Translated from Indonesian to English - www.onlinedoctranslator.

com

Nani Indah Hardiyanti, Betta Kurniawan, Hanna Mutiara and Jhons Fatryadi Suwandi P Managementediculus capitis

Management Pediculosis capitis

Nani Indah Hardiyanti1, Betta Kurniawan2, Hanna Mutiara2, John Fatryadi Suwandi2
1Student, Faculty of Medicine, University of Lampung
2Parasitology Section, Faculty of Medicine, University of Lampung

Abstract
Pediculosis capitis is an infection of the skin or hair of the head caused by an infestation of Pediculus humanus var. capitis. The
prevalence of this disease is quite high, especially in school-age children. Factors that influence the occurrence of
Pediculosis capitis are age, gender, sharing bed or pillow, sharing comb or hair accessories, hair length, hair
washing frequency, economy and hair shape. Islamic boarding school is an educational institution with a system
ofboarding school or education together so as to form a separate community. This is a risk that the disease will
quickly spread to members of the pesantren community. The spread of this disease can be through direct and
indirect contact transmission. Clinical symptoms of the disease in the form of itching, causing scalp abnormalities
when scratched and can cause secondary infections, sleep disturbances at night due to itching, and from a
psychological point of view, children feel embarrassed because they are isolated from other children.Pediculosis
capitis are socio-economic factors, level of knowledge, personal hygiene poor condition, population density, and
individual characteristics such as age, hair length, and hair type. Definite diagnosisPediculosis capitis
is to find Pediculus humanus var. capitisadults, nymphs, and eggs in the skin and hair of the head. Treatment
methods can be done using physical or chemical methods. Pediculosis capitis can also be prevented by avoiding
direct and indirect contact.

Keywords: pediculosis capitis, treatment

Treatment of Pediculosis capitis

Abstract
Pediculosis capitis is an infection of the skin or scalp hair caused by infestation of Pediculus humanus var capitis. The prevalence
of this disease is high especially at school-aged children. Factors that influence the occurrence ofPediculosis capitis role are age,
gender, or bed pillows together, using a comb or hair accessories, hair length, hair washing frequency, the economy and the
shape of the hair. Boarding schools are educational institutions with a system of boarding school or education together so that it
forms a separate community. This is a risk the disease will be quickly transmitted to the members of the public boarding school.
The spread of the disease can be through the transmission of direct and indirect contacts. The clinical symptoms of the disease
in the form of itchy scalp disorder giving rise when carded and can cause secondary infections, impaired sleep at night because
of the itching, and from the psychological side of making children feel ashamed because isolated from other children. Some of
the factors that can help the spread ofPediculosis capitis is a socioeconomic factors, level of knowledge, personal hygiene, poor
housing, overcrowding and the characteristics of the individual as age, length of hair, and the hair type. Pediculosis capitis sure
diagnosis is finding Pediculus humanus var capitis. adults, nymphs and eggs in the skin and hair of the head. Method of
treatment can be done by using physical or chemical methods.Pediculosis capitis can also be prevented by avoiding direct and
indirect contact.

Keywords: Pediculosis capitis, treatment

Correspondence: Nani Indah Hardiyanti, address Jl. Soemantri Brojonegoro Unila. Alyssha Home boarding house, Bandar Lampung, HP
085758188878, e-mail naniindahh@gmail.com

