Have Questions About Lice, Fleas, Ticks and Bedbugs? (podcast)

Find out about prevention and treatments

Christen Benke, DO, Scripps Clinic.

Dr. Christen Benke, Family Medicine, Scripps Clinic

Find out about prevention and treatments

Learn how to prevent and treat everyday insects that families commonly experience. Lice, fleas, ticks, bedbugs and even dust mites are tiny critters that can wreak havoc on your family. Some thrive outdoors in warm weather regions, such as Southern California, and an infestation can occur rapidly once they are brought into your home.


In this episode of San Diego Health, host Susan Taylor and Christen Benke, DO, a family medicine physician at Scripps Clinic Del Mar, discuss how to prevent and treat these bothersome pests.


If your family is active, enjoys being outside or travelling, being aware of these tiny terrors can give you some peace of mind—and remember, you can always visit your primary care doctor to get your questions answered.


Listen to the episode on how to deal with creepy crawly bugs

Listen to the episode on how to deal with creepy crawly bugs

Podcast highlights

How common are lice? What are treatments? (0:44)

Lice are super common. They’re tiny, tiny, little insects that like to live on a host, whether it’s an animal or a human. They like to feed on our scalp. That’s what causes the itching.

They cannot jump, so you don’t have to worry about them getting onto you from some place you don’t know. But they do like to crawl from one head to the next.

The way you know you have them is if you have some itching where they are living. After a couple of days or weeks, if that itching isn’t going away, you can have them looked at by a doctor, a close friend, or your hairdresser. But basically, they look like a little sesame seeds, and, unlike dandruff, they won’t rub off if you rub the hair. They’ll be stuck on. That’s how you know what they are.


The way you treat them is with a cream rinse. Either an over-the-counter brand or a prescription brand. The cost varies based on the newest, greatest brands that are out. What you have to do is put on the cream rinse, walk around for 10 minutes, and then rinse it off. Wash all the bedding, the clothing, hats and headbands, and hairbrushes in hot water.

Lice can live for up to two days without a host, but after that, they’ll die. Louse combs are every parent’s dream. It’s a very, very fine-toothed comb used on wet hair. You’ll sit in the bright light, probably in your kitchen or bathroom, and very carefully go through each little strand of hair. This is what gets the little eggs off that are so sticky.

You’ll collect the nits and the little eggs and then wipe them off the comb with a tissue. Nine days later, you’ll do the cream rinse one more time. That’s what will kill all of the little eggs that have had a chance to hatch.

Whats the difference between head lice and body lice? (2:39)

Body lice are much less common, typically found in areas where there is poor hygiene, where there is communal living, where there are people in communal beds.

They live on fabric, usually at the seams of the waistband of your pants or of a shirt. They cause irritation to the skin, not necessarily itching so much. The treatment is a lot easier. You just wash all that clothing in really hot water. The areas under the armpits and along the waistband will clear up all on their own.

Do home remedies, such as mayonnaise, work on lice? (3:12)

People apply them to the scalp in an attempt to suffocate the little lice insect and asphyxiate it to death. Unfortunately, as natural and holistic as home remedies sound, they just haven’t been proven to be effective.

How do you get fleas? What is treatment? (3:38)

Fleas typically live on animals, pets, dogs, cats. They can jump up to two feet. You’ll see them usually within two feet of the carpet or of a cushion that an animal, maybe your dog, likes to sleep on, and that’ll be the extent of it there.

Signs of a flea bite include irritation of the skin, little red bites, a little itching and scratching.

For treatment there are shampoos and collars that you can put on your animal. You would treat your animal and then be cured after that.

What are ticks? What is treatment? (4:23)

Ticks live out in nature also, typically on wild animals like deer and rabbits. They will be in the shrubs and the tall grasses, near hiking trails or even out in your backyard. They will transfer by maybe a small jump, but mostly just from brushing against the foliage. They will typically grab on and bite and hang on for a few hours, feeding on your blood.

They’ll fall off all on their own within a day. If you didn’t notice that you had the tick on you initially, it will fall off all by itself leaving no trace.

