Chapter 37 Treatment of Lice and Scabies

Lice

Group of parasites that can live on the body, scalp, or genital area of humans.

Nits

Head lice eggs.

Nymph

Baby louse.

Ovicidal

Kills eggs.

Parasite

Organism that benefits by living in, with, or on another organism.

Pediculicide

Drug that kills lice.

Scabicide

Drug that kills the scabies mite.

Scabies

Parasitic infection caused by the mite Sarcoptes scabiei.

Pyrethrins + piperonyl butoxide (US Brand Name)

ZAP Maximum Strength

Pyrethrins + piperonyl butoxide (Canadian Brand Name)

R&C Shampoo with Conditioner

Pyrethrins + piperonyl butoxide (Dosage Forms & Strengths)

Shampoo: pyrethrins 0.33% + piperonyl butoxide 3% or 4%

Pyrethrins + piperonyl butoxide (OTC/Rx Status)

OTC (Over the counter)

Permethrin (US Brand Names)

Nix, RID Home Lice, Bedbug & Dust Mite Spray

Permethrin (Canadian Brand Names)

Kwellada-P Cream Rinse, Kwellada-P Lotion, Nix Cream Rinse, Nix Dermal Cream

Permethrin (Dosage Forms & Strengths)

Cream rinse (1%), Lotion (1%, 5%), Cream (5%)

Permethrin (OTC/Rx Status)

OTC (Over the counter)

Ivermectin (US Brand Names)

Sklice, Soolantra

Ivermectin (Canadian Brand Names)

Rosiver

Ivermectin (Dosage Forms & Strengths)

Cream (Rosiver, Scoolantra): 1%, Lotion (Sklice): 0.5%

Ivermectin (OTC/Rx Status)

Prescription, OTC

Malathion (US Brand Name)

Generics

Malathion (Dosage Forms & Strengths)

Lotion: 0.5%

Malathion (OTC/Rx Status)

Prescription

Crotamiton

A scabicide that can be used during pregnancy.

Malathion (Drug Class)

Organophosphate pesticide

Malathion (Medical Indications)

To kill head lice and their eggs

Malathion (US Market History)

Withdrawn, then reintroduced in 1999 after labeling changes

Crotamiton (US Brand Names)

Eurax, Crotan

Crotamiton (Dosage Forms & Strengths)

Lotion: 10%

Crotamiton (OTC/Rx Status)

Prescription (United States)

Spinosad (Drug Class)

Pediculicide

Spinosad (Medical Indications)

Topical treatment of head lice in patients 4 years and older

Spinosad (Origin)

Derived from Saccharopolyspora spinosa, a bacterium found in soil

Spinosad (US Brand Name)

Natroba

Spinosad (Dosage Forms & Strengths)

Topical suspension: 0.9%

Spinosad (OTC/Rx Status)

Prescription

Crotamiton (Eurax) — Dosing Schedule

Apply to entire body chin-to-toes. Repeat in 24h. Bathe 48h after second dose.

Crotamiton (Eurax) — Warning Label

SHAKE WELL.

Dimethicone 100 cSt (NYDA) — Dosing Schedule

Wet hair with spray, leave 30 min, comb, dry 8h, wash. Repeat in 8-10 days.

Malathion — Warning Label

FLAMMABLE; AVOID FLAMES.

Spinosad (Natroba) — Dosing Schedule

Apply to dry scalp/hair for 10 min, rinse. Retreat in 7 days if live lice seen.

Pyrethrins + Piperonyl Butoxide — Hair Washing Restriction

Do not rewash hair for 1-2 days after treatment.

Head lice parasite

Pediculus humanus capitis

Body lice parasite

Pediculus humanus corporis

Epidemics caused by body lice

Typhus and louse-borne relapsing fever

Pubic lice parasite

Pthirus pubis

Scabies transmission environment

High population density environments like hospitals, nursing homes, childcare facilities, and schools

Sarcoptes scabiei survival away from host

Dies if away from a human host for longer than 48 to 72 hours

Lice/scabies washing temperature prevention

Wash clothing, linens, and bedding in hot water at 130 °F (54 °C)

Lice/scabies plastic bag prevention duration

Seal non-washable items in a large plastic bag for 2 weeks

Permethrin drug resistance cause

Residue left after treatment

Pyrethrins vs. Permethrin indications

Pyrethrins treat head/body/pubic lice; permethrin is approved only for head lice

Dimethicone 100 cSt 50% mechanism

Asphyxiates the louse

Ivermectin routes of administration

Topically for head lice; orally for worm infections