preliminary Investment ratio Pediculus humanus var. capitis

Pediculosis capitis is an infection of the
skin or hair of the head which is caused by an
infestation Pediculus humanus var. capitis.1
The prevalence of this disease is quite high,
especially in school children and this disease has
also become a problem in developing countries
as well as developed countries. In the
United States every yearPediculosis capitis
it affects 6 to 12 million people.2 By gender,
the risk is twice as great for women as for
men.3
in school children in Thailand ranges from
12.26%-29.76%. The ratio in the age group of
children aged 12 years was 26.07%. Meanwhile, the
ratio for the age group of children aged 8 years
increased to 55.89.4
Pediculus human var. capitis
It is an obligate blood-feeding
ectoparasite. Its life cycle is always related
to humans, cannot jump, does not have
wings and its life cycle does not occur in
animals.2 This disease can be spread by
direct contact with people's heads
Majority | Volume 4 | Number 9 | December 2015 |47
Nani Indah Hardiyanti, Betta Kurniawan, Hanna Mutiara and Jhons Fatryadi Suwandi P Managementediculus capitis
infected and indirect transmission such as
wearing combs, hats, towels, pillows,
mattresses and veils.5
This disease has connected
people with poverty or social status, low
economy and slum environment.6 This
disease is often overlooked, especially in
countries where there are other, more
serious health priorities because it is
considered mild and has low mortality, but
this disease among school children
worldwide has caused significant
morbidity.7.1
Clinical symptoms of the disease Pediculosis capitis
is itching that causes
scalp disorders and can cause secondary
infection when scratched. In school children
chronic infestationPediculosis capitis
causes anemia which will make children
lethargic, sleepy, and
affect learning performance and cognitive
function, in addition at night infected children will
experience sleep disturbances due to itching and
frequent scratching. From a psychological point of
view, head lice infestation makes children feel
ashamed because they are isolated from other
children.8
Deployment Pediculosis capitis can be
influenced by several factors, namely socio-
economic factors, level of knowledge,
personal hygiene poor condition, population
density, and individual characteristics such
as age, hair length, and hair type.9 In densely
populated areas, this disease is often found,
one of which is a boarding school.10
Islamic boarding school is an educational
institution with a system of boarding school
or joint education so as to form a separate
community whose members consist of
students, teachers or ustadz and families
of pesantren caregivers. This matter
is a risk that the disease will quickly spread
to members of the pesantren community.11
In school children, the prevalence of
skin the disease is generally still high
cause prevalence Pediculosis capitis
still high in boarding school because
lack of attention from both the owner,
management, and government in terms of
cleanliness, behavior, and concern for
health. Traditional culture is also another
risk factor where they will share food, bed,
and knowledge with each other. These
conditions are very supportive
Majority | Volume 4 | Number 9 | December 2015 |48
survival cycle of mites, ticks, and even other
parasitic and fungal infestations.12.13
Seeing the high incidence
Pediculosis capitis that occurs, it is important
to know the treatment method to minimize
the occurrence Pediculosis capitis.
Contents
Pediculosis capitis is a scalp disease
due to infestation of obligate ectoparasites
or can be called mites or mites lice species
Pediculus humanus var. capitisbelonging to
the family Pediculidae, This parasite
throughout its life cycle depends on humans
and includes blood-sucking parasites or
hemophagydea.14.8
Children often get this disease,
especially aged 3-11 years. Infection
Pediculosis capitis In Indonesia, there are no
definite figures. In Malaysia about 11% of children
aged 3-11 years are infected and about 40% in
Taiwan. In the United States, approximately 6
million–12 million children are affected by the
disease in the 3-11 year age group.8
Girls are more often affected by this
disease because they have long hair and
often wear hair accessories. Apart from
that the conditionshygiene which is not
