How can subcutaneous lice be treated? - briefly
Effective management of subcutaneous lice involves systemic insecticidal therapy, typically oral ivermectin administered at a dose of 200 µg/kg, repeated after 7–10 days to cover the life cycle. Adjunctive topical pediculicides may be applied to the skin surface to eliminate residual ectoparasites.
How can subcutaneous lice be treated? - in detail
Effective management of subcutaneous lice infestations requires a coordinated approach that combines pharmacological intervention, environmental control, and patient education.
First‑line pharmacotherapy consists of topical pediculicides containing permethrin (1 %) or pyrethrins combined with piperonyl‑butoxide. Apply the preparation to clean, dry skin, leave it for the recommended duration (usually 10 minutes), then rinse thoroughly. Repeat the application after 7–10 days to eliminate newly hatched lice that escaped the initial dose.
When topical agents fail or resistance is suspected, oral ivermectin is the preferred systemic option. A single dose of 200 µg/kg is administered, with a second dose 7 days later. For severe or refractory cases, a three‑dose regimen (days 0, 7, 14) may be employed. Monitor for adverse effects such as mild gastrointestinal upset or transient dizziness.
Adjunctive measures enhance treatment success:
- Wash all clothing, bedding, and towels in hot water (≥ 60 °C) and dry on high heat for at least 30 minutes.
- Seal non‑washable items in airtight plastic bags for a minimum of two weeks to deprive lice of a host.
- Vacuum carpets, upholstery, and vehicle interiors to remove detached insects and eggs.
- Advise patients to avoid scratching or picking at lesions to prevent secondary bacterial infection; topical antiseptics may be applied if needed.
Follow‑up evaluation should occur 2–3 weeks after the final medication dose. Inspect the skin for live lice, viable nits, or persistent erythema. If any remain, repeat the selected therapeutic protocol or consider combination therapy (topical plus oral) under medical supervision.
Education reinforces compliance: instruct patients to keep nails trimmed, maintain personal hygiene, and avoid sharing personal items such as combs, hats, or clothing. Providing written instructions and a schedule for re‑treatment improves adherence and reduces recurrence risk.