubic lice. You can typically buy shampoos and creams for pubic lice over the counter, without a prescription. Theyre safe and effective. Make sure to follow the directions on the package carefully. […] For the best results from the lice treatment, follow these steps: […] You should make sure everyone in your household and any sexual partners from the last two months receive treatment for pubic lice.
- #2 Body lice – Diagnosis & treatment – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/body-lice/diagnosis-treatment/drc-20350316
Body lice are primarily treated by thoroughly washing yourself and any contaminated items with soap and hot water and drying clothing and bedding in a machine dryer using the hot cycle. Dry cleaning and ironing clothing that cannot be washed also is effective. […] If these measures don’t work, you can try using an over-the-counter lotion or shampoo that has 1% permethrin (Nix) or pyrethrin. If that still doesn’t work, your doctor can provide a prescription lotion. Lice-killing products can be toxic to humans, so follow the directions carefully. […] You can usually get rid of body lice by cleaning yourself and any personal belongings that may be contaminated. Wash infested bedding, clothing and towels with hot, soapy water at least 130 F (54 C) and machine dry them on high heat for at least 20 minutes.
- #2 Pediculosis and Pthiriasis (Lice Infestation) Medication: Antiparasitic Agentshttps://emedicine.medscape.com/article/225013-medication
The goal of therapy is to eliminate lice and eggs. Chemical pediculicides are the mainstay of pharmacotherapy. With most medications, treatment should be repeated in 7-10 days (the time needed for the eggs to hatch) because nits are less effectively killed than adults. […] Treatment options include pyrethrins with piperonyl butoxide (A-200, Pronto, RC, Rid, Triple X), permethrin 1% lotion (NIX), permethrin 5% (approved to treat scabies but occasionally used to treat lice; Actin, Elimite), malathion 0.5% (Ovide), lindane 1% shampoo and lotion, ivermectin 0.5% lotion (Sklice), spinosad 0.9% (Natroba), benzyl alcohol 5% lotion (Ulesfia), isopropyl myristate (Resultz), dimethicone (LiceMD Pesticide Free, NYDA) and a mineral oil-based shampoo (Nix Ultra shampoo). […] Resistance to pediculicides has increased over recent years. Therapeutic agents can be rotated to slow the emergence of resistance.
- #2 Body Lice Infestation: Causes, Symptoms & Diagnosishttps://www.healthline.com/health/body-lice
Good hygiene and regularly washing clothing and bed linens are generally enough to treat and prevent infestations of body lice. […] A body lice infestation is normally treated through improved personal hygiene and regular changes of clean, washed clothing. […] All clothing, bed linens, and towels used by the infested person should be washed with hot water (at least 130 degrees) and then dried in a machine with hot air. […] Medications that kill lice, called pediculicides, may be used to treat body lice infestation. However, this is usually not necessary if clothing is laundered and personal hygiene is maintained. Lice-killing products may be toxic to humans, so be sure to follow the instructions carefully.
- #3 Body lice – Diagnosis & treatment – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/body-lice/diagnosis-treatment/drc-20350316
Body lice are primarily treated by thoroughly washing yourself and any contaminated items with soap and hot water and drying clothing and bedding in a machine dryer using the hot cycle. Dry cleaning and ironing clothing that cannot be washed also is effective. […] If these measures don’t work, you can try using an over-the-counter lotion or shampoo that has 1% permethrin (Nix) or pyrethrin. If that still doesn’t work, your doctor can provide a prescription lotion. Lice-killing products can be toxic to humans, so follow the directions carefully. […] You can usually get rid of body lice by cleaning yourself and any personal belongings that may be contaminated. Wash infested bedding, clothing and towels with hot, soapy water at least 130 F (54 C) and machine dry them on high heat for at least 20 minutes.
- #3 Lice – Diagnosis and treatment – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/lice/diagnosis-treatment/drc-20374404
A health care provider may diagnose body lice if they find eggs or crawling lice in clothing seams or on bedding. You can see a body louse on skin if it crawls there to feed. […] If you have body lice, first bathe with soap and water. After bathing, apply permethrin (Nix) to the affected areas before bedtime and then shower in the morning. Repeat this treatment nine days after the first application. […] Also take other measures to get rid of body lice. Wash clothing and bedding with hot, soapy water at least 130 F (54 C) and dry them at high heat for at least 20 minutes. Vacuum the floors and furniture. And seal unwashable items in an airtight bag for two weeks.
