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Have itching and crawling in head and see white bugs. What is it?

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Practicing since : 2005
Answered : 1919 Questions
I have itching and crawling in my head and see small white bugs around me I read about them on Internet that people suffering from them and they don' t go away . I see them very stubborn . Can I get advice? I really really appreciate that!
Posted Sun, 15 Sep 2013 in Skin Hair and Nails
Answered by Dr. Johny Chacko 1 hour later
Brief Answer:
Yes, you will get advice.

Detailed Answer:
From your description, you could be suffering from head lice (pediculosis capitis). They can cause crawling sensation and scratching. Have you seen any of these bugs closely? You can search for head louse in Google images and compare with the bug you have.

I usually treat head lice with permethrin 1 % creamy rinse. This is applied all over the scalp and hair half an hour before head bath and after application head is covered in a towel. During head bath, this is shampooed off. This treatment is repeated after a week.
Hope I have answered your query. If you have any clarifications I will be happy to help.
Take care
Above answer was peer-reviewed by
Follow-up: Have itching and crawling in head and see white bugs. What is it? 20 hours later
I appreciate your response but I wonder why you diagnosed lices (as lices are not white bugs) I have pictures of them that I can not paste in this message.
Doctor Chako I have nothing against you but I have paid to get advice from group of specialists who are expertise and I need their help as I am desperate because this itching and crawling does not go away.
These bugs are springtails and soft bodied hexapods. first time when I had itching and crawling I saw tiny pink about 40 eggs in the strainer( I put strainer on the tub drainer when I took shower and washed head).
But When I changed my bathroom (for shower ) I stopped seeing eggs but I have been infested since then. I Washed my head so many times with differen shampoos but itching and crawling does not go away.
I request group of doctors to confer and diagnose it and reccommend me some shampoo or medicine strong enough to kill them and stop itching and crawling and recommend me some strong repellent for hair and scalp.
I appreciate doctor Chako's time and advice but please 'ask a doctor' should do as they committed and ask specialists for advice !
I appreciate your business and commitment !
Thanks, XXXXX

Answered by Dr. Johny Chacko 4 hours later
Brief Answer:
Clarification on head lice

Detailed Answer:
Welcome back.
Head louse is grey in color, not totally white. I agree to that , but they are described as white by a lot of my patients. Nymph or the young ones look very greyish white. It is only after a blood feed that a louse will look dark. And head louse also has six limbs.

If it is possible, could you please mail the pictures to YYYY@YYYY with subject as Attention to Dr. Chacko. Alternatively, you could upload them on the right side of this query page. I do not think there is an option for pasting picture on the query page. Sorry about that.

I wanted to tell you that I have completed my post graduation in dermatology, venereology and leprosy from St John's Medical College where exchange students from USA come for experience. I am quite an authority in Arthropods in Dermatology as I have researched and presented seminar on this topic. So I assure you that no other arthropod or bugs fit the symptoms you give. Spring tails do not reside on the scalp and lay eggs.

I am not telling you that you are infested with head lice for sure. You may not be infested with any bugs for that matter. You told me that you have dandruff. Dandruff can cause itching and crawling sensation. The scaling can resemble eggs or bugs as well. Kindly consult a dermatologist for face to face examination for confirming the diagnosis and treatment. Online consultation is mainly to give you expert advice and clarify your doubts. This cannot replace a face to face consultation.

I usually treat dandruff with a shampoo containing 2 % ketoconazole and 1 % ZPTO which is used for two to three times a week. Once patient notices good improvement which is usually after one month, I maintain this once a week. This is a prescription shampoo and not over the counter in US.

Ask a doctor means ask one doctor, not many doctors, so naturally group of doctors cannot confer and diagnose your condition.

If you think that I am not expert enough and the opinion given by me is not scientific and accurate enough you may contact the customer care and ask for refund.

Take care and wish you good health and peace.
Above answer was peer-reviewed by
Follow-up: Have itching and crawling in head and see white bugs. What is it? 31 hours later
Dear doctor chacko,
I really really appreciate your response and please accept my apology and tons of thanks for spending that much time to explain all that.
You are very highly qualified and very knowledgeable doctor and I am lucky I communicated with you.
You are right I will have face to appointment with dermatologist. But I think I will be very unlucky if I do not get advantage from your expertise.
I will email you images those are exactly like what I see attached to hair in the strainer that I put on the drainage where I wash my hair.
since I have been infested i see these bugs in house also. these bother me when I feel itching on my scalp and body ( more on scalp) and crawling sensation on my scalp. It makes me hard to sleep at night.
These are bothering me on my nostrils, corners of mouth, ears and eyes. Though I can not see them near these parts but feel them.
In the beginning when I washed my hair I saw jelly like embryos came from my hair but after washing my hair thoroughly and daily these are gone.
I had bad dandruff and may be that initiated all this problem but now after washing my head daily and using so much different things that dandruff is totally gone.
Doctor Chicko once more I apologize for having little annoying comments but I need your help.
After looking at images please investigate and diagnose my problem I will say special prayers for you and send you a beautiful gift that you will always remember.

Thanks o much for your time I will write your review as you need twenty times more money.
Answered by Dr. Johny Chacko 3 days later
Brief Answer:
Attempt to diagnose your problem

Detailed Answer:
Hello Kay,
Welcome back.
I was waiting for images, but I i did not get any through healthcare magic or e mail.
Possibilities that I think of in your case are as follows.

When a lot of bugs are there in the house around you naturally one or two can crawl onto the hair and you would have noticed them. For you to be infested by a bug, the bug should complete its entire life cycle inside your scalp. That means at a time we will see adult bug, eggs and young ones in your scalp. A dermatologist will be able to identify the presence of these during examination. If after examination if he does not find any bugs on the scalp that means you are not infested.

