How can lice that are under the skin be removed? - briefly
Apply a medicated cream or lotion containing permethrin or ivermectin to the affected area and repeat the treatment after 7–10 days; oral ivermectin may be used for extensive infestations. Follow with thorough washing of clothing, bedding, and personal items at high temperature to prevent reinfestation.
How can lice that are under the skin be removed? - in detail
Effective elimination of ectoparasites that have penetrated the epidermal layer requires a systematic approach: accurate identification, pharmacologic intervention, mechanical extraction, and environmental control.
The first step is confirmation that the organism is indeed a biting or burrowing louse. Visual inspection reveals tiny, translucent cysts or dark specks at the entry points, often accompanied by itching or a localized rash. Dermatoscopic examination can distinguish the parasite from other skin conditions.
Pharmacologic treatment:
- Topical pediculicides containing permethrin 1 % or pyrethrin‑based formulations applied to the affected area for the recommended duration (usually 10 minutes), then rinsed thoroughly.
- For resistant cases, a second‑generation agent such as ivermectin 0.5 % cream applied once daily for three consecutive days.
- Oral ivermectin (200 µg/kg) may be prescribed when extensive infestation or failure of topical therapy occurs; repeat dose after 7 days improves eradication rates.
- Adjunctive corticosteroid cream can reduce inflammation and pruritus, but should not replace the antiparasitic agent.
Mechanical removal:
- After the chemical agent has softened the cuticle, use sterile fine‑point forceps or a needle to lift each embedded organism from the follicle.
- Perform the procedure under magnification to avoid damaging surrounding tissue.
- Collect extracted specimens for laboratory confirmation if diagnosis is uncertain.
Environmental decontamination:
- Wash all clothing, bedding, and towels used within the previous 72 hours at ≥60 °C; dry on high heat for at least 30 minutes.
- Vacuum carpets, upholstered furniture, and vehicle seats; discard vacuum bags immediately.
- Seal non‑washable items in airtight containers for a minimum of two weeks to deprive surviving parasites of a host.
Follow‑up:
- Re‑examine the skin 7–10 days after treatment to ensure no new lesions appear.
- If symptoms persist, repeat the therapeutic regimen or consider alternative agents such as benzyl benzoate or malathion, guided by susceptibility testing.
By integrating chemical eradication, precise manual extraction, and rigorous hygiene measures, embedded lice can be removed completely, preventing recurrence and secondary infection.