17919 Body Lice

Overview

Body lice are tiny, wingless insects that live in clothing and bedding and feed on human blood. They are different from head lice, and they crawl onto your skin only to feed, then return to the seams of your clothes. An infestation can cause intense itching and a rash.

Body lice are less common than head lice. They are most often seen in people living in overcrowded conditions, such as homeless shelters, refugee camps, or other settings where washing laundry regularly is difficult.

Body lice can affect anyone, but they are more common in people who experience homelessness, live in crowded institutions, or have limited access to bathing and clean clothing. It is not an infection that spreads easily through casual contact or from pets.

Symptoms

Common symptoms

• Intense itching, often worse at night when you are resting
• Red or pink bumps or a rash, especially around the waist, groin, armpits, and shoulders
• Small bites or sores from scratching
• Finding lice or their tiny eggs (nits) in the seams of clothing, especially underwear and shirts
• A feeling of something crawling on your skin

Symptoms in children

• Children may scratch a lot, especially at night
• Irritability or trouble sleeping
• Small red spots or scratch marks on the skin where clothing seams touch
• In school-age children, lice may be shared through naptime mats, shared clothing, or close play

Symptoms in older adults

• Itching may be less noticeable because older skin is often drier, so some people may not feel the bites
• Redness and scratch marks may be more obvious than itching
• Older adults with limited mobility may have a harder time washing clothing and bedding, which can prolong the infestation

Causes

Main causes

• Direct contact with a person who has body lice, such as through sharing a bed, clothing, or close physical contact
• Sharing infested clothing, towels, or bedding
• Lingering in infested furniture or mattresses that have not been cleaned

Risk factors

• Living in crowded conditions like shelters, refugee camps, or dormitories
• Not having regular access to baths or showers
• Not having a reliable way to wash and dry clothing and bedding in hot water
• Sharing personal items like shirts, blankets, or towels with someone who has lice

When to see a doctor

See a doctor urgently if:

• See a doctor the same day if you have signs of a skin infection, such as spreading redness, warmth, pus, fever, or increasing pain.

Book a routine appointment if:

• Make an appointment if you have persistent itching or a rash that does not go away after treating your clothing and bedding.
• If you find body lice or nits and are not sure how to get rid of them, a healthcare provider or pharmacist can advise you on safe treatment options.

Diagnosis

A doctor or nurse can usually diagnose body lice by examining your skin and looking closely at the seams of your clothing for live lice or eggs.

Tests that may be done

• Visual inspection of clothing seams and skin
• Sometimes a magnifying glass is used to spot lice or nits
• In rare cases, if the rash looks unusual, a small skin scraping may be taken to rule out other conditions

What to expect at your appointment

Your healthcare provider will ask about your symptoms and living situation, and may look at the seams of a shirt or undergarment for evidence of lice. They will also check for any skin infections caused by scratching. The visit is normally quick, and no special preparation is needed.

Treatment

The main treatment for body lice is to remove the lice from your body and to destroy them in your clothing, bedding, and towels. You will need to treat both at the same time, otherwise you may get re-infested.

Self-care at home

• Wash all clothing, bedding, towels, and personal fabrics in hot water (at least 60°C / 140°F) and dry them on a high heat setting for at least 20 minutes.
• Items that cannot be washed can be dry-cleaned or sealed in a plastic bag for at least two weeks to kill lice and eggs.
• Take a regular bath or shower, and put on freshly washed clothes after treating your skin.
• Vacuum furniture and mattresses, especially along seams and folds, and dispose of the vacuum bag or contents immediately.
• Avoid sharing clothing, hats, towels, brushes, or bedding with others until the infestation is cleared.

Medical treatments

Your healthcare provider may recommend a prescription lotion or cream to apply to your skin. These treatments are usually applied from the neck down and should be left on for a specified time before rinsing off. Follow your provider's instructions exactly, and only use treatments that are recommended by a qualified professional. Do not use more than directed, and do not use head lice treatments on the body unless specifically advised.

When is surgery considered?

Surgery is not needed for body lice.

Living with this condition

While dealing with body lice, wear freshly laundered clothes each day, and keep your bedding clean. Check the seams of your clothes and bedding regularly for any remaining lice or eggs. Keep your personal belongings separate from others to avoid spreading lice.

Lifestyle tips

• Bathe or shower regularly, and aim to change into clean clothes after washing.
• Wash and dry your clothes and bedding in hot water as often as possible, ideally every day until the lice are gone.
• If you do not have access to laundry facilities, ask your local shelter, community health centre, or social services for help.
• Avoid napping or sleeping with clothing, bedding, or towels that have not been washed recently.

Diet and exercise

A balanced diet and regular activity can help keep your skin healthy and support your immune system, but they do not directly prevent or cure body lice. The most important factors are washing, clean clothing, and proper treatment.

Mental health and emotional wellbeing

Itching and the worry of having lice can affect your sleep, confidence, and mood. It is normal to feel embarrassed, but body lice are common in certain situations and it is not a personal failure. Talk to a trusted friend, family member, or healthcare provider if you feel anxious or down.

Prevention

Body lice can be prevented by washing your body and clothing regularly, and by not sharing clothing, bedding, or towels. In high-risk settings, weekly washing of clothes and bedding in hot water is especially important.

Vaccines

There is no vaccine to prevent body lice. Prevention relies on good personal hygiene and avoiding close contact with infested items.

Screening programmes

Routine screening is not usually needed. If you live in a crowded or high-risk environment, check the seams of your clothing and bedding regularly for lice or eggs, especially if you notice itching.

Complications

If left untreated

• A skin infection from constant scratching, which may require antibiotics
• Spreading the lice to other people, especially those you share a home or bed with
• Scarring or permanent darkening of the skin in places that have been scratched for a long time
• In very rare cases, body lice can carry certain infections, but this is uncommon in everyday settings

Long-term outlook

The outlook is very good. With proper treatment of your skin and thorough washing of your clothing and bedding, body lice go away completely. Even if the itching continues for a few days after treatment, it usually settles within a couple of weeks. You can get back to a comfortable, normal life quickly.

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