Even thinking about parasites that can feed on or in human skin makes most of us feel itchy! Mention head lice and scalps suddenly feel uncomfortable. You might even want to run screaming out OFthe room, but you can’t, you have to deal with it.

Parasites are a common problem and, as they say about head lice: there’s no shame in getting them, but there is shame in keeping them.

Acting fast is essential, because as well as the discomfort you’ll be in, not dealing with the problem puts other people at risk – and that doesn’t make for a happy social circle.

So what are the main parasites that can affect human skin? Grit your teeth now, while you read the list: head lice, body lice, crab lice, mites, scabies, fleas, bedbugs and ticks.

Consultant dermatologist Sally O’Shea, who works with the Mater Private Hospital, gives us the heads-up on the different types and how best to get rid of them. “Many of these conditions can be treated by your GP,” she says, “but if there is uncertainty about the diagnosis or if the treatments do not seem to be working, it is best to seek referral to a consultant dermatologist”. “Resistant or complicated cases may require treatment with oral medication (tablets),” according to Dr O’Shea.

FLEAS

Flea bites usually occur on the legs, as red spots. Water blisters may also develop. Fleas can spread from an infected pet or animal to humans, so it is important that pets or animals suspected of being infested by fleas are assessed by a vet and treated appropriately.

Flea bites in humans can be treated symptomatically; for instance, with a steroid cream or ointment prescribed by the GP. If you have bites, you could see your GP, who could prescribe a steroid ointment or cream that could be applied directly to the bites.

HEAD LICE

Also known as pediculosis capitis, these tiny, bloodsucking insects can cause an intensely itchy scalp. They may also affect the nape of the neck and behind the ears.

Head lice can easily be spread through head-to-head contact or by using a hairbrush or comb belonging to someone who has head lice. Egg capsules or “nits” can be seen attached to the scalp hair.

Head lice can usually be easily treated using a cream, lotion or shampoo applied to the hair and rinsed off, for example permethrin, which is available from the pharmacy without a prescription. The treatment must be repeated after one week, however.

It is best to see your pharmacist or to attend your GP as soon as possible if you think you or your child might have head lice, in order to reduce the chances of spreading them to others.

BODY LICE

Body lice, or pediculosis corporis, live and lay eggs in people’s clothing and bedding and tend to be associated with overcrowding. They can cause an itch affecting the shoulders, back, neck and waist. Red spots or scratch marks may be noticed on the skin.

To treat these, bedding and clothing should be tightly sealed in bags and incinerated. A five-percent permethrin cream can be applied overnight to the body from the neck down to the soles of the feet, and repeated after one week.

See your family doctor as soon as possible, if you think that you might have body lice, again in order to reduce the chances of spreading them to others.

CRAB LICE

Crab lice, or pediculosis pubis, can affect the eyelashes, eyebrows, beard, scalp, armpits, genitals and the perianal area (around the back passage).

People tend to become infected through sexual or close contact or through contact with affected clothing or bedding. People often notice an intense itch affecting the pubic area. Nits can also be seen in affected areas.

Treatment involves applying a five-percent permethrin cream to hairy areas and leaving it on overnight. The treatment should be repeated after one week. Sexual partners should also be treated. If the eyelashes or perianal area are affected, treatment with a tablet requiring a prescription may be needed.

Again, it is best to attend your GP as soon as possible, if you think that you might have crab lice, in order to reduce the chances of spreading them to others. Your GP may also recommend testing for other sexually transmitted diseases.

MITES

A variety of mites exist. They may live on plants, grains, birds and animals. Red spots and water blisters can develop at sites of bites.

In some cases, bites may be more prominent along underwear edges or on the legs. A more widespread rash may also develop. Washing well with soap and water can be helpful. Pets should be examined for mites by a vet. The key is to identify the source of the infestation and to avoid and treat the source.

Anti-itch creams are available from the pharmacist. Your GP could prescribe a steroid ointment or cream, which could help to reduce the itch. It may also be helpful to treat clothing with permethrin.

It is important to see your GP if you are unsure if you have mites or not, or if your rash is not resolving.

SCABIES

Scabies is caused by a mite called Sarcoptes scabiei var hominis. People tend to become infected through close contact with an infected person or with affected bedding or clothing. It is also possible to become infected through sexual intercourse.

People who have scabies usually feel very itchy and may have scratch marks, red spots or pustules on their body. Dry, flaky skin can develop in between the fingers. The itch may be worse at night or after bathing.

There is often a delay of two to six weeks from the point of contact with an infected person and the development of itch. The scabies mite burrows into the skin and burrows can usually be seen in between the fingers, the wrists, armpits, nipples, ankles and in the genital area.

A more severe form called “crusted scabies” can develop in the elderly, or in people with HIV or who have an organ transplant. In such cases, the person might not feel itchy but will be highly infectious.

It is best to attend your GP as soon as possible to start treatment with an anti-scabetic cream or lotion, for instance a five-percent permethrin cream. This is usually applied from the neck down to the soles of the feet and left on overnight. The treatment should be repeated after one week.

All close contacts and family members should be treated, even if they don’t feel itchy.

All bed linen and recently worn clothing should be washed with hot water and dried on high heat. In some cases, your GP may recommend treating the face and scalp also.

It is best to attend your GP as soon as possible if you think you might have scabies, in order to start the appropriate treatment and, again, to reduce the chances of spreading them to others.

BEDBUGS

Bedbugs are blood-sucking insects that feed at night. They can hide in cracks by day. They cause red, itchy spots, which tend to occur in rows or lines and may have a scab at the centre.

These sometimes occur in threes, called “breakfast, lunch and dinner”. Bites may affect the head, neck, shoulders, waist and limbs.

Your GP may prescribe a steroid ointment or cream to be applied to the affected areas.

Professional exterminators are usually needed to eradicate bedbugs in infested households. It is best to attend your GP as soon as possible, if you think you might have bedbugs.

TICKS

People tend to know when they have been bitten by a tick, because the tick often remains attached. Several ticks exist. Sometimes, a tick may go unnoticed; for example, if it has become attached to the scalp.

A red spot, lump or water blister can occur at the site of the tick bite, after the tick has been removed. Redness tracking from the site of the tick bite can also occur.

The tick should be removed. Special devices have been developed in order to remove the tick in its entirety. Your GP may prescribe a steroid ointment or cream.

Remember that ticks can spread infections, such as Lyme disease and Rocky Mountain Spotted Fever. If such an infection is suspected, your GP could prescribe an oral antibiotic. Animals should be assessed by a vet for ticks. It is best to see your GP as soon as possible, as tick bites can potentially cause serious problems, including the transmission of infections, as mentioned above.

OTHER REASONS FOR ITCHINESS

It is important to bear in mind also that there are several reasons why you might feel itchy, without having any of the above. For example, people with dermatitis or eczema often feel itchy.

It is best to make an appointment to see your GP if you feel itchy or have a rash that is not settling. Your GP may prescribe some ointments or creams.

In some cases, blood tests may also be done to see if there is an underlying cause for the itch. Your GP could refer you to a dermatologist if necessary. CL