Very rarely, can it cause some diseases. You’ll see a rash, either on your wrists or on your body where the tick had been. You’ll know that you have maybe contracted something from a tick that way.

If you see a tick on you, you want to carefully grab it with some tweezers or come into the office and we’ll do it under a bright light. You want to make sure you grab it at the neck where it’s attached onto you.

How common are bed bugs? (5:48)

For bed bugs, we often think about hotels and places where we’ve gone traveling. Bedbugs typically live in the seams or on the edge of your mattress. They will cause bites usually, whatever body part was in contact with that mattress.

If you’re being really, really attentive, you could strip the bedding off the bed and inspect the mattress. Typically, any place that’s of good quality will have a good-quality housekeeping team that will make sure the bed bugs are taken care of. If you do notice that you have bugs in the upholstery of your chairs or of your mattress, you pretty much have to get an exterminator service to come and take care of it. There’s no way to treat it yourself.

When should you turn to a prescription drug for treatment of lice? (7:36)

It’s pretty much how much patience you have. How many times do you want to run through the scalp with the little comb that I showed you? That’s quite tedious. I know families that will do it two or three times over the course with the nine days in between. But if the itching comes back each time, that’s probably the time to get a prescription strength cream rinse. For the cost and the hassle, it does give you some peace of mind.

When we had this run through our family, we went straight to a prescription. The one that we used is called Sklice. It kills the nit as well as the lice. You don’t have to go back nine days later and do another treatment. You don’t have to be so diligent about making sure you got every last egg off of every last hair.

What do you tell people who might feel shame for having a bug problem? (8:31)

Everyone’s been there, I promise you. What we really just want to do is get rid of the itching. There’s no person of any socioeconomic status or living situation that isn’t at risk for these little guys and we just treat them when they happen.

How do you keep pets clean and check them for bugs? (8:59)

If you have a cat or a dog that comes in and out all the time, you’re going to be seeing your vet regularly and doing some flea treatment a couple times a year. You’ll notice if your pet is itching and scratching and you’ll get them treated by the vet.

For ticks, if you’ve gone out hiking and come home, showered within two hour and rinsed your clothes in really hot water, that’ll help to kill any tick that might have hitched a ride on your clothes.

Can common bugs cause serious disease? (9:40)

Typically when it’s lice or flea bites or bed bugs, there’s no serious illness involved. It’s just the itching of the skin and the irritation of the skin.

With ticks, there are two diseases that can happen. One is called Rocky Mountain Spotted Fever and the other one is Lyme disease, which everyone’s heard of. They’re both very easy to detect. They both cause similar type symptoms: malaise, fever, body aches, a rash.

The classic Lyme disease rash is called the erythema migrans. It’s a target-like rash. It’s red in the center with a little clearing and then another red ring around the outside.

The Rocky Mountain Spotted Fever typically will have a rash on the wrist or the ankles. That’ll progress to a rash on the palms and soles. Doctors and any nurse practitioners can pick them up pretty easily. They’re both easily treated with a course of antibiotics. Typically it is doxycycline.

What can happen if you don’t deal with a bug problem early? (11:58)

You’d have to set off maybe some flea bombs in your house or take on the cost of hiring a service to come in and clean out your house from all of these little bugs that like to live deep in the cushions of your bedding and of your pillows.

How do you treat for dust mites? (12:48)

Pretty much every pillow, every mattress, every cushion is going to have some dust mites in them after a period of time. These are all animals that live in nature, and we live and coexist with nature.

If someone’s having an allergy to dust mites, stuffy nose, runny nose, waking up in the morning with a sore throat, I might advise them to try going out and buying a hypoallergenic cover that goes over your pillow or over your mattress. They’re a little bit stiff and crinkly, but they create a little extra barrier between you and those little buggies. That might help to improve sore throat, stuffy nose, upon waking up in the morning only.

Lightly edited for clarity.

Watch the video on creepy crawly bugs

Watch the San Diego Health video with host Susan Taylor and Dr. Christen Benke discussing how to deal with creepy crawly bugs.

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