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How To Spot, Treat & Prevent Head Lice

School is back in session. And while many of us know this can lead to the beginning all sorts of activities it can also mean the rise of calls to the doctor for respiratory ailments, stomach bugs and yes head lice. We reached out to our own Dr. Kathryn Skuza for more information on how parents can help spot, treat, and hopefully prevent lice from affecting their home.

The head louse is a wingless insect that loves the human head. It doesn’t care about geographic location or socioeconomic background. And it loves kids’ heads.

How does it spread? Well, literally, from head to head [see prevention below]. So the most common places that suffer from lice infestation are expectedly, daycares, schools, and camps – where there is close contact. It may spread at sports activities, playgrounds and slumber parties. And, of course, households of affected children…

Lice move by crawling – they do not jump or fly. They move from head to head when possible – dropping off if one were to visualize the process... Personal hygiene or cleanliness has nothing to do with it.

The female louse lives for approximately 1 month. She lays 7-10 eggs per day – these eggs are called NITS. They are cemented to the base of a hair and are not very visible at the time. For them to survive they need to be within a ¼” above the scalp. Baby lice hatch in 8 days and require another 8 days to mature. The empty nits become more visible at that point.

An adult louse is about 1/10” long. It has blood-sucking mouth parts & legs that can grasp hairs. It feeds on the scalp and adjacent face and neck areas. It loves to feed at night. If it drops off its human host, it can live up to 55 hours [about 2-1/4 days].

Its presence on the human scalp can cause a tickling feeling but usually a pretty intense itch. The itch is probably an allergic reaction to louse saliva as it may only present itself 4-6 weeks after initial infestation. As a result, a child’s head/scalp may show multiple excoriations, in addition to nits