Head Lice

HEAD LICE PREVENTION LASTS ALL YEAR

* if you are having a problem with reoccurance please scroll down to the bottom for tips*

Head lice prevention needs to happen all year round in order to keep this problem under control. Lice outbreaks don't occur just in the back-to-school month of September. It happens after the holiday break, winter vacation, and spring break too! These are important times to be proactive and screen your children, so that they are lice and nit free and ready to learn.

Children transmit the lice most often during the back-to-school months of August through November, and therefore results in huge manifestations by December and January. Periodic inspections can help detect individual head lice early, when they are easier to control. Parents are the keys to this success by being properly educated about head lice detection and removal.

DID YOUR FAMILY HAVE A "LOUSY" VACATION?

Sometimes parents get more than they bargained for when they travel to visit friends and relatives over the school breaks. Head Lice, an unfortunate part of raising children today, may have returned home along with the happy memories and yellow credit card slips.  Parents need to screen for head lice and their eggs (nits) before their children return to the classroom or to child-care after their vacation.

Routine screening, early detection, and removal of lice and nits will minimize disruption, save money, and, most importantly, protect against unnecessary and direct exposure to potentially harmful chemicals, many of which now have no benefit because of lice resistance.  For children who have other medical problems and mothers who may be pregnant or nursing, the National Pediculosis Association urges a manual and non-chemical approach using the LiceMeister® comb especially.

 WHAT IS PEDICULOSIS OR HEAD LICE?

Head Lice or Pediculus humanus capitis are insects about the size of sesame seeds that feed by sucking blood from the human scalp.  They like the warm humid conditions near the scalp and dislike the light, so they will move to thicker areas of hair when the hair is parted for examination.  Head lice are uniquely human parasites.  They are not transmitted from pets or to pets.  Head lice infestation is called Pediculosis. School children between the ages of 5 and 12 years are most commonly affected.

Signs and symptoms of Head Lice are scratching and observation of the adult lice and nits.  The head louse is about 1/16 inch long and light tan in color.  They may turn brown or reddish after feeding.  It crawls fairly quickly but cannot fly or jump like a flea.  They do move quickly by crawling with 6 powerful legs and strong claws that allow them to cling to the hair-shaft.  They can reach speeds of nine inches per minute. The adult female louse lays eggs (also called ova or nits) at the base of the hair shaft next to the scalp.  The adult female louse lays 3 to 6 nits every 24 hours, laying a total of about 150 nits during her 30-day life span.  When adult lice are not seen on examination, you may find unhatched or hatched nit casings attached to the hair very close to the scalp (3-4cm).  Nits differ from dandruff in that they are regular and oval in shape and cannot be shaken easily from the hair as dandruff can. The nit is covered with a tiny bit of gelatinous material that hardens into a semi-opaque, tiny, pearly, whitish mass that is stuck tight to the hair shaft.  In about 7 to 10 days, the egg matures and hatches into a louse that lives by sucking blood from the scalp.  Without a human host, it can live only 1 to 3 days, usually 48 hours.  The adult louse lives 1 to 3 weeks on a human host, and a female can lay eggs several times before dying of old age.  The biggest problem with lice is reinfestation, especially when siblings share the same bed or when friends sleep over. 

HOW DO I GET RID OF HEAD LICE?

TREATMENT:   All medications used for Pediculosis are applied to the hair; no medication is taken internally. They fall into three categories: lindane lotion (Kwell), pyrethrin (RID), and permethrin (Nix).  Nix is a cream rinse that is not only ovicide, but also binds to the hair and remains effective for several weeks. Please check with your doctor for his/her recommendations for treatment before starting any treatment.

1.    Apply the treatment your doctor recommends, following product guidelines.

2.    Remove all clothing from the waist up before applying treatment. 

3.    Put on clean clothing after treatment. 

4.    For children with extremely long hair, a second bottle may be necessary. 

5.    Do not use cream rinse or shampoo/conditioner before using lice medicine.

6.    The product should be applied and left on the hair for 4 to 5 minutes before rinsing and drying. 

7.    Do not wash hair for one to two days after treatment. 

8.    Nits must be removed by combing the hair with a special fine-tooth comb that should be included or bought with the treatment you purchase.

