Lice and Scabies


The information provided below is for readers based in the United States of America. Readers outside of the United States of America should seek the information from local sources.

What are lice and scabies?

Lice and scabies are both dermatological conditions resulting from invertebrate animals living as parasites and laying eggs on your body. Lice are a type of wingless insects, whereas scabies is caused by mites, which are arachnids, like ticks and spiders. The most common type of lice that infest humans are head lice, which live in the hair and nourish themselves through tiny blood vessels of the scalp. These are very common but more of a nuisance than a health threat. In contrast, body lice are less common in developed countries but can carry serious disease. A third type of lice are called public lice, which live in hair thats on the body, but not on the scalp. Head lice make the scalp severely itchy, while the mites of scabies produce an itchy rash of the skin. In many cases, scabies can lead to a bacterial infection, which can affect the kidneys or heart.

How common are scabies and lice during pregnancy?

Reports in the scientific literature reviewed by the World Health Organization vary from 3 cases to as high as 460 of scabies per 1,000 people. This variation is so great that its not possible to say exactly how common scabies is in your location. However, scabies infestation does tend to spread in outbreaks that tend to affect socially disadvantaged people and those with weakened immune systems. Head lice infestation also is quite common, especially among those who are around pre-school and school-aged children. This includes a lot of mothers.

How are scabies and lice diagnosed during pregnancy diagnosed?

With both conditions, diagnosis depends mostly on the history that you report on the development and characteristics of your symptoms, such as itching, plus information that you provide about close contacts who may have had the same condition recently. In the case of scabies, two important clues are the presence of burrow holes created by the parasites on the skin as well as severe itching that is particularly bad at night. Inspection of the hair roots can reveal lice and their eggs, which can be withdrawn with a fine comb. Scraping the skin with a certain method can pull some mites of scabies from the skin, and both lice and mites can be identified easily under a low power microscope.

Do scabies and life cause problems during pregnancy?

Continuous scratching of scabies can lead to an infection.

Do scabies and lice during pregnancy cause problems for the baby?

Since both problems are on the skin, the parasites themselves do not cause direct problems for your future baby. However, if an infection develops, this can lead to fever, which can affect the developing baby, plus there is some risk that he infection work its way into the body, making you septic, which would severely harm the baby or cause a spontaneous abortion.

What to consider about taking medications when you are pregnant or breastfeeding:

  • Any risks to yourself and your baby if you do not treat the scabies or lice 
  • The risks and benefits of each medication you use when you are pregnant
  • The risks and benefits of each medication you use when you are breastfeeding

What should I know about using medication to treat scabies and lice during pregnancy?

There are roughly one dozen medications, or categories of medications, that are used as active ingredients in lice and scabies preparations on the market in North America. Every one of them is mentioned in the scientific literature as being potentially harmful to the developing baby but, with most of these agents, the harm is demonstrated only when significant amounts of the drug reach the womb. This happens only when the products is misused. Since each agent is designed to be used topically (on the skin or in the hair), misuse means ingesting the agent or rubbing in quantities far in excess of the recommended amount. If used as directed, products containing camphor, benzyl benzoate, malathion in aqueous solution (not in alcoholic solution), menthol, permethrin, precipitated sulfur, and spinosad are considered to be safe, whereas crotamiton and ivermectin should be considered only when no other agents are available (an unlikely situation). Concerning another agent called lindane, although more studies are needed, available data have linked it to birth defects, so it is best avoided.

Who should NOT stop taking medication for lice or scabies during pregnancy?

Everybody who is infested with a skin or hair parasite should select a topical medication. Otherwise, the parasite and the itching are unlikely to go away. As long as the product is used as directed, the risks to the baby are minimal.

What should I know about choosing a medication for my lice or scabies during pregnancy?

As noted earlier, there is some concern about anti-lice and anti-scabies medications when they get into a mothers system. However, these concerns are negligible when you consider that the treatments are to be applied topically (to the hair or skin).

You may find Pregistrys expert reports about the individual medications to treat this condition here. Additional information can also be found in the sources listed at the end of the report.

What should I know about taking a medication for my lice and scapies when I am breastfeeding?

The same perspective that applies to pregnancy applies to breastfeeding. The treatments are to be applied topically, to the hair or skin. When used correctly, they are unlikely to enter breast milk. One caveat, however, is that scabies typically erupts on the breasts, among other regions of the body. If you are using any scabies medication on the breasts, you must take care to keep the medication away from the babys mount, or near your nipples. If the location of the scabies lesions makes this impossible, consider halting breast feeding and using infant formula until your scabies treatment is complete. If you hope to resume breast feeding later on, pump your milk in order to continue lactating, but discard the pumped milk, as it may contain medication that has rubbed off from your breast and entered the pump.

What alternative therapies besides medications can I use to treat my lice or scabies during pregnancy?

There are no alternatives to medication.

What can I do for myself and my baby when I have lice or scabies during pregnancy?

Stay in close contact with your obstetrician and pediatrician. Work with your doctors to choose a treatment strategy that minimizes risks for the fetus, or the nursing infant.

Resources for lice and scabies in pregnancy:

For more information about lice and scabies during and after pregnancy, contact (800-994-9662 [TDD: 888-220-5446]) or read the following articles:

  • American Academy of Dermatology: Headlice.
  • American Academy of Dermatology: Scabies.


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General information

It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.

For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.

It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.

If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.

If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.

Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.

Medications for Lice and Scabies

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