Newsletters

Healthy Child Fall/Winter 2004

Treating Head Lice

BY TARA A. MATTHEWS, M.D.
ATTENDING PEDIATRIC HOSPTIALIST,
SAINT BARNABAS MEDICAL CENTER

LICE. The four letter word sends shivers down every parent’s spine. They say, “What do you mean MY child has head lice?” People often assume head lice are related to personal hygiene /cleanliness, and that people who have head lice are dirty and don’t keep themselves clean. Nothing could be further from the truth. This article will help to dispel some myths about head lice and offer some reassurance and helpful hints on how to deal with these annoying little creatures.

THE LIFE OF LICE
Head lice, or Pediculosis capitis, are small parasites that like to live on the scalp and neck hairs of humans. They are transmitted by direct head to head contact. They can also be acquired by sharing hats, combs, bedding, couches, blankets and stuffed animals (particularly in a day care setting) that have touched an infected person’s hair. They need human blood to live, but can live for up to 24 hours on inanimate objects. Lice do not jump or fly but they do crawl. They have six little legs specially adapted to hold onto a hair shaft. They do not burrow into the scalp.

A female "louse" hatches from its egg after eight days of development,
then it feeds on human blood, and grows until it reaches adulthood 9-12 days later. It then lives for up to 40 days on a human head and deposits 100-300 eggs at a rate of six eggs a day. Not all of these eggs hatch. Usually a person who has lice will have less than a dozen active lice on his/her scalp, yet may have hundreds of eggs on the scalp as well.

AN ITCHY SITUATION
The biggest medical problem these little creatures cause is intense itching. They do not cause any serious infection. You do need to watch, however, that children do not scratch their scalp so intensely as to cause bleeding. This potentially may lead to a skin infection.

Just the sensation of itching or seeing something hop on the scalp isn’t enough to diagnose head lice. Remember, lice don’t fly or jump! You need to have someone with experience, like a nurse or physician, to properly identify head lice.

Sometimes it requires using transparent tape to capture the suspected
lice and eggs and view them under a microscope.

So who gets head lice? EVERYONE!!!!! It has nothing to do with the length of a child’s hair or how often they bathe or wash their hair. Lice do not care if you are rich or poor. It is most common in children ages 3 to 12, and it is seen at all different times of the year.

TREATING LICE
What do you do if your child has head lice? DON’T PANIC! Don’t look to blame anyone. You need to reassure your child that head lice are NOT a big deal. Children should not be embarrassed. Lice can crawl onto ANYONE! These little creatures have been around since the beginning of time and will continue to be around as long as there are people with hair on their heads!

The first thing to do if your child has been diagnosed with head lice is to wash all their combs, brushes, hats and bedding. Then check all the other family members for lice. The best way to get rid of the lice and the eggs (also called nits) is to comb them out of the hair, since they are only on the hair shaft, not technically attached to the scalp.

It is best to wash the hair first and then carefully comb them out. There are many products available that will also help kill the lice and eggs. Nix® is a crème rinse that is applied once for ten minutes, then washed out (it kills lice and eggs). It can be reapplied a week later if lice are still seen. RID® is a shampoo that has to be used two times, a week apart (kills lice but not eggs). Kwell® is another treatment that can be used as a shampoo or left on the head overnight as a lotion.

If these therapies, in conjunction with careful combing out the lice and eggs, do not work, you need to talk with your pediatrician.

When can my child go back to school? Many schools used to have a “no nits” policy, meaning if there was any trace of eggs, the child could not go back to school. The American Academy of Pediatrics discourages such policies, and in fact, states that once a child has undergone treatment with one of the lotions or shampoos mentioned above, they can return to school the following day, even if all of the nits have not been combed out.

For more information, you and your children can log onto www.headlice.org, sponsored by The National Pediculosis Association. There are games and pictures that make learning about head lice fun.

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