Lice Infestations in the Pediatric Population

Abstract

Lice cause a common pruritic condition known as pediculosis, which can cause significant psychosocial distress and embarrassment. The infestations can present differently in the pediatric population compared with the adult population, and certain infestations such as head lice are found more commonly in children. To avoid delayed diagnosis, healthcare providers should be knowledgeable of these differences. This article provides an overview of epidemiology and pathophysiology, clinical presentation and diagnosis, and management of lice infestations, specifically addressing the infant and children population.

Staying Ahead of Head Lice: Pediculosis Treatment Updates

“…Head lice are known to alter their color to match hair color and camouflage themselves (Kamath & Kenner-Bell, 2020). In addition, the claws of the lice can adapt (regionally) allowing them to affect different hair types depending on the global location of the louse (Vassantachart et al, 2021). The louse must feed from the human host or it will die in 24 to 48 hr (CDC, 2019b).…”

“…Permethrin acts as a neurotoxin and cause paralysis of the head lice although it is not ovicidal and therefore requires retreatment 7 to 10 days (optimally 9 days) after the initial treatment to kill newly hatched eggs if live lice are seen (Devore et al, 2015). The concern with permethrin is that it has increasingly been found to be resistant to headlice in many regions (Feldmeier, 2014; Imboden, 2019; Vassantachart et al, 2021). Application is straightforward as the cream rinse is applied to damp hair and scalp for 10 min and then rinsed with water.…”

“…Nits are most often visible at the occipital area of the hairline and in the hair behind the ears. Cervical and suboccipital lymphadenopathy may also be present (Vassantachart et al, 2021). Diagnosis, and subsequently, treatment of head lice should only be considered if at least one live louse is found (Bohl et al, 2015; CDC, 2019c).…”