good such as rarely cleaning the hair is
also one of the causes of this disease.
Transmission of this disease can be
through direct contact, namely hair to hair
or through indirect contact, namely
intermediaries such as hats, pillows,
mattresses, combs, hoods.7.1
Pediculus humanus var. capitishas a
flat dorso ventral body, has a suction type
mouth for sucking human blood, its body
is segmented,
It has 3 pairs of legs and is yellow-brown
or grayish-white in color. These mites do
not have wings, therefore this parasite
cannot fly and the transmission of
infection must be from objects or hair that
stick together.8
Mites have claws on their feet to
hang on to hair. The adult form of the
female is larger than the male. Eggs ornits
oval or oval in shape with a length of about
0.8 mm, white to brownish yellow. Eggs
are laid along the length of the hair and
follow the growth of the hair, which means
that towards the end there are more
mature eggs.15
Nani Indah Hardiyanti, Betta Kurniawan, Hanna Mutiara and Jhons Fatryadi Suwandi P Managementediculus capitis
Mites are obligate ectoparasites that
spend their entire life cycle, namely eggs,
larvae, nymphs and adults in human hair
and scalp. In previous studies it was said
that this mite can only survive for 1 to 2
days if it is not in human hair or scalp,
more than 95% of people infected with this
disease have adult mites8.15
Skin disorders caused by mite bites
are itching and scratching to relieve
itching. The effect of saliva and the
excretion of mites that enter the scalp
when the mites are sucking blood is what
causes itching. According to some studies
it is said that these mites can only survive
less than 48 hours without sucking blood
or not being on the scalp. While the eggs
can last about 1 week when not in human
hair or scalp.8
Some factors which could
affect the occurrence Pediculosis capitis:
1. Age, especially in the age group of 3-11
years.14
2. Gender, women are more often affected
by the disease Pediculosis capitis
because almost all women have longer
hair than men.7
3. Using a bed or pillow together.8
4. Using a comb or hair accessories
together, in a situation using a comb at
the same time will make eggs and even
adult mites stick to the comb it will be
infected, as well as hair accessories
such as veils, headbands and ribbons.5
5. Long hair, people who have longer hair
are difficult to clean it than people with
short hair.14
6. Frequency of washing hair.7
7. Economic, low socioeconomic level is a
significant risk with the presence of
mite infestations, but also due to the
inability to treat infestations effectively.7
8. Hair shape, in Africans or African-
Americans who have rare curly hair
infested with head lice due to female
adult mites
hard to lay eggs. 14
Itching is the main symptom of the
manifestation of head mites but some people
are asymptomatic and can be a carrier. The
incubation period before symptoms occur is
about 4-6 weeks. Mites and eggs are most
abundant in the occipital area of the skin and
retroauricular.1 Bites from mites can
produce skin abnormalities in the form of
erythema, macules and papules, but the
examiner often only finds erythema and
excoriations. However, there are other
individuals who complain and show signs
of fever and local enlarged lymph nodes.15
Scratching that occurs on the scalp can cause
erosion, excoriation and secondary infection in
the form of pus and crusts. If there is a severe
secondary infection, the hair will clump
because of the abundance of pus and crusts.
This situation is calledplicapolonica which can
grow fungus.2
Definitive diagnosis of Pediculosis capitis
is found Pediculus humanus var. capitis
adults, nymphs, and eggs in the skin and
hair of the head.1 The presence of adult
mites is a sign that you are having an
active infection, but adult mites are very
difficult to find because they can move
about 6-30 cm per minute and avoid light.
The way to find adult mites and nymphs
can be done by
serial sweeping which is a more effective
method than visual inspection.8
There are several other skin diseases that
can cause itchy scalp, including seborrheic
dermatitis, psoriasis, insect bites, eczema
and fungal or fungal infections.
tinea capitis.1
The method of treating this disease
can be done using two methods which
include physical and chemical methods.
Chemical methods, namely the use of