9.    Lice treatment pesticide shampoos and lotions are not to be used repeatedly, in conjunction with, or as a follow-up to other chemical formulations.

10. Repeat this procedure in 7 to 10 days.

IMPORTANT:  No matter how effective a pesticide is in killing lice on the head, there will be reinfestation if all of the nits are not removed.  This is the most tedious and dreaded part of lice treatment.  If the comb cannot remove the nit, it must be MANUALLY pulled down the hair shaft with a fingernail or tweezers.  It may help to dip the comb in warm vinegar (50% white vinegar / 50% warm water or commercial pediculicide) during the combing process to loosen the glue-like material that hold the nit to the hair shaft.  Manual removal of all of the nits is the best guarantee to prevent re-infestation.

Repeat shampoo applications will depend on the type of medication you use.  If after 8 to 12 hours, some live lice are found moving more slowly than before, do not retreat.  However, if no dead lice are found at this time and the live lice are as active as before, the medicine might not be working.  Consult your healthcare provider for an alternative treatment.  This may be a sign of incorrect use of the pediculicide or the lice's resistance to the therapy.   

Children should be reminded not to share combs or hats with other children.  Have children bring their own pillows to sleepovers and wash the pillowcases afterward.  Don't pile coats on top of each other. 

Mode of Transmission: Head lice are crawlers that are only spread by direct contact.  

Although most transmission is head-to-head, treatment of the environment is also recommended.  Please follow these guidelines:

• Wash all bedding in the washing machine on the hot cycle.

• Soak combs and brushes in the same medication solution used on the head or boil them for 20 minutes; small nonmetal items can be microwaved for 60 seconds.

• Dry-clean clothing and other items that cannot be washed.

• R&C Spray insecticide may be used on bedding, clothing, and non-washables or a solution of ammonia and water can be used for cleansing purposes.

• Repeat the above steps in 4 days.  Items that cannot be laundered can be placed in a plastic bag and secured at the top for at least 5 days - some of the literature states a minimum of 14 days.

Are you having a problem with reoccurrence of head lice?  

Please read on:

Please note this fact:  30% live after the 1st treatment.  It is therefore absolutely necessary to do a second treatment in 7 days.  A 3rd treatment is highly recommended in 14 days if you want to completely eradicate the lice.

The following are several common reasons why treatment for head lice may fail sometimes:

1.      Applying the treatment to hair that has been washed with conditioning shampoo or rinsed with hair conditioner. Conditioners can act as a barrier that keeps the head lice medicine from adhering to the hair shafts; this can reduce the effectiveness of the treatment.

2.      After treatment, the hair was not checked - use a fine-toothed nit comb to check the hair for live lice every 2-3 days for 2-3 weeks until sure that all lice are gone.

3.      Not following carefully the instructions for the treatment that is used. Some examples of this include not applying a second treatment if instructed to do so, or retreating too soon after the first treatment before all the nits are hatched and the newly hatched head lice can be killed. Another reason is retreating too late after new eggs have already been deposited.

4.      Resistance of the head lice to the treatment used. The head lice may have become resistant to the treatment. If the treatment used does not kill the head lice, your health care provider and pharmacist can help you be sure the treatment was used correctly and may recommend a completely different product if they think the head lice are resistant to the first treatment.

5.      Re-infestation. The person was treated successfully and the lice were eliminated, but then the person becomes infested again by lice spread from another infested person.

6.      Sometimes re-shampooing the hair too soon (less than 2 days) after correctly applying and removing permethin can reduce or eliminate any residual (continued) killing effect on the lice.

7.      Improper treatment of the home: Routine house cleaning, including vacuuming of carpeting, rugs, furniture, car seats, and other fabric covered items, as well as laundering of linens and clothing worn or used by the infested person is sufficient. Only items that have been in contact with the head of the infested person in the 48 hours before treatment need be considered for cleaning. Soak combs and brushes in hot water (at least 130°F) for 5-10 minutes