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Q. I have head lice and body lice for almost a year. Please suggest some remedy.

Answered by
Dr. Dhepe Snehal Laul
and medically reviewed by Dr. Preetha J
This is a premium question & answer published on Oct 19, 2020

Hi doctor,

I have had (what I think is) head lice and body lice for almost a year. I have tried all Permethrin creams and shampoos, including Kennel Dip for dogs. We have shampooed, sprayed, and broomed my bedroom and house, and I am currently taking Epsom salt baths. I need help. My NP cannot see them (which I am continually using treatments and regularly combing my hair, and they are small, hopefully, because I am killing them before they mature). I have pictures. A key here, maybe as I comb my hair, they also run into my nose and ears. I believe that they are dying, plus giving birth in my nose. I find perfectly round sacs with what looks like an embryo inside. I am so stressed and depressed over this.

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#

Hi,

Welcome to icliniq.com.

Attach the picture of the lesion for a better understanding.

  • Do you scratch and rub your lesion?
  • Do you have any excoriation marks?
  • Do you have any drug history?
  • Do you have the delusion of parasitosis?
  • Do you have any psychiatry history?
  • Do you have mite allergies?
  • Does itching aggravate during the night?
  • Do you follow improper hygiene?

Please do reply.

Hi doctor,

Thank you for your reply.

Yes, excessive itching during the day also, but a lot at night. Only scab behind my psoriasis' ears and bleeding (not using my regular cream) because now I am using lice creams. I have no history of drug abuse or psychiatry use. I follow good hygiene. My doctor or my NP cannot see them when I visited them, probably because I am combing and doing treatment regularly. I have attached the picture of the lesion.

#

Hello,

Welcome back to icliniq.com.

For pediculosis capitis (head lice) 1 to 5 percent Permethrin (Perlice lotion), three applications on consecutive days followed by tying a cloth on the scalp and shampoo after seven days. For Pediculosis corporis, Permite 5% cream on day one and day seven (all over the body below the neck). Laundering and ironing of clothes are needed. Tablet Levocetirizine 5 mg twice daily for ten days (when itching). Permite (Permethrin) Bb bar soap for bath. Liquid Moyzen lotion (liquid paraffin) at daytime on psoriasis lesions.

  • Are the psoriasis lesions scaly?
  • Does it have thick silvery-white scales?
  • Where is the location or size of the lesion?
  • Is the psoriasis present in the scalp?
  • Does the lesion aggravate during winter?
  • Does it have any aggravating factors?
  • Does it have any emotional aspects?
  • Do you have any history of trauma or injury?
  • Do you take any painkillers?
  • Do you have any history of illness?

Please attach the picture of the lesion for confirmation of diagnosis.

Hi doctor,

Thank you so much for your reply.

There is a good chance. I have all three lice. I have taken pictures of them but do not know how and where to upload them.

Yes, psoriasis is crusted, silvery, diagnosed by the dermatologist. It is on my two elbows, knees, belly button, and above my butt. I cannot take Prednisone or Steroids or Ibuprofen. I am allergic to dairy products. I have a spinal injury called CRPS. I cannot walk well, have chronic pain, legs swelling, and go dead.

I take,

Atenolol 25 mg one tablet during the day, Amlodipine 10mg one tablet at night, Hydrocodone 10/325 three tablet a day (I take in halves), Amitriptyline 50 mg one in day and 25 mg one tablet at night, and Multivitamins like Vitamin D3, C 1000, and Vitamin E.

#

Hi,

Welcome back to icliniq.com.

Chronic plaque Psoriasis is your diagnosis. It is a chronic inflammatory condition of the skin that presents with a scaly plaque with redness. In 25 percent of cases, it can be itchy.

  • Topical Steroids with Salicylic acid or Calcipotriene (Vitamin D derivative Calcitriol) application with moisturizers help Psoriasis. Triggering factors of Psoriasis are immunological, certain drugs, weight gain, seasonal variations, stress, environmental changes, trauma, cold weather, and genetic factors.
  • Apply Topisal (Clobetasol Propionate and Salicylic acid) 3 % ointment at night for 15 days.
  • Topical Calcipotriol cream is also another option.
  • Topical Corticosteroids, Calcipotriene, a Vitamin D analog, Omega 3 fatty acid, and Salicylic acid are the initial treatment line.

Other options are PUVA (Psoralen ultraviolet A), phototherapy, NBUVB (Narrow band UVB phototherapy), MTX (Methotrexate), Biologics, Apremilast (in joint pain) for psoriatic arthritis.

  • Avoid emotional stress.
  • Practice yoga, relaxation techniques.
  • Avoid trauma or injury to the skin.
  • Do not scratch the lesions.
  • Use a good moisturizer, always keep the skin hydrated.
  • Use Cetaphil moisturizing lotion thrice daily for 15 days.
  • Avoid painkillers like Diclofenac, Ibuprofen as these exacerbate Psoriasis.
  • Treat infection or illness, if any.
  • Use Moisturizers in winters to avoid exacerbation of the lesions.
  1. Do you have any joint pains?
  2. Do you have Psoriatic Arthropathy?
  3. Which prescription do you want?

Hi doctor,

Thank you so much for your reply.

I have an excellent cream for psoriasis, and I have Krave cream moisturizer. The medicines or creams or soap for lice, do they come in prescription?

I have insurance. I see they are costly. Can you get them cheaper?

#

Hello,

Welcome back to icliniq.com.

  • You can apply the Perlice lotion to the scalp on three successive days. Shampoo the scalp on the seventh day.
  • Permite 5 % cream on day one and day seven (after six days) at night all over the body below the neck, and wash off the next morning.
  • Apply Permite Bb bar soap for bath.
  • Tablet Levocetirizine 5 mg twice daily for seven days.

You can get over-the-counter. These are not very costly.

Hi doctor,

Thank you for your reply.

Does my husband need the same treatment? What about my bed? I think they are on it. Can you put any of these items on the genital area? How long should I expect them to be gone? Will this kill pubic lice also? Can my dogs get any of these lice?

#

Hi,

Welcome back to icliniq.com.

Yes, similar treatment to your husband also.

  • Regularly change bed linens.
  • Wash clothes separately in hot water.
  • Do not use cream or lotion on the genital area.
  • You can use soap to clean the genital areas.
  • You can use Permite Bb bar soap. It will take a few weeks to months to heal completely.
  • Avoid pets, as it can be a source of spreading infection.
  • Bath twice daily with lukewarm water.
  • You can add little antiseptic liquid-like Dettol or Savlon or neem leaves to the bathtub water.
  • Please avoid scratching or rubbing lesions as it may cause secondary bacterial infection and spread of the disease.
  • Cut your nails short.
  1. Do you have itching in the genitals?
  2. Do you have pediculosis pubis?
  3. Do you have excess hair growth in the genitals?

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