01/07/2008Head Lice
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How do I get rid of these bugs?

    Head Lice (Pediculosis capitis) is a nuisance condition.  Anyone can get head lice--they are transmitted either by direct contact (head to head) or by articles that have been in contact with an infested person (such as combs, brushes, hats, scarves, bedding and upholstery).  It is estimated that two to three million people in this country get head lice every year; no one is immune, although head lice prefer young children to adults. 

    So, what is it?  A head louse is a tiny insect (an adult is the size of a sesame seed) which only lives on the heads of humans. The adult louse lives on the blood it sucks from the victim's scalp.  Adult lice feed approximately 5 times a day, and this piercing of the skin and sucking cause irritation which in turn causes itching. Lice can live off a host for up to 24 hours.

    How does a person get lice?   Lice have no regard for the hygienic or socioeconomic status of their hosts--anyone can get head lice.   Lice move by crawling, not flying or jumping from person to person.  A louse may crawl to another's head while sharing the same bed.  Shared hairbrushes and combs can also transfer the louse.   Sometimes soon-to-hatch eggs may be securely fastened to the hair shaft entwined in the comb or brush's teeth, or fall to a surface when infested hair is brushed or combed.   Once hatched, the louse may attach to another person's comb, hair brush, or head gear, depending upon where it had fallen.

    How do I know if I have it?  Persistent scalp itching tells you to look closely.  We use a magnifying glass to inspect hair, looking for the tiny grayish adult lice; but we are more likely to see their eggs (called nits), which are whitish oval specks attached to the hair shafts. 

    Then what? If you discover your child has lice, please call your school nurse for assistance.    Remember that head lice is not life threatening--they are upsetting and annoying.   The treatment of lice has changed alot in recent years, as the lice appear to have developed some resistance to the shampoos which used to be quite effective in destroying them.  Therefore there are a number of new strategies being discovered to eliminate them.  We have a video available which is an excellent resource.  A few basic principles apply:
        1.  Shampooing the head with a lice-killing shampoo is usually the first step.  Lice shampoos are available over-the-counter and are as effective as prescription shampoos.  Follow the directions meticulously as each shampoo has its specific directions.  Do not repeat the shampoo in less than 7 days.  Remember it is an insecticide and side effects are unknown so they must be used with caution.  These shampoos will kill some of the lice, but perhaps not all.  They will kill some eggs, but not all.
        2.  Getting the nits out is the challenge.  This takes time, patience and persistence.  And if one nit remains and hatches out, you will have a recurrence within a week or two when it matures and starts laying its own eggs.   There are several styles of combs available for combing out the nits.  Some work in fine hair, some in coarser hair.  It may take some experimentation to find the right one.  Sometimes, using a bath oil, like Avon's Skin So Soft, will work to loosen the glue which holds the nits to the hair.   There is a product called Neon Nits, which when sprayed on the hair, will highlight the nits so you can see them to then snip them out with a small scissors.
        3.  Olive oil.  Some people have found that using olive oil during the week between the use of the lice-killing shampoos helps.  The theory is that soaking the scalp and hair with olive oil, will smother the louse as it hatches out.  The procedure involves applying the olive oil at bedtime, combing out the hair in the a.m., then washing out the olive oil with a dish soap. The oil makes the egg removal somewhat easier and actually makes the hair shine.
        4.  Clean the environment.   Most of your time should be focused on the head, but there are key parts of the environment which need attention.  Lice are killed with heat, so drying bedding in a dryer for 20 minutes will kill lice.  Vacuum the mattress, pillow, rugs, the car, couches and chairs.  Such things as dolls, toys, teddy bears, and other unwashable items may be placed in large plastic garbage bags, sealed, and left at room temperature for two weeks.
        5.  Robicomb.  This is a new discovery.  A battery operated tool which is able to find live lice which cannot be seen easily.  It is a small hand held tool which emits a high-pitched beeping sound.   When you use it to comb through the hair, the beeping sound stops when a live louse is detected.  We have these on hand to loan out for you to use at home on a daily basis.  What seems to help eradicate lice which are resistent to treatment is to wash the hair with a regular shampoo and use a conditioner every night, then use the robicomb when hair is dry (i.e., in a.m.).  If you are having trouble getting rid of lice, this can be extremely helpful.
        6.  Notify others who may have had close contact with your child before you discovered the lice.  This may be hard for you to do, but they will appreciate it greatly.  They will then be able to moniter their children and find it early if it does develop.

School Attendance:  A child with active head lice is required to leave school.  Your child can return to school after treatment with a lice killing shampoo.  Our school policy allows a week for work on egg removal--that is, by the end of a week, there should be no evidence of eggs in the hair.  Your school nurse will work with you to help achieve this goal. 

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