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1

What Scabies medication is this?

Leave on body for 8-14 hours

Safe in children > 2 months of age!

SAFE IN PREGNANCY!

PERMETHRIN = Elimite 5% cream

RX only

 Bathe before medication, apply to ENTIRE BODY except FACE

TREAT OTHER HOUSEHOLD MEMBERS

2

Infestation of Scabies

Adult FEMALE burrows UNDER skin

EGGS Deposited and hatch

Larvae -> adults

Can survive 2-3 days off skin

Infect the:
 web spaces / wrists / elbols / umbilicus / knees / buttocks / scrotum

3

S/Sx of Lice

Bite causes a Wheal to develop

24 hours -> PAPULE

Itching / Scratching --> Secondary INFECTION

4

EX-ST

for Pediculocides

HYPERsensitivity to Chrysanthemums / Ragweed
pyrethrins / permethrin

Presence of secondary skin infection

<2y/o for Pyrethrins

<2m/o for Permethrins

avoid eyelids / eyebrows

PREGNANCY OR BREAST FEEDING

5

What type of Pediculocide?

Head Lice only

Strong Odor / FLAMMABLE

RX ONLY

leave on scalp for 8 - 12 hours

MALATHION

Ovide

 

 

6

Treatment for SCABIES

PERMETHRIN 5% Cream
RX only, leave on for 8-14 hours, treat other household members
safe in children >2moths & pregnancy

CROTAMITON
RX only, bathe b4 applying TREAT OTHER HOUSEHOLD MEMBERS
DNU in pregnancy / BF

Ivermectin
tablets for head lice & scabies, RX ONLY, not for pregnant/BF/children <15kg

Lindane

head / pubic lice, but also for scabies, but SEIZURES IN CHILDREN

7

​What type of Lice?

Encountered in all people regardless of hygiene practice

transmitted through:
sexual contact / toilet seats / sheets

Phthirus PUBIS

PUBIC LICE

CRAB LICE

8

What type of Pediculocide?

DNU if patient is < 2 MONTHS OLD

HEAD LICE ONLY

DNU if allergies to chrysanthemums

Do NOT apply to eyelashes / eyebrows

 

PERMETHRIN

HEAD LICE ONLY AND < 2 MONTHS

 

AA for 10 min then RINSE

 

Pruritis / Burning / Irritation

9

Which Pediculosides ALSO treat Scabies?

LINDANE

but reports of seizure

IVERMECTIN

tablets  avoid in pregnancy / BF / children <15kg

RX ONLY

10

Directions for use of 

Pediculocides

Applly enough to Wet the dry hair/scalp
leave it in for 10 minutes

After rinsing --> use a NIT REMOVAL COMB
wash hands immediately

AVOID EYES / MUCOUS MEMBRANES
do not use on eyelashes or brows

may REPEAT process in 7-10 days if needed

11

What type of Pediculocide?

Head Lice + SCABIES

RX ONLY

DNU in Pregnancy / Breast Feeding / Children <15kg

IVERMECTIN

Stromectol

3mg tablets -->  200mcg/kg

REPEAT in 1-2 weeks

12

What type of Pediculocide?

HEAD LICE ONLY

Do NOT use in children < 4 years old

NO CONTRAINDICATIONS
aside from age

RX ONLY

SPINOSAD

​RX ONLY

AA for 10 min then RINSE

 

Pruritus / Burning / Itching

13

What type of Lice?

Commonly called "cooties"

Live / Hide in CLOTHING

Crawl onto th ebody to feed

larger / longer type of lice

seen in crowded / unsanitary conditions

Pediculus Humanus CORPORIS

Body Lice

14

Adjunctive Measures for treating

Pediculocides​

Machine wash ALL CLOTHING in HOT WATER

Dry clean non-washable fabrics

Wash brushes / combs

Vacuum furniture / rugs

 

PUBIC LICE = ALL PARTNERS SHOULD RECIEVE TREATMENT

15

Types of Pediculocides:

RX TREATMENTS

Spinosad
HEAD only, <4 y/o

Lindane
Head + Pubic, REPORTS OF SEIZURE, resistance
but EFFICACIOUS IN SCABIES

 

Malathion
HEAD only, strong odor, flammable -> 8-12 hours

Benzoyl Alcohol 5%
HEAD only, asphyxiates lice, 6months>, dose varies by hair length

Ivermectin
3mg ORAL tablet, both lice & SCABIES, repeat in 1-2 weeks
DNU in PREGNANCY / BF / children <15kg

16

Unproven Remedies of 

LICE / Pediculosis

Mayonnaise 

Petrolatum Jelly

Olive Oil

Tea Trea Oil

17

Emerging Therapies of

LICE / Pediculosis

DSP Lotions
Nuvo method = shrink wraps lice

 

Dimethicone 4% Lotion
Immobilizes lice in 5 minutes
 

Louse Buster
HEAT applying machine, needs technician

18

Non-Pharmacologic Therapy of

​Pediculosis

Prevent future lice infestations

 

Avoid PHYSICAL CONTACT w/ infected individuals

 

Avoid SHARING personal articles

19

Causes of SCABIES

Sarcoptes Scabiei

POOR HYGIENE

Crowded conditions

POVERTY / MALNUTRITION

Sexual promiscuity

20

What type of Pediculocide?

Head + Pubic Lice

REPORTS OF SEIZURE IN CHILDREN

Some lice are becoming RESISTANT

EFFICACIOUS IN SCABIES

LINDANE

21

Types of Pediculocides:

OTC TREATMENTS

Pyrethrins
Head/Pubic, allergies to chrysanthemus / ragweeds, avoid EYES

Permethrin
HEAD only, chrysanthemus allergy, <2months

22

Pathophysiology / Life-Cycle

of LICE

Head lice -> hair shaft

Feed on blood of host

Female lays eggs which are CEMENTED into place to the hair

Adult on head = 20 day life --> 10 eggs/day

hatch in 5-10 days

ADULT AGAIN in 6-10 days

23

What type of Pediculocide?

HEAD only

RX ONLY

ASPHYXIATES the lice

6 months +

local side effects

BENZOYL ALCOHOL 5%

Ulefia

AA x 10 min REPEAT IN 7 DAYS

Dose adjusted on HAIR LENGTH

6months +

24

What type of Pediculocide?

DNU if patient is < 2 years old

Head + Pubic Lice

DNU if allergies to chrysanthemums / ragweed

Do NOT apply to eyelashes / eyebrows

 

PYRETHRINS

 

AA x 10 min --> repeat in 7-10 days

 

AE = irritation / erythema / itching

25

General Treatment of

Pediculosis

do NOT use Chemical treatments on people who are:

NOT INFESTED or to PREVENT Head Lice

Goal is to kill adults + remove nits/eggs from hair

 

Comb + Pediculocide

26

Counseling for

Pediculocides​

Need BOTH pharmacologic + nonpharm treatment

not the result of poor hygeine in children, just transferred

Preventative measures

27

Symptoms and Transmissions of 

SCABIES

Intense NIGHT TIME ITCHING / Skin Scrapings as a Wet Mount

Excoriation
excessive / repetitive itching of skin --> tissue damage

Burrows / Narrow Dark Lines / Raised Bumps

 

Bodily Contact w/ infected host

Contact w/ infected clothing / linens

28

Which Scabies medication is this?

Repeat in 24 hours

Do NOT use in pregnancy / breast feeding

CROTAMITON = Eurax

RX only,

 Bathe before medication, apply to ENTIRE BODY except FACE

TREAT OTHER HOUSEHOLD MEMBERS

 

 

29

Lice = Pediculocides

General Facts

WingLESS parasites w/ well developed legs

DO NOT JUMP OR FLY

Depend on frequent BLOOD MEALS

Inject a chemical into skin --> ITCHING

HEAD / BODY / PUBIC (phthirus Pubis)

30

What type of Lice?

Most common lice infestation

Females @ increased risk

Direct / Indirect Contact

Pediculus Humanus CAPTIS

Head Lice