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Dr. Alpana Mohta Ranka, MD, DNB, IFAAD, is a dual-board-certified dermatologist with over 90 research publications in peer-reviewed scientific journals.

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Eyelash Lice and Eyebrow Lice: Causes, Prevention and Effective Treatment

Updated: Feb 24

Eyelash lice, scientifically known as Phthiriasis palpebrarum, is a relatively uncommon but concerning condition caused by tiny wingless parasitic insects. These insects infest the eyelashes and feed on human blood. These minuscule pests can also affect the eyebrows, leading to eyebrow lice.


This article will explore the transmission, symptoms, and effective ways to manage and eradicate eyelash and eyebrow lice.

 

Table of Contents

 

The Different Types of Lice


There are three main varieties of lice which infest humans:

  1. Pediculosis capitis (head lice), which reside on the hairy parts of the head and neck. They attach their eggs or ‘nits’ to hair shafts.

  2. Pediculosis corporis (body lice), which lay eggs on clothing and move to the skin for feeding.

  3. Pediculosis pubis (pubic lice) or "crabs" infest the genital area. Pubic lice may occasionally harbor other coarse body hair like eyelashes, eyebrows, beards, and armpits.

Lice have three stages of development: nit, nymph (hatching from a nit), and adult. They typically require human blood for survival and can spread through close person-to-person contact.


Eyebrow and Eyelash Lice


The infestation of eyelashes with lice is known as phthiriasis palpebrarum. Lice found over eyelashes are often pubic lice that have made their way to the eye area through hand contact from the genital region. They cling to the eyelid's skin near the eyelash's root.


Eyebrow lice can occur concurrently with eyelash lice. The symptoms and transmission methods for both conditions are nearly identical. These lice can easily move to the eyebrows when the eyelashes are insufficient to sustain the infestation.


Is Eyelash Lice Contagious?


Yes, eyelash lice are highly contagious. The primary transmission mode is through close contact with an infected person - since lice cannot fly or jump.

Additionally, sharing personal items such as clothes, towels, caps, and bedding can facilitate the spread of eyelash lice. Although rare, eyelash lice can also spread indirectly through contact with infested objects like combs and spectacles. However, generally, these lice cannot survive away from the human host for more than 72 hours.


Can Eyelash Lice Spread to Hair?


Although eyelash lice primarily infest the eyelashes and eyebrows, they can potentially spread to other sites of the body. Often, they harbor regions with coarse yet sparse hair like the axillary and pubic hair. Usually, this happens only if the infestation becomes severe.

According to a 2009 report, pubic lice are adapted to a sedentary lifestyle and prefer sites with minimal motion, like the axilla and groin. However, pubic lice are an entirely distinct species from the lice that commonly infest your head or body. This means you won't encounter "crabs" on your scalp or skin, or head lice in your pubic region.

Eyelash Lice Symptoms


An individual with eyelash lice may experience the following symptoms:

  1. Persistent itching around the eyes.

  2. Redness and irritation of the eyelid margins.

  3. The sensation of movement or tickling near the eyelashes.

  4. Presence of small, white or gray lice eggs (nits) attached to the base of the eyelashes or eyebrows.

  5. Mild swelling of the eyelids due to the body's allergic response to lice bites.

Eyebrow Lice Symptoms


Eyebrow lice exhibit similar symptoms to eyelash lice, including itching, redness, and the presence of lice eggs at the base of hairs. However, the symptoms may be less noticeable in the early stages, and people might mistake the condition for other skin irritations. Some people might also experience patchy loss of eyebrows due to constant scratching and secondary infections.


Can Lice Get in Your Eyes?


While eyelash lice predominantly infest the base of the eyelashes, they rarely venture directly into the eyes. Lice lack the necessary adaptations to survive in the eye's environment and are more likely to remain on the eyelashes and the surrounding area where they can feed on blood. However, their presence near the eyes can cause discomfort and may lead to secondary bacterial infections like conjunctivitis (pink eye) or stye if not treated promptly.


How to Get Rid of Eyebrow Lice

  1. Consult a Medical Professional: If you suspect you have eyelash or eyebrow lice, seek medical advice from a healthcare provider, preferably an ophthalmologist or a dermatologist. They can accurately diagnose the infestation and provide appropriate treatment options.

  2. Mechanical Removal: The lice-infested eyelashes or eyebrows can be cut. Conversely, you can manually remove them using tweezers. However, both methods are pretty radical, and physically removing lice and nits from the eyelashes can be challenging, especially in non-cooperative patients.

  3. The journal Case Reports in Medicine reports a successful Over-the-Counter treatment for eyelash mites, a three-day procedure with petroleum jelly for treating eyelash lice. The treatment involves applying petroleum jelly (use the classic Vaseline Pure Petroleum Jelly) thickly to the eyelids twice daily. After approximately two hours, a 1-percent permethrin shampoo is applied to the eyelids and washed off after 10 minutes.

Medical Treatment of Eyelash Lice

Consult a medical professional before resorting to any form of treatment.

  1. Topical Drugs: Various topical treatments have proven efficient against eyelash lice. Some of these treatments include 1% mercuric oxide ophthalmic ointment, tobramycin eye ointment, moxifloxacin eye ointment, pilocarpine gel, and topical botulinum toxin. Antiparasitic agents such as natural pyrethrins, permethrin, phenothrin, and tea tree oil can also be prescribed.

  2. Another effective method involves using botulinum toxin A, as reported in a 2014 case study, which is applied with a swab stick on the eyelashes. This treatment helps by paralyzing the lice, making removing them from the eyelashes easier.

  3. Cryotherapy and Argon Laser Therapy: In some cases, destroying the parasites through cryotherapy using liquid nitrogen or argon laser therapy may be an alternative to physical removal or topical treatment. Argon laser therapy effectively kills both lice and nits, but it requires strict eye protection and may not be widely available.

  4. Role of Ivermectin: Oral ivermectin in a single dose is effective, but a second dose may be necessary after seven to 10 days to control newly hatched nits. Pregnant and lactating women or children under five years should also avoid using this treatment due to potential side effects.

General Hygiene Measures


In addition to specific treatments, maintaining good hygiene is crucial to prevent recontamination and spread to others. Treating associated body hair infestations using antiparasitic topicals or shaving is necessary. Washing clothing, bedding, pillowcases, and towels in hot water (50 C) and heat drying them for up to 10 minutes will help eliminate lice and nits. It's also essential to evaluate and treat all sexual contacts and family members, if necessary, to prevent the infestation from spreading.


While taking care of your eyelashes and eyebrows, don't forget about sun protection for your eyes. Do use sunscreen for eyelids, too.


Conclusion


Eyelash lice, while not commonly encountered, can be a bothersome and contagious condition. Prompt diagnosis, appropriate treatment, and preventive measures are crucial for managing the infestation effectively. You don't want to keep rubbing the area around your eyes, as that could damage your eyelids. It might even lead you to develop hooded eyes.


If you suspect you have eyelash or eyebrow lice, consult a medical professional for accurate diagnosis and guidance in eliminating these pesky parasites.



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