What Are Lice, Scabies, and Bed Bugs?

Lice, scabies, and bed bugs affect people all over the world. They can infest clean or dirty homes, and can be very annoying. Sometimes lice, scabies, and bed bugs can cause big problems like allergic reactions or infections. All three can be a cause of missed school and work.

Treating the Home for Lice, Scabies, and Bed Bugs

  • Make sure to clean the following:
    • Brushes and combs. Soak these in boiling water for 10 minutes.
    • Sheets, pillowcases, clothes, blankets, and towels. Wash all linens in hot water in the washing machine. Dry all machine-washed items in a hot dryer using the hottest setting. Dry for at least 10 minutes.
    • All stuffed animals and pillows. Place items that cannot be machine washed in a hot dryer and run the dryer on the hottest setting for 20 to 30 minutes.

  • Other personal items can become infested with lice, scabies, or bedbugs. You can kill them by:
    • Sealing the objects in plastic bags
    • Placing the plastic bags in the freezer overnight or keeping the bags sealed for 2 weeks
    • Furniture, carpets, and floors. Vacuum these thoroughly


  • Lice is caused by the head louse
  • In an active infestation, both adult lice and their eggs (nits) are present
  • Lice is spread by head-to-head contact or by sharing items that were worn near the hair, such as hats, scarves, bandanas, or head bands
  • Lice is VERY contagious
  • Having lice is very annoying, and one of the worst parts is that it causes children to miss school

Symptoms of Lice:

  • Lice causes itchiness, with resulting scratching, and sometimes scalp infection
  • Children may feel the bugs crawling on their scalps
  • Children may experience swollen lymph nodes (often called "glands") at the back of the neck or behind the ears

Diagnosing Lice:

  • Check the child's hair in a well-lit area and use a fine-tooth comb to examine the entire head
  • Comb outward slowly from the scalp through the hair, section by section. Be sure to look behind the ears and along the neck
  • Adult lice look brown and can resemble sesame seeds, while the eggs (nits) are clear

Treating Lice:

  • Lice can usually be treated at home
  • Lice shampoo is sold at drugstores and grocery stores. The packages have specific instructions for how to use the shampoo.
  • The child must be treated twice with the shampoo
  • First treatment:
    • The shampoo should be lathered onto dry hair and then rinsed after a few minutes
    • All hair should be combed with the special lice comb
    • Comb hair every day with the lice comb for several weeks. This is the best way to get rid of lice
  • Second treatment:
    • One week after the first treatment, re-treat the child's head with the lice shampoo as recommended on the package
    • Again comb through the hair
  • Check for lice in people who have been in close contact with the child and treat if necessary
  • If the home treatment doesn't work, call the pediatrician or dermatologist for a prescription


  • Scabies is caused by the human itch mite. It burrows into the skin and causes lots of itchiness.
  • The mite can get into your skin through skin-to-skin contact or by contact with an infested object such as a bed sheet or a towel

Symptoms of Scabies:

  • Scabies causes itching that is usually most intense at night. The constant scratching can cause skin irritation and infection.
  • Scabies in children often affects most of the body

Diagnosing Scabies:

  • Scabies can be diagnosed by a pediatrician or dermatologist. Sometimes a skin scraping will be taken to confirm the diagnosis.

Treating Scabies:

  • The child and those he or she may have come in contact with require treatment because scabies is VERY contagious
  • The child's doctor will prescribe a medicine that needs to be applied to the skin. After a shower, you should massage the medicine onto clean, dry skin, and leave it there for 8-14 hours.
    • Most people apply the medicine at night and wash it off when the child wakes up in the morning
  • The medicine is applied from the neck to the toes. The child's doctor will indicate whether the medicine should also be applied to other body parts.

Bed Bugs

  • Bed bugs are tiny insects that live on human blood. They bite humans and then crawl away.
  • Bed bugs come out at night and are rarely seen during the day

Symptoms of Bed Bugs:

  • Bed bugs leave bite marks and welts that are very itchy. Sometimes it takes a few days for the bites to itch.

Diagnosing Bed Bugs:

  • Bite marks often appear in a "zig zag" pattern on the skin
  • Other common signs of bed bugs include a sweet, musty smell in the room; flecks of blood on the child's bedding; bed bug shells; black spots (excrement) on bedding; and small white eggs

Treating Bed Bugs:

  • Call an exterminator or contact your landlord
  • To treat the symptoms of bed bug bites, steroid creams can help with itchiness, and some times anti-itch medicines taken by mouth are required. If the skin has become infected from so much scratching, a doctor can prescribe an antibiotic.

Jennifer E. Wolford, DO, MPH, FAAP
Children's Hospital of Pittsburgh,
Division of Child Advocacy

Rachel P. Berger, MD, MPH
Children's Hospital of Pittsburgh,
Division of Child Advocacy

Adelaide L. Eichman, MD
Children's Hospital of Pittsburgh,
Division of Child Advocacy

Content Sources:
American Academy of Dermatology. "Head lice: diagnosis, treatment, and outcome": www.aad.org
American Academy of Dermatology. "Bed bugs": www.aad.org
American Academy of Dermatology. "Scabies": www.aad.org
Mumcuoglu, K.Y., J. Hemingway, J. Miller et al. 2002. "Permethrin Resistance in the Head Louse Pediculus capitis from Israel." Medical and Veterinary Entomology 9(4): 427-32.

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