Head Lice: Diagnosis and Therapy

Gabriel J. Martinez-Diaz, MD; Anthony J. Mancini, MD


Dermatology Nursing 

In This Article

Abstract and Introduction


Children worldwide are commonly infected with head lice, or pediculosis capitis. The epidemiology, etiology, clinical manifestations, diagnosis, and preventive and treatment modalities for managing head lice in children are reviewed.


Head lice, also known as pediculosis capitis, has a worldwide prevalence of up to 60% (Falagas, Matthaiou, Rafailidis, Panos, & Pappas, 2008). It is caused by the head louse, Pediculosishumanus var. capitis, which may infest children of any age, but most frequently those between 3 and 12 years of age in the United States (Falagas et al., 2008). African Americans are less commonly infested, which may be due to the twisted nature of the hair shaft, the use of hair pomades, or the diameter and shape of their hair shafts, which may make grasping of the shaft more difficult (Diamantis, Morrell, & Burkhart, 2009; Frankowski & Weiner, 2002; Ko & Elston, 2004; Rubeiz & Kibbi, 2009). Although traditionally believed to be associated with low socioeconomic status, poor hygiene, longer hair, or frequency of shampooing or brushing, head lice infestation is not dependent on these variables. The human head louse does not transmit disease, but can be socially stigmatizing and places a significant burden on patients, parents, and society. The annual direct and indirect costs of head lice infestations in the United States are estimated to be in the hundreds of millions of dollars (Clore & Longyear, 1990; Frankowski & Weiner, 2002; West, 2004).


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