Have an Itch? The Truth about Scabies, Lice and Bedbugs

By Gretchen Jenkins, PharmD, BCACP

Have an itch that just will not quit? If so it could be caused by tiny microscopic “bugs” on or under the skin.  Scabies, lice, and bed bug infestations are not that uncommon especially if you are living in close quarters, sharing clothing or traveling. While the symptoms and stigma can be quite traumatic, the good news is these conditions are all easily treatable upon proper detection and diagnosis.



Scabies usually pass via skin to skin contact. The female mites burrow just under the top layer of the skin and lay eggs which hatch. The result is intense itching, especially at night. The rash primarily appears on areas of hairless thin skin, such as between fingers and toes, wrists, elbows, feet and buttocks; avoiding face, head or neck. Over time the infection can cause severe allergic disease such as asthma, eczema or dermatitis.

Scabies Treatment: A simple overnight topical prescription treatment kills the mites. After treatment all bed linens, clothing or personal items in close contact with skin should be washed in hot water and dried in high heat. Items not able to be washed should be sealed air tight for 72 hours. It is important that all close contacts such as sleeping partners or anyone who has shared clothes be treated.


Blood-engorged head lice (Pediculus humanus capitis de Geer)

Lice are insects that live on top of the skin and lay eggs that attach to hair follicles. There are 3 different types of lice: head, body and pubic (aka. crabs). All lice cause intense itching to the area of infection. Head lice, the most common form, are often visible at the base of the hair follicle, the scalp, and around the hair line. The small white nits or “eggs” can be seen attached to the hair follicle.

Lice treatment: There are over- the- counter and prescription treatments for head lice. Often 2 treatments approximately a week apart are required. It is important to clean all clothing, hats, towels and bedding in a hot washer and dryer. Any personal items that cannot be washed should be sealed air tight for 2 weeks. The living area should be cleaned and well vacuumed. All household and close contacts should be treated.

Bed bugs

Adult Male Bed Bug

Bed bugs typically bite at night on exposed areas of the skin; such as face, neck, hands, arms and legs. The bites produce whelps that have puncture or bite marks in the center and are usually in a linear pattern.  The bugs have a flat oval shaped body with no wings and are usually not visible on the skin. The bugs or their feces may be seen upon inspection of the underside of the mattress or back of the headboard.

Bed bug treatment: Professional extermination of the bugs from the living environment is the best method of eradication. Bite reactions can be topically treated with steroid creams and oral antihistamines.


  • If you think you have any of these conditions seek medical treatment right away
  • Clean and eradicate the living environment as soon as possible
  • Wash bed linens and clothing regularly in a hot washer and dryer
  • Do not share hair brushes or personal items
  • Always inspect the underside of mattresses or back of headboards in hotels upon arrival for bed bugs or their feces


Gretchen is a Pharmacist at Student Stores Pharmacy.

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