- #3 Pediculosis and Scabies: A Treatment Update | AAFPhttps://www.aafp.org/pubs/afp/issues/2012/0915/p535.html
First-line pharmacologic treatment of pediculosis is permethrin 1% lotion or shampoo. […] Permethrin 1% lotion (Nix) is first-line treatment for pediculosis, except in places with known permethrin resistance. […] A key to formulating an effective treatment regimen is recognizing that available treatments destroy lice, but do not reliably destroy eggs. […] Resistance to permethrin and pyrethrin/piperonyl butoxide can be significant in various communities, necessitating the use of malathion, which has maintained relatively low resistance because of limited use in the United States. […] In 2009, the first prescription suffocation treatment, a nonovicidal benzyl alcohol 5% lotion (Ulesfia), was approved by the FDA. […] In early 2011, the FDA approved a pediculicidal topical suspension agent, spinosad 0.9% (Natroba), which provokes hyperexcitation and eventual death by paralysis.
- #3 Management and Treatment of Human Licehttps://pmc.ncbi.nlm.nih.gov/articles/PMC4978820/
In clinical trials, oral ivermectin, given twice at a 7-day interval, may be more effective or as efficacious as topical 0.5% malathion lotion. […] Symbiotic treatment remains promising and it would be interesting to evaluate the effectiveness of other drugs alone or in combination on lice by targeting their endosymbiont bacterium. […] The effectiveness of this combination has also been confirmed in naturally infected dogs with Dirofilaria immitis. […] Thus, we conclude that the synergistic effect is one of the most effective means of lice treatment and also prevents reemergence and resistance.
- #3 Body lice | Better Health Channelhttps://www.betterhealth.vic.gov.au/health/conditionsandtreatments/body-lice
use medication to reduce itching and control secondary infection, if necessary. […] To prevent body lice infestation, avoid close contact with infested persons, their clothing and bedding. […] To avoid bringing body lice into your home, check the seams of any second-hand clothing or bedding for the presence of body lice.
- #4 Body Lice (Pediculosis): Symptoms, Treatment & Preventionhttps://my.clevelandclinic.org/health/diseases/17919-body-lice
Bathe with soap and water and wash and dry fabric items on the hottest possible settings to get rid of body lice. […] Most people successfully get rid of body lice infestations by regularly bathing with soap and warm water and washing their clothes. Try to bathe daily until you no longer see body lice or nits on your body, clothes, bedding or other fabric items, like towels. […] To prevent body lice from coming back, try to bathe and wash your clothing, bedding and other fabric items at least once a week. […] Wash your clothing, bedding and any other fabrics that have been in contact with the body lice in hot water (at least 129 degrees Fahrenheit or 54 degrees Celsius). […] You can also help kill nits and body lice by ironing your clothing. […] Many people recover without medication, focusing on keeping their bodies, clothing and bedding clean and free of lice. But if you cant regularly bathe or wash your clothes, your healthcare provider may suggest medications, including: Oral antiparasite medication, like ivermectin tablets.
- #4 Lice and Scabies Treatments, Shampoos, and Morehttps://www.webmd.com/skin-problems-and-treatments/understanding-lice-scabies-treatment
To treat body lice, wash the entire body with soap and water. If this is not effective, you may have to use pediculocide preparation — either over-the-counter or prescription. As with a head lice infestation, you’ll have to wash all clothing, towels, and bedding in hot water and dry in a hot dryer.
- #4 Pediculosis and Pthiriasis (Lice Infestation) Medication: Antiparasitic Agentshttps://emedicine.medscape.com/article/225013-medication
Pyrethrins are first-line treatment in head, pubic, and severe body louse infestation. […] Permethrin is the drug of choice recommended by most authorities as the first line of treatment in head, pubic, and severe body louse infestation, especially for infants older than 2 months and small children. […] Malathion is approved by the FDA for the treatment of head lice. […] Topical ivermectin causes parasite death by selective, high-affinity binding to glutamate-gated chloride channels located in invertebrate nerve and muscle cells. […] Lindane stimulates the nervous system of parasites, causing seizures and death. […] Benzyl alcohol inhibits lice from closing their respiratory spiracles, allowing the lotion to obstruct the spiracles, which ultimately results in asphyxiation. […] Spinosad causes neuronal excitation in insects, followed by hyperexcitation, paralysis, and death.
- #4 Body Lice â Advanced Dermatologyhttps://www.advanced-dermatology.com.au/body-lice
One can prevent body lice by washing or bathing daily. Body lice tend to infect that do not wash on a regular basis and do not wash bedding and clothing on a regular basis. Wash all bedding at least once a week to prevent body lice. Do not share bedding with anyone that has body lice. Towels and clothing should also not be shared.
- #5 About Body Lice | Lice | CDChttps://www.cdc.gov/lice/about/body-lice.html
The only treatment is to improve hygiene and access to clean clothes. […] Improved hygiene and access to regular changes of clean clothes is the only treatment needed for body lice infestations; however, in some cases peduculicides are recommended. […] You can treat a body lice infestation by improving personal hygiene. Bathe and change into clean clothes at least once a week. Wash clothing, bedding, and towels used by the person infested with lice using hot water (at least 130F) and machine dry using the hot cycle. […] Pediculicide, a medicine that can kill lice, is sometimes used for treatment. If prescribed a pediculicide, apply it exactly as directed on the bottle or by your healthcare provider. However, a pediculicide is generally not necessary if hygiene is maintained and items are machine washed appropriately at least once a week.
- #5 Pediculosis Corporis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK482148/
Treatment of body lice does not usually require the use of a pediculicide because improvements in hygiene, including showering and laundering clothing in hot water at least 50 C, will most often eradicate the infestation. All clothing, bed linens, and towels should be washed in hot water and machine-dried on the hot cycle. […] Itching can be treated with topical corticosteroids and systemic antihistamines. Secondary skin infections are managed with appropriate systemic antibiotics. While pediculicides are not required to eradicate body lice infections, they are often used if body lice or nits are found on body hair or if there is a co-infection with head lice, pubic lice, or scabies. In these cases, pharmacologic treatment employs the same agents for pubic and head lice, most commonly permethrin cream applied to the entire body for 8 to 10 hours. Additional treatments include 5% benzyl alcohol lotion, 0.5% ivermectin lotion, 0.5% malathion lotion, 0.9% spinosad topical suspension, and 1% lindane shampoo.
- #6 Body lice – Diagnosis & treatment – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/body-lice/diagnosis-treatment/drc-20350316
Clothing that can’t be washed may be dry cleaned and ironed. […] Items that can’t be washed or dried should be sealed in a plastic bag and stored in a warm area for two weeks. Mattresses, couches and other upholstered furniture items should be hot ironed or sprayed with lice-killing products to eliminate eggs from seams. Exposure to infested items should be avoided for two weeks.
- #6 Body and Pubic Lice (Causes, Symptoms, and Treatment)https://patient.info/sexual-health/pubic-and-body-lice-leaflet
Pubic lice infestation is treated with insecticide specially formulated to be used on the human body. It kills the pubic lice. The whole body should be treated, twice – seven days apart. You should avoid getting insecticides in the eyes. […] The two commonly used insecticides to treat pubic lice are malathion lotion and permethrin 5% cream. […] Malathion is suitable for all people. Permethrin is NOT usually used if you are under 18. […] You should put the lotion or cream on all your body, including the scalp. […] You should leave the lotion or cream on for the full recommended time and then wash it off. Malathion and permethrin should both be left on for 12 hours (overnight) and then washed off. […] Repeat the same treatment after seven days. Although lice are usually killed by one application, not all eggs may be. The second application makes sure that any lice that hatch from eggs that survived the first application will be killed before they are old enough to lay further eggs.
- #7 Body Lice Symptoms, Diagnosis, and Treatment| Everyday Healthhttps://www.everydayhealth.com/lice/body-lice-symptoms-diagnosis-treatment/
Because body lice reside in clothing and bed linens not on the individual medication is usually not used to treat a body lice infestation. Heres what to do instead: […] Wash or replace clothes and linens. Because body lice may live in clothing, bedding, and towels for up to 10 days without a blood meal, those who are infested must replace or decontaminate their clothes, towels, and bed linens by thoroughly washing and drying the items at high temperatures. The wash should be set at least 130 degrees F, with the dryer at 149 degrees F, minimum. The temperature is critical, as soap and water alone will not kill body lice. […] Dry-clean or seal up the rest. Clothing and other items that arent machine washable can be either dry-cleaned or placed inside a tightly sealed plastic bag for two weeks.