Describe the etiology, epidemiology, and pathophysiology of pediculosis. o Head lice Most common 10-12million Americans annually o Body lice “Cooties” Live, hide, and lay eggs in clothing Can attach body areas for feeding Controlled by appropriate hygiene o Pubic lice
“Crabs” Spread by sexual contact, toilet seats, shared undergarments, or bedding Found in pubic area, armpits, eyelashes, mustaches, beards, and eyebrows List signs and symptoms of pediculosis and recommend appropriate treatment given a set of patient specific data. o Non-Pharmacologic Therapy Prevent spread or re-infestation Avoid direct physical contact Do not share combs, brushes, towels, caps, hats etc. Wash bedding in HOT water and dry clothes in dryer May also seal contaminated items in a bag for 2 weeks Head shaving Louse combs Airalle FDA approved medical device 30 min treatment session Applies airflow and heat o Dehydrates and kills the lice Nuvo method Lice-Treatment Cataphil skin cleanser applied to hair and dried with hairdryer “shrink wraps” lice o Suffocation of the louse 2 treatments needed o Second treatment needed 7-10 days later Dimethicome Gel of 100% concentration Coats lice and immobilizes them o Works within 5 minutes of application Exclusions for Self-Treatment Hypersensitivity to chrysanthemums, ragweed, or pediculide ingredients Secondary infection in area of lice infection <2 years of age for pyrethrins <2 mos of age for permethrins Lice infestation of eyelids or eyebrows Pregnancy or breastfeeding Presence of active tumors o Pharmacological Therapy Synergized Pyrethrins MOA: block nerve impulse transmission o Leads to paralysis and death of the insect o Syngergized effect with with the addition of piperonyl butoxide Inhibits pyrethrin breakdown Indication: head and pubic lice Concentrations:
o 0.17-0.33% Pyrethrins o 2-4% piperonyl butoxide Availability: shampoos, foams, solutions, or gels Dosing: o applied topically to affected area ( area must be dry ) for 10 minutes then rinsed or shampooed o lice comb following treatment o repeat in 7-10 days A/E o Irritation o Erythema o Itching o Swelling Contraindications o <2 years of age o Hypersensitivity Pyrethrins Chrysanthemums Ragweed o Avoid contact with eyes and mucous membranes Permethrin MOA: acts on the nerve cell membrane of lice o Delays repolarization causing paralysis of the parasite PK o <2% is absorbed o Metabolizxed hepatically thru hydrolysis to inactive metabolites Indications: o 1% --Head lice only for self care (cream rinse) Dosing o Washing hair and scalp prior to application o Apply to hair and scalp o Leave in hair for 10 minutes prior to rinsing with water o Comb with a lice comb o May repeat in 1 week ONLY if lice or nits are still present Contraindications o <2 mos of age o Hypersensitivity Pyrethrins Chrysanthemums ragweed A/E o Pruritic
o Burning o Stinging o irritatoin Indications: o 5% Prescription only—Scabies Adults o Apply cream from head to toe o Leave on 8-14hours prior to washing off o May reapply in 1 weeks if mites appear Infants o Apply from head to toe o Also, apply on hairline, neck, scalp, and forehead Benzyl alcohol 5% lotion (Ulesfia) Kills lice but not eggs o
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- Spring '17
- Head louse, Irritation, Pediculosis, Body louse, Louse, Mites