PEDICULOSIS CAPITIS

By Gary M. White, MD

Pediculosis capitis.  Nits in the scalp


Pediculosis capitis represents infestation of the scalp by the louse Pediculosis humanis.

Clinical

Small, white eggs (nits) are seen attached to the hair. With careful inspection, one may see the louse hiding amongst the hair near the scalp. Typically, there is much itching and inflammation of the skin. Cervical lymphadenopathy may occur.

Treatment

All contacts should be assessed for infestation. Treatment should be contemporaneous so as not to spread disease back and forth.

Hygiene

Machine wash and dry all clothing and bedding worn in the two days before treatment. If unable to wash something, place the item in a plastic bag for two week. Vacuum floors and furniture around where the infested person sits or sleeps. Combs and brushes should be soaked in hot water for 10 minutes. A fine toothed (nit) comb may be used to remove dead lice and nits.

OTC treatments

OTC treatments for head lice (permethrin 1%, pyrethrins with piperonyl butoxide) have lost their effectiveness and in some studies are no better than placebo. Prescription products should be used.

Prescription Products:

AirAllé Lice Treatment is an FDA-cleared device which uses heated air (different from a blow dryer) to treat head lice. One treatment is needed (one hour of nit-picking and an hour of device usage) and it is approved for patients ages 4 and older.

Additional Pictures

Microscopic examination of hair showing hair nit (egg). Nits are laid by the adult female and are cemented at the base of the hair shaft near the scalp. Nits take about 1 week to hatch (range 6 to 9 days). Viable eggs are usually located within 6 mm of the scalp. This one is empty--already hatched.
hair nit

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