insecticides or pediculicides, are widely
used throughout the world. Insecticides
are easy and convenient to use and the
results are very effective. However, there
are potential side effects and there is also
a high prevalence of mite resistance
against some insecticides. The physical
method that can be used is to shave the
hair to prevent infestations and help the
topical medication work better and not be
blocked by hair.16
The kinds of drugs could
Majority | Volume 4 | Number 9 | December 2015 |49
Nani Indah Hardiyanti, Betta Kurniawan, Hanna Mutiara and Jhons Fatryadi Suwandi P Managementediculus capitis
used for therapy Pediculosis capitis namely
pyrethrins derived from natural extracts of flowers
Chrysanthemum cineraria efolium but in
people who are allergic to plants
chryantheums or related plant extracts will
experience shortness of breath and dyspnea. In
the United States, pyrethrins are the only
commercially available, over-the-counter
pediculicides that are licensed byFood and Drug
Administration (FDA). This insecticide is available
in the form of:lotion, shampoo, foam mousse
and cream. Pyrethrin products are applied
to the head for 10 minutes and then
rinsed. Even though effectiveness
pediculisidae near 100% by the mid-1980s,
there was also a treatment failure of 88%
due to recently reported resistance.17
Permethrin is the only synthetic
pyrethoid that has a use for killing mites
worldwide.
Introduced in the United States in 1986,
permethrin has residual activity for 2
weeks after a single 10-minute treatment.
Permethrin cream is applied for 10
minutes, but treatment is 8-12 hours with
5% cream for scurvy or
scabiesis an alternative and more effective
treatment. Resistance to high concentrations
is also a problem, especially in areas where
there is DDT or resistance
pyrethroids.14
Lindane is Chlorinated hydro carbon,
like DDT, and this class of compounds is
generally slow to kill. Available in stock
shampoo 1% applied for 4 minutes.
Previous researchers did not recommend
usingLindane because of resistance, the
side effect is that it can affect the central
nervous system (CNS). This drug is only
recommended for patients who fail to
respond to mite therapy.14
Carbaril is cholinesterase inhibitor.
In the UK and other countriescarbaryl
available in the form of lotion and shampoo
0.5%. This product is not available in the
United States and may not be FDA
approved due to its toxicity.Carbaril more
toxic and carcinogenic to the patient and
less lethal to mites.8As Carbaril,
Malathionis cholinesterase inhibitor and
has been used for 20 years to treat mites.
Topical treatment includes the
administration ofmalathionwhich exerts a
pediculosid effect by
Majority | Volume 4 | Number 9 | December 2015 |50
giving as much as 0.5% or 1% in the form
of lotion or spray. malathion lotion
used at night before going to bed after
washing the hair with soap, then covering
the head with a cloth. The next day the
hair is washed again with soap and
combed using a tight comb or series.
Treatment can be repeated one week later
if eggs are still present. In secondary
infections, first treated with systemic and
topical antibiotics such as:
Erythromycin, Cloxacillin and Cephalexin
then followed by the above drug in the form
of shampoo.1
There are two methods of prevention,
namely preventing direct and indirect
transmission.
A. Methods of preventing direct contact
transmission:
Avoid being direct contact
hair with hair when playing and doing
activities at home, school, and
anywhere.
B. Methods of preventing indirect
transmission:
1. Do not use clothes such as hats,
scarf, jackets, hoods, sports
costumes, hair tie together.
2. Do not use a comb, brush, towel at
the same time. If you want
using a comb or brush from an
infected person can disinfect combs
and brushes by soaking them in hot
water around 130F for 5-10 minutes.
3. Washing and dry in the sun clothes,
bedding, rugs, and other items.
4. Sweep and clean floors and other
furniture.18
summary
Pediculosis capitis is an infection of the
skin or hair of the head which is caused by an
infestation Pediculus humanus var. capitis.
This disease can be spread through direct
transmission of head-to-head contact with
infected persons and indirect transmission
such as wearing combs, hats, towels, pillows,
mattresses and veils. The clinical symptom of
Pediculosis capitis is itching, causing scalp