The other possibility is that you had an inflammation of the scalp, maybe due to dandruff which caused itching and crawling sensation. Simultaneously you noticed bugs around you and your mind connected the two. This firm belief of mind cannot be shaken in some people. For this sometimes even a psychiatrist help will be required to finally shake it off. Doctors call it delusion of parasitosis.
So if dermatologist is not able to detect any bugs inside your head during examination you should consider getting an appointment with a psychiatrist.

Hope this helped
Take care.
Wish you good health.

Above answer was peer-reviewed by
Follow-up: Have itching and crawling in head and see white bugs. What is it? 23 hours later
Doctor Chacko,
I appreciate your response. By the way I am also a highly professional person and also got awards from different companies as i was very true to my professional. Thanks God I am still emotionally strong and very much alert to distinguish between delusion and reality!
I physically saw these bugs and took them as well as their eggs to my primary doctor but i was shocked to see her reaction and it was very first time i saw this attitude of her as she did not even want to see !! Because that was the true evidence of what doctors are trying to prove it as " delusion of parasitosis".
That's why I do not blame you. But I wonder why you did not get my pictures as exactly same pictures at same time I sent to your other doctor and she got them and prescribed me some thing better.
Thanks for your time.
You have a whole life in front of you and I pray for you to be a true and
successful doctor.
I will attach you one document in my email and I wish this time you get it. As you have busy schedules so don't need to respond me but at least have a look at that may be some time in future it will be of some help.
Thanks again,
Answered by Dr. Johny Chacko 24 hours later
Brief Answer:
Had a look at the images.

Detailed Answer:
Thanks for the pictures. I hoped to see a picture of bugs that has infested you and not something from internet.
Nevertheless the pictures that you have sent me are of springtails. The good news is that they usually feed on algae, fungi and other micro organisms and they cannot infest humans. But they can be quite a nuisance and can multiply fast and will be all over the house within no time. Usually they love humid areas, So bathoom is a common site where you can spot them as in your case. They can jump if disturbed and therefore there is a chance of spotting them on your scalp as well, but they do not make nest in human body as they won't find any food in human body. Their fine hairs can cause irritation to human skin in some people.

I am not telling you that you have delusion of parasitosis. I just wanted to inform you that such a condition exists.

You definitely seem to have a bug problem at home, so I will recommend you to consult pest control to tackle this springtail menace. But you need not worry about them infesting you.

Hope I have answered your query. If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health.
Above answer was peer-reviewed by
Follow-up: Have itching and crawling in head and see white bugs. What is it? 12 hours later
Doctor Chacko,
Thanks so much for quick response. I am glad you got attachments I sent to you actually one of them was of bugs but I don't know how that is not there though I uploaded it again and hope you get it. But you are right these are called springtails and very tiny (like small piece of tissue paper) flat with legs on the sides and two antennas in the front. Thats how they looked like When first time I saw them (in the strainer when I washed my head)with magnifying glass. First those were eggs then jelly like embryos and then these white bugs.
You are right and I feel better after your suggestion (as I am very much desperate at this time) that I should consult a pest control company. I just talked to three different companies and they will come for inspection and then they will suggest me. I had steam washed my carpets and got thorough duct cleaning and now getting window cleaning(as that has fungus in the fixed part of windows)
Next thing I will try to get my house water inspected and lab tested because my assumption is that somewhere in the pipes there lot of fungus.
Then eventually I will try to see a dermatologist also ( I hope he listens to me) and may be ask him to subscribe some antibiotics to me.
It was hard to sleep at night for itching and crawling in the head and some time itching on the body also.
After getting refusal from my doctor I concentrated more on Internet that's how I reached you also and that I am so glad because at least I can talk to somebody about that and exchange ideas.
Since last three weeks I am trying essential oil drops in my shampoo and put some drops in the water (in the little spray bottle) and spray it on my hair, scalp and body and believe me that helped a lot and at least I can sleep at night. Though in between I am switching to something different ( like selsun blue shampoo plus XXXXXXX cider vinegar rinse) that also helps but then they migrate real quick to my eyes, ears, nostrils and mouth corners ( that I don't know what to do)and that is very irritating.
I am worried about long term side affects of essential oils(though those are natural like peppermint, cider and eucalyptius mixed oil and tea tree oil is another one( these are just used by drops). Also I am washing my head daily and I using all this like dandruf shampoo, vinegar and essential oil drops in water ect; within last about two months I ave been very tough with my head as in the beginning when I found 50 tiny pink eggs in my strainer and had bad itching and crawling in my head at that time I wet my hair so many times during day with rubbing alcohol and dettol(very strong)
Believe me I am very strong nerve person and very rational and realistic and always believe in physical evidence.
You are expertise and I feel very good with your suggestions.
Thank you for listening to me doctor Chacko, I feel comfortable because I know you are very intelligent.
If you have more suggestions, I will always appreciate,
Answered by Dr. Johny Chacko 12 hours later
Brief Answer:

Detailed Answer:
You are welcome.
I don't see any harm in the essential oil and selsun shampoo routine and also XXXXXXX cider vinegar rinse.
However there is no need of wetting your hair so many times with alcohol and dettol. Alcohol and dettol are disinfectants and they are useful against bacteria and not bugs. More over it is damaging to hair on long term use. You will also become sensitive to dettol and mount allergic and irritant contact dermatitis to it thereby making your itching worse.
My suggestion is to focus more on making your house bug free and less on your scalp.
Again antibiotics will help only in bacterial infections and not in case of bugs. So there is no rationale in using antibiotics in your case.

Nice interacting with you. Take care and wish you good health.
Above answer was peer-reviewed by
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