Head Lice-How to Recognize, Treat and Prevent

When parents hear the words "Head Lice" or their child brings the dreaded "Head Lice in Your Child's Classroom" letter home from school it is not good news. Although Head Lice are not harmful, they are highly contagious and quite a creepy-crawly nuisance!

Head Lice or Pediculosis Capitis affect millions of children yearly worldwide and it is most prevalent in preschool kids attending day care and those kids attending elementary school (ages 3-10)

A Head Lice is a tiny wingless parasitic insect that infests the human head and neck and feeds on very small amounts of human blood daily. They hold firmly onto the hair shaft with hook like claws at the end of each of their six legs.

• Head Lice cannot hop or fly. They move by crawling and can do so at a rapid pace.
• Human Head Lice feed on human blood and are not transmitted by cats, dogs or other pets.
• Head Lice do not transmit any diseases so are not considered a health threat.
• Head Lice can live on a Human Scalp for up to 30 days but can only survive 1-2 days away from a Human Scalp which is their sole source of nutrition.
• Head Lice prefer clean hair. Having Lice is not a sign of poor hygiene or low socioeconomic status.
• Although not common, Head Lice can come from sharing combs, hats, scarves and helmets that have been used by someone infested with head lice
• It is also uncommon but possible to get Head Lice from lying on a couch, pillow or stuffed animal that has been in close contact with someone infested by Head Lice.

Egg or Nit: Laid by the adult female louse at the base of a hairshaft. The egg is cemented firmly in place and appears yellow or white. It is oval shaped and very small and hard to see. The eggs take about 9 days to hatch.

Nymph: Immature Lice that hatch from the egg. It matures into an adult 9-12 days after hatching.

Adult: About the size of a sesame seed and tan to grayish white. An Adult Female Louse can lay up to 10 eggs daily.

Itching is caused by an allergic reaction to the Head Lice bites. With a first time infestation itching can take 4-6 weeks to start.

Tickling of the Scalp or Feeling Like something is Moving in the Hair

Sores on the Scalp, Neck or Behind the Ears caused by scratching. Some of these sores could become infected from excessive scratching and need to be treated with an antibiotic.

Head Lice and Nits are very small and hard to find but they can be seen by the naked eye.

Use a fine toothed comb and part the hair into very small sections. They are frequently seen behind the ears and near the back of the neck.

The Lice Nits or Eggs:

The female louse lays the eggs very close to the hair shaft. They are firmly attached and difficult to remove. The eggs are about the size of a knot in a thread and resemble dandruff but cannot be shaken off or brushed out. They are yellow, tan or white and may appear white or clear after the eggs have hatched.

As the eggs mature and hatch over 1-2 weeks, the hair is growing longer. The eggs will move further away from the scalp and be easier to spot.

Nymphs and Adult Lice:

They are about the size of a sesame seed and appear tan to grayish white. They sometimes appear close to the color of the hair they are infesting. Unless the infestation is very large it will be easier to see the eggs than spot live crawling lice on the scalp. They avoid light and can crawl very rapidly from searching fingers!

Lice can be gross and scary for kids (adults, too!)

Here you can find some fun "Head Games" for kids to play!

Head Lice should be treated promptly and thoroughly once discovered. It is a frequently misdiagnosed condition so have your personal Physician or a School Nurse check your child's head if there is any question about the infestation.

OTC treatments such as Nix (1% Permethrin) work well. Although it is possible for Lice Killing Medications to be susceptible to resistance, Nix claims that clinical studies have shown Nix to be the most effective OTC lice treatment.

Follow the directions on the box carefully.

These OTC treatments are Pediculicides, meaning they kill the live Lice. They are not Ovicidal, meaning they cannot kill the eggs.

• First RINSE and dry hair (Do not shampoo or condition before application of medicated shampoo)
• Apply product to hair and scalp
• Rinse off according to package directions

NOTE: It is common to repeat the treatment in 7-10 days once the eggs that were not removed hatch. Nix states their product works for a full 14 days so it may not be necessary to repeat. Because it is advised you comb the hair for nits daily for 2 weeks after treatment you will see if there is any lice activity. Contact your Physician if you think the first treatment did not work completely.

Using a fine-toothed metal comb:

• Part wet hair into very small sections. Work one section at a time.
• Thoroughly comb each section and pin hair back after you have combed out the nits and lice.
• Clean the comb as you go. Wipe off the nits/lice with a tissue. Place the tissue in a plastic bag that you will seal when all sections have been combed.
• The hair should be combed daily for 2 weeks.

Malathion is a prescription medication that is approved by the FDA. It kills live Lice (Pediculicide) and is partially Ovicidal in that it will kill some lice eggs. Malathion is safe and effective when used as directed. Having said that, there are precautions that must be taken when using Malathion.

• Malathion can cause stinging if there are open sores from scratching on the scalp.
• Be careful to keep Malathion away from the eyes
• It is flammable! Keep heat sources such as electric hair dryers, cigarettes and open flames away from the medication and wet hair.
• Safety for children under six has not been established.

For more detailed information on precautions and side effects go to this site.

• Some dishwashing detergents can help to dissolve the "glue" that keeps the nits so firmly attached to the hairshaft.
• Olive Oil rubbed in hair prior to combing can help with removal.
• Run the metal comb through bees wax before removal of nits. A Fine-toothed Metal comb is stronger and more effective than a plastic comb and can easily be found at a Pet Store or on the Internet.

• Attempts to smother the lice with vaseline are usually unsuccessful. It is not only very difficult to remove the nits and lice but cleansing vaseline from the hair is nearly impossible!
• Tree Oil is somewhat controversial as it is toted as safe and natural yet it is also said to be a fungicide and bacteriocide. Use in babies, young children and pregnant women is contraindicated. If used daily it can irritate the skin and cause allergic reactions as well as cause liver damage depending on the dosage.
• You should not use medicated lice treatments on a child that is 2 years old or younger. You'll need to remove the nits and lice by hand using a method called "wet combing."

Wet and Condition the child's hair. Use a fine-tooth comb on your child's hair every 3 to 4 days for 2 weeks. Wetting the hair is recommended because it temporarily immobilizes the lice. Conditioner makes it easier to get a comb through the hair.

• Wet combing is also an alternative to pesticide treatments in older kids.
• Here are some other home remedies for treating head lice

"Kids can return to school after they have been treated with an anti-lice shampoo, even if they still have nits. Although they have long been against no-nits policies at schools, the American Academy of Pediatrics now states that 'no healthy child should be excluded from or allowed to miss school time because of head lice."

Once the infestation has been treated it is important to clean your home and the personal items of the affected person.

• Vacuum furniture, rugs, car seats and throw pillows to remove any lice that may have fallen from the infested head.
• Wash clothing, including hats and scarves, towels, blankets and bed linens in hot water. Items should then be dried using the hot cycle for at least 20 minutes.
• Soak barrettes, hair ribbons, combs and all things worn in the hair in hot water for at least 20 minutes. You can boil the water, turn off the burner and drop the items in for soaking (or throw them away and replace them)
• Items that can't be washed, such as stuffed animals and coats should be dry cleaned or sealed in a plastic bag for 2 weeks.

Remind your child not to borrow or share hair ornaments, combs, brushes, hats and helmets in the future and to avoid head-to-head games with others.

Be sure to check all household family members for Head Lice!! If someone else is infested and goes untreated the cycle will repeat itself.

Also make sure that the parents of the children that have been in close contact with your child are aware of the infestation.