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Having small spots under skin after the treatment of louse infestation. Permanent cure?

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Posted on Wed, 14 Aug 2013
Question: Following a severe body louse infestation treated with permethrin and ivermectin I now have dark small spots under my skin which seem to "hatch out". Many are small and hard, the size of a full stop, others are larger and move. My dermatologist has not looked at them but has referred me to a psychiatrist, which is okay by me, he also prescribed Avatax for the stress and crawling feelings. I know he thinks I have a delusion, but the black things persist in reality and not in my mind. My husband also has seen them and seen them moving on my skin. What can they be? They actually exist and I am not imagining them.
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Answered by Dr. Kalpana Pathak (1 hour later)
Hi,
Thanks for writing to us.
firstly I would like to let you know that body lice does not hatch or live underneath skin. Body lice lives in the clothes seams and attaches to body only while feeding. Sometimes even after disease has been treated, itching or hypersensitivity induced small red brown or black bumps persist. Now I would like to offer a treatment protocol that would treat you completely
1) wash all your clothes, undergarments, bed linens, towels in hot water and dry it in hot dryer. Also make it a point to iron the clothe seams using hot iron.
2) repeat permethrin application overnight and then bathe in morning
3) oral ivermectin is taken three times after a gap of a week ie 0 day, day 7 and day 14
4) take tablet cetirizine twice in a day to control itch.
5) after a single overnight permethrin application, start applying a mild steroid lotion twice daily to help resolve the skin bumps.

The treatment has been offered considering that may be you are still infested or the infestation has cleared but hypersensitivity induced lesions are persisting.

Follow these guidelines and let me know in a week whether you have improved or not.
If having any doubt, please write back.
Take care
Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Kalpana Pathak

Dermatologist

Practicing since :2006

Answered : 2014 Questions

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Having small spots under skin after the treatment of louse infestation. Permanent cure?

Hi,
Thanks for writing to us.
firstly I would like to let you know that body lice does not hatch or live underneath skin. Body lice lives in the clothes seams and attaches to body only while feeding. Sometimes even after disease has been treated, itching or hypersensitivity induced small red brown or black bumps persist. Now I would like to offer a treatment protocol that would treat you completely
1) wash all your clothes, undergarments, bed linens, towels in hot water and dry it in hot dryer. Also make it a point to iron the clothe seams using hot iron.
2) repeat permethrin application overnight and then bathe in morning
3) oral ivermectin is taken three times after a gap of a week ie 0 day, day 7 and day 14
4) take tablet cetirizine twice in a day to control itch.
5) after a single overnight permethrin application, start applying a mild steroid lotion twice daily to help resolve the skin bumps.

The treatment has been offered considering that may be you are still infested or the infestation has cleared but hypersensitivity induced lesions are persisting.

Follow these guidelines and let me know in a week whether you have improved or not.
If having any doubt, please write back.
Take care