How Are Skin Parasites Spread?

Despite what many believe, people do not get skin parasites because of poor hygiene. Instead, skin parasites tend to spread in situations where they can walk or fall from one person to another (or in the case of chiggers, from vegetation to human skin). The parasites often require relatively prolonged and close contact to move between people, and they spread most easily in crowded conditions, from sharing personal items, and from skin-to-skin contact.

Head lice in particular fall casily onto their next victims in close quarters. They also can infest hairbrushes, barrettes, hats, and sometimes clothes or bed linens. Other people become infested by using these items. Pubic lice spread mostly through sexual contact, but people also can get them from bed linens and clothes.

Scabies spread quickly in crowded living conditions or in places with lots of skin-to-skin contact (such as daycare centers and nursing homes). Like lice, scabies can be passed through sexual contact and by sharing clothes, towels, and bed linens.

How Are Skin Parasites Diagnosed and Treated? 

Doctors often diagnose skin parasite infestations just by spotting the parasites, their eggs, larvae, or characteristic red bumps on the skin. With scabies, a skin scraping might be taken to check for mites, eggs, and mite feces (FEE-seez, or bowel movements). However, this test is not always accurate because the mites may have moved from the spot that was scraped.

Over-the-counter and prescription lotions and shampoos (known as pediculicides, peh-DIH-kyoo-lih-sides) can be used to kill head lice. In some cases, treatment may need to be repeated or replaced with stronger medications because lice are becoming resistant to some treatments. Other people living in the same house with the infested person may be treated at the same time.

Pubic lice also are treated with a pediculicide, similar to the treatment of head lice. If the infestation includes the eyelashes, petroleum jelly is applied several times a day to the eyelids for a week or more.

Patients with scabies are given medicated lotions to apply over the entire body, and the lotion must stay on for 8 to 12 hours. Chigger bites do not require any special treatment to heal, but antihistamines may case itching.

Infestation with lice and scabies can persist until they are treated properly. Once treatment begins, patients usually are no longer contagious after a day or two, but sores and itching may continue for several weeks. Chigger bites heal quickly.

Can Skin Parasites Cause Medical Complications?

Complications of skin parasites are rare. Frequent or rough scratching of bites or sores can lead to bacterial infections, such as impetigo. If lice spread to eyebrows or eyelashes, the eyelids may become infected. Norwegian or crusted scabies is a form of scabies that can be severe in people with weak immune systems*, such as those with a chronic illness and elderly people.

How Infestation with Skin Parasites Be Prevented?

To avoid skin parasites, experts recommend that people take the following precautions:

* shower daily, wash hands frequently, and wear clean clothes

* avoid anyone who has lice or scabies until that person is treated

* never share brushes, hats, bed linens, or clothes

* practice abstinence (not having sex); birth control does not prevent pubic lice or scabies

* avoid chigger-infested areas and wear socks, long pants, and long sleeves in wooded or grassy areas

To prevent the spread of parasites in a home when a family member has been diagnosed with an infestation, it is wise to do the following:

* wash bed linens, towels, and clothes in hot water, then dry them on high heat

* vacuum the entire house, then throw the vacuum cleaner bag away 

* disinfect combs and hair items

* seal items that cannot be cleaned in airtight plastic bags for two weeks; at the end of that time, any parasites on those items will have died

In addition, children who have skin parasites should stay home from school or daycare until a day or two after they begin their treatment.

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