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Stop head lice in their tracks
Health advice
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I must admit that this is one topic I find somewhat distasteful. Usually in the process of writing this article, I imagine I feel something crawling on me — I rather dread that feeling!
I am a parent (although most of my family now calls me “Grammie”) and remember well the years of checking the heads of my children every summer about this time. Just like the “old days,” the first couple months of school this year will probably bring mini epidemics of head lice. No matter the year, every parent panics at the thought — and especially the discovery — of crawling things on their children’s heads.
Head lice, or pediculus humanus capitis, are tiny insects that live primarily on the head and scalp. They breed rapidly and will hop from one head to another, leaving eggs wherever they go. The frustrating thing is, it doesn’t matter whether you keep the heads of your little darlings scrubbed clean. Lice simply don’t care — they’ll deposit eggs on just about any head, but actually prefer clean heads.
The presence of head lice is not a sign of uncleanliness. On a recent Regis and Kelly show, Kelly Rippa talked about discovering a lice egg (or nit) in her daughter’s hair. The story had everyone in the audience scratching throughout the rest of the show.
Although small, adult head lice may be seen with the naked eye. They are two or three millimeters long (the size of a sesame seed), have six legs and are usually tan to grayish-white in color. The female lives up to three or four weeks and, once mature, can lay up to 10 eggs per day. Lice cannot hop or fly. They crawl, but they move rapidly and may prove difficult to see.
Head lice suck blood and the most common symptom of a head lice infestation is itching. This is caused by the louse’s saliva, which irritates the skin on the scalp. The itching can occasionally be severe enough to result in head sores or impetigo.
Head lice, unlike body lice, do not transmit any disease agent. Head lice attach their eggs at the base of a hair shaft within approximately four millimeters of the scalp with a glue-like substance produced by the louse. These eggs, or nits, camouflaged with pigment to match the hair color of the infested person are often seen more easily on the back of the neck and around the ears. Adult head lice cannot survive for more than 48 hours apart from their human host.
Empty egg casings (nits) are easier to see because they appear white against darker hair.
The eggs are incubated by body heat and typically hatch in eight or nine days, but hatching can vary from seven to 12 days, depending on whether the climate is hot or cold. Once it hatches, a louse leaves the shell casing and passes through a total of three nymph stages during the next nine to 12 days. It then reaches the adult stage. A female louse can mate and begin to lay viable eggs approximately one and a half days after becoming an adult. If not treated, this cycle may repeat itself approximately every three weeks
Head lice are primarily spread through direct, head-to-head contact, although sharing personal items such as hats, brushes, combs and linens may play a role in their spread between children. Children with head lice should be treated with a medicated shampoo, rinse or lotion developed specifically for head lice. These treatments are very powerful insecticides and may be toxic if not used as recommended. The need to remove nits or egg capsules is controversial. Those found more than a quarter inch from the scalp probably have already hatched or are not going to hatch.
Treatment should be initiated with over-the-counter permethrin 1 percent or pyrethrins when resistance to these products is not suspected. Malathion 0.5 percent can be used in people who are 24 months of age or older when resistance to permethrin or pyrethrins is documented or when treatment with these products fails despite correct usage. Other treatments can be considered for people who cannot afford or who wish to avoid pediculicides. Pediatricians and school or public health nurses are skilled in the identification of head lice and will avoid treating patients unnecessarily or falsely identifying “resistance” in the community to a certain product.
To prevent the spread of head lice:
• Children will be temporarily excused from school until 24 hours after treatment. Most schools require that children be free of nits before readmission. To ensure effective treatment, check previously treated children for any evidence of new infection daily for 10 days after treatment. Repeat treatment in 7 to 10 days may be necessary.
• Nits can be removed using a fine-toothed comb. (A pet flea comb may work best.) Some commercial products or a weak vinegar and water solution may make removing nits easier. Commercial preparations to remove nits should be made according to the manufacturer’s recommendations to assure the residual activity of the insecticide is not affected.
• Screen all siblings and adult family members for adult lice or nits. Anyone found to be infested should be treated. Simultaneous treatment of all infested family members is necessary to prevent spread back to previously treated children.
• Notify the school if head lice have been found on your child or any member of the household.
• Although head lice are not able to survive off of humans for more than a few days, many persons recommend washing clothes (including hats and scarves) and bedding in very hot water and vacuuming carpets and upholstered furniture in rooms used by the infested person. Combs and hair brushes may be soaked in hot water for at least one hour. Flea bombs and other environmental insecticides are not effective against head lice.
• Children should be taught not to share personal items such as combs, brushes and hats to decrease the risk of head-to-head contact.

Ratcliffe is a consultant to the Coastal Health District. You can call her at 876-6399.
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