Body Lice

Overview

Body lice are tiny insects that live on clothing and bedding and feed on your blood. They are different from head lice — body lice mostly stay in the seams of clothes and only crawl onto your skin to feed. They can cause intense itching and a rash.

Body lice are much less common than head lice in most countries. They mainly affect people in crowded living situations, such as homeless shelters, refugee camps, or other places where access to clean clothes and bathing is limited.

Anyone can get body lice, but they are most common in people living in crowded conditions or without regular access to bathing and clean clothing. They can also affect people who share clothing or bedding with someone who has lice.

Symptoms

Common symptoms

• Intense itching, especially at night
• A rash or tiny red bumps on the skin, often around the waist, armpits, or groin
• Tiny red or dark spots on the skin (from lice bites or droppings)
• Thickened or discolored skin in areas where lice have bitten repeatedly

Symptoms in children

• Children may have a rash and itching on their body, and they may scratch enough to create sores. They can get body lice from close contact with an infected family member or from sharing clothes or bedding.

Symptoms in older adults

• Older adults may not mention itching, so look for signs like scratching, a red rash, or irritation in skin folds or along the waistband. It can appear as dry, crusted, or discolored patches.

Causes

Main causes

• Body lice are tiny insects called Pediculus humanus corporis. They feed on human blood and lay eggs (nits) in the seams of clothing and in bedding.
• They are spread from person to person by close physical contact, or through sharing clothes, towels, or bedding that has lice or eggs on it.
• They do not jump or fly; they crawl.

Risk factors

• Living in crowded conditions, such as shelters, refugee camps, or dormitories
• Limited access to bathing or clean clothes
• Homelessness or poverty
• Sharing clothing, towels, or bedding with an affected person

When to see a doctor

See a doctor urgently if:

• You have intense itching with signs of skin infection, such as redness, swelling, warmth, or oozing sores.
• You have a fever, chills, or swollen lymph nodes and a skin rash.
• You are caring for someone who seems confused or very unwell.

Book a routine appointment if:

• You have persistent itching or a rash that does not improve after washing your clothes and bedding.
• You keep getting body lice even after cleaning and treating your clothing.
• You need advice on how to treat your home and clothing to get rid of the lice.

Diagnosis

A healthcare provider can usually diagnose body lice by looking at your skin and examining the seams of your clothing and bedding for lice or eggs. They may use a magnifying glass or a special light.

Tests that may be done

• No tests are needed in most cases.
• Occasionally, a provider may scrape a tiny sample of skin from an affected area to look under the microscope.
• If a bacterial infection is suspected, a provider may order blood tests or check a swab from a sore.

What to expect at your appointment

The visit is quick and painless. You may be asked to remove some clothing so the provider can examine your skin, especially around the waist, armpits, and groin. The provider may also recommend checking close contacts.

Treatment

The main treatment for body lice is to wash all clothing, bedding, and towels in hot water (at least 60°C or 140°F) and dry them on high heat. In some cases, a healthcare provider may also prescribe or recommend a lotion or shampoo that kills lice. It is important to treat everyone in the household at the same time to prevent re-infestation.

Self-care at home

• Wash all clothing, bedding, towels, and washable fabrics in hot water and machine-dry on the hottest setting for at least 20–30 minutes.
• If you cannot wash items, have them dry-cleaned, or iron them with a hot iron, especially the seams.
• Place non-washable items (e.g., coats, blankets) in a sealed plastic bag for at least two weeks, because lice cannot live long without a blood meal.
• Take a regular bath or shower and put on clean, freshly laundered clothes each day.
• Avoid sharing clothing, towels, or bedding with others until the infestation is gone.
• Vacuum floors, mattresses, and upholstered furniture to remove lice and eggs.

Medical treatments

Sometimes a healthcare provider will prescribe or recommend a topical lotion, cream, or shampoo that contains an insecticide that kills lice and eggs. You apply it to your body according to the instructions, and then wash it off after a set time. Do not use any product without speaking to a healthcare provider first, especially if you are pregnant, breastfeeding, or applying to a child. If a secondary bacterial infection has developed, a provider may also prescribe an antibiotic — but this treats the infection, not the lice themselves.

Living with this condition

Once you have washed all your clothes and bedding and treated your skin, focus on simple daily habits: bathe regularly, change into clean clothes, and keep your sleeping area clean. This will prevent the lice from coming back.

Lifestyle tips

• Keep a regular bathing schedule when possible.
• Change into clean underwear and clothes every day.
• Wash bedding at least once a week in hot water.
• Avoid sharing personal items like towels, clothing, or combs.
• Vacuum your living area regularly, especially around where you sleep.

Diet and exercise

No special diet or exercise is needed to treat body lice. Eating well and staying active can help your skin heal and improve your overall mood and well-being.

Mental health and emotional wellbeing

Having body lice can feel embarrassing or stressful, and the constant itching can be exhausting. It may help to remind yourself that this is a medical issue, not a judgment on you. Talk to a trusted friend, family member, or counselor if you are feeling overwhelmed. If your feelings are very heavy and you are having thoughts of self-harm, please contact a mental health crisis service or go to your nearest emergency department.

Prevention

Yes. The best way to prevent body lice is to wash your body regularly, wear clean clothes, and wash your bedding and clothes often. Avoid sharing clothing, towels, or bedding with other people. In crowded settings, regular cleaning and checking for lice can help stop the spread.

Vaccines

There is no vaccine against body lice.

Screening programmes

Most people do not need routine screening. In high-risk places like shelters, staff may check for lice regularly, but individual screening is only needed if you have symptoms or have been exposed.

Complications

If left untreated

• Bacterial skin infections from scratching, such as impetigo (a contagious skin infection) or cellulitis (a deeper skin infection).
• In some parts of the world, body lice can spread infections like epidemic typhus or trench fever, though these are rare in most countries today.
• Persistent scratching can lead to thickened, dark, and irritated skin, sometimes called 'vagabond's skin.'

Long-term outlook

Body lice can be completely eliminated with thorough washing of clothes and bedding, plus good personal hygiene. Most people recover fully without long-term problems. If a skin infection has occurred, it can usually be treated successfully with antibiotics.

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