abnormalities and can cause secondary
infection when scratched. In school children
chronic infestationPediculosis
Nani Indah Hardiyanti, Betta Kurniawan, Hanna Mutiara and Jhons Fatryadi Suwandi P Managementediculus capitis
capitis causes anemia which will make
children sluggish, sleepy, and affect
learning performance and cognitive
function, in addition at night infected
children will experience sleep disturbances
due to itching and frequent scratching.
From a psychological point of view, head
lice infestation makes children feel
ashamed because they are isolated from
other children. Definite diagnosis
Pediculosis capitis is to find Pediculus
humanus var. capitisadults, nymphs, and
eggs in the skin and hair of the head.
Treatment methods can be done using
physical or chemical methods. In addition,
Pediculosis capitis can also be prevented
by avoiding direct and indirect contact.
Conclusion
From the explanation above, it can be
concluded that the treatment of Pediculosis
capitis can be done by two methods, namely
physical treatment methods and chemical
treatment methods.
References
1. Djuanda, Adhi, Mochtar Hamzah, Siti
Aisyah. Dermatology and Venereology.
Jakarta: Faculty of Medicine, University of
Indonesia; 2007.
2. Nutanson I, Steen CJ, Schwartz RA,
Janniger CK. Pediculosis humanus
capitis: An update. Acta Dermatoven
APA. 2008; 17(4): 147-53.
3. Burgress IF. Current treatments for
pediculosis capitis. Curr Opin Infect
Dis. 2009; 22(1):131–6.
4. Rassami W, Soonwera M. Epidemiology of
pediculosis capitis among school children
in the eastern area of Bangkok, Thailand.
Asian Pac J Trop Biomed. 2012; 2(11): 901–
4.
5. Natadisastra, D. & Ridad, A. Medical
Parasitology: Viewed from the Body
Organs Attacked. Jakarta: EGC; 2009.
6. Oh JM., Lee IY., Lee WJ., Seo M., Park SA.,
Lee SH., Seo JH., Yong TS., Park SJ., Shin
MH., Pai KS., Yu JR., Sim Seobo 2010.
Prevalence of pediculosis capitis among
Korean children. Parasitol Res. 2010;
107(6):1415–9.
7. Barbara L. Frankowski, Leonard B. Weiner.
Committee on school health and
committee on infectious diseases.
Headlice. Pediatrics. 2002: 110; 638-40.
8. Stone SP. Jonathan N Goldfarb. Rocky E.
Baceleri Scabies, Other Mytes and
Pediculosis. In : Freedberg IM, editors.
Fitzpatrick's Dermatology in General
Medicine volume 2 eighth edition. USA:
The McGraw-Hill, 2012. pp. 2573 – 8.
9. Kamiabi F, Nakhaei FH. Prevalence of
pediculosis capitis and determination of
risk factors in primary-school children in
Kerman. J Am Academy Dermatol.
2005;50(1):1-12
10. Ansyah AN, Pramuningtyas R,
Kariosentono H. Relationship of
personal hygiene with incidence rate
pediculosis capitis in female students of
modern Islamic boarding school Assalaam
Surakarta [thesis]. Surakarta: Faculty of
Medicine, Muhammadiyah University of
Surakarta; 2013.
11. Laily and Sulistyo. Basic Human Needs
and Nursing Process.
Jakarta: Salemba Medika; 2004
12. Rahman Z.A. Factors Which
Associated with the Incidence of Pediculosis
capitis at the Rhodlotul Quran Islamic Boarding
School Santri in Semarang [Scientific Paper].
Semarang: Faculty of Medicine
Dipenogoro University; 2014.
13. Wijayati, Fitriana. The Relationship Between
Healthy Behavior And The Incidence Of
Pediculosis Capitis In Santriwati Darul Ulum
Islamic Boarding School Jombang [Thesis].
Jombang: Faculty of Medicine, University of
Jombang; 2007.
14. Saad. The Influence of Individual Hygiene
Factors on the Incidence of Scabies in An-
Najach Islamic Boarding School, Magelang
[Scientific Paper]. Semarang: Faculty of
Medicine, Diponegoro University; 2008.
15. Meinking TL. C Buckhart. Infestations. In:
Jean L. Bolognia, Joseph L. Jorizzo,
Ronald P. Rapini, editors. Dermatology
volume one. Britain; 2008. p. 1321 – 8.
16. Burns DA. In: Burns T, Breathnach S, Cox
N. Rooks Textbook of Dermatology;
2004(2):446-8.
17. Habib TP. Pediculosis. In: Clinical
dermatology 4th edition. British : Mosby;
2004.
18. Ohio Department of Health. Pediculosis.
Ohio: Department of Health. 2014; 1-15.
19. Center for Disease Control. 2013. Parasite-
Majority | Volume 4 | Number 9 | December 2015 |51
Nani Indah Hardiyanti, Betta Kurniawan, Hanna Mutiara and Jhons Fatryadi Suwandi P Managementediculus capitis

Lice-Head lice. Available in index.html. Retrieved On August 20, 2015.

http://www.cdc.90v/parasites/lice/head/

Majority | Volume 4 | Number 9 | December 2015 |52