Understanding Lice and Scabies - Treatment

There has been some controversy about the dangerous side effects of some pediculicides, which kill mites and lice. Several alternatives exist, including herbal remedies for those who want a more benign, though also potentially less effective, solution.

Gamma benzene hexachloride (also known as lindane) was at one time the most commonly prescribed pediculicide. If used improperly, it can attack and permanently damage the central nervous system.  Multiple applications, especially in young children, have led to brain damage, paralysis, and seizures.  In 1990, the FDA approved the use of permethrin, a cream that works well against scabies without the

What Is the Treatment for Lice?

The goal of treatment is to remove all lice and nits.  This usually requires repeated efforts, because lice eggs are difficult to kill and a few adult lice may escape by hiding in clothing or bedding.

To get rid of head lice, the most common treatment is to kill the adults with an insecticidal shampoo and to clear out the nits with a special fine-toothed comb.  The safest and most effective shampoo preparation is permethrin cream rinse, available over the counter.  For best results, follow the directions exactly.  Other family members should be treated as well. About 60% of infected children have relatives who carry lice.

To avoid spreading the lice, keep infected children at home, away from school, until they are fully treated.  Wash all clothing, towels, and bed linens in hot, soapy water and dry in a hot dryer.  Dry clean clothing that is not washable.  You can also "sterilize" bedding or other items by placing them in a plastic bag for 14 days.  The nits will hatch in about a week and die of starvation.  Combs, brushes, and barrettes can be disinfected by soaking in hot, soapy water for 10 minutes.

For those who prefer to avoid the use of insecticides, try a "combing only" technique.  Wash the hair with ordinary shampoo and conditioner, and leave wet.  With a fine-toothed comb, stroke slowly outward from the roots through one lock of hair at a time.  Lice will land on the back of the comb, get caught between the teeth, or fall off.  Space at least 30 strokes over the head.  Repeat every 3 days.  Because newborn lice do not lay eggs for the first week, all the lice should disappear after about 2 weeks of combing.

Pubic lice can be treated with over-the-counter medications containing pyrethrins (natural insecticides).  Your sexual partners will also have to be treated.  Crabs are also sometimes found on eyelashes or eyebrows.  To remove them, use an ophthalmic ointment such as physostigmine or coat the lashes with petroleum jelly; both of these methods should be supervised by your doctor.

To treat body lice, wash the entire body with soap and water.  If this is not effective, you may have to use an insecticidal 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.  Store clothes for 14 days in plastic bags or place them in dry heat of 140° F for 3 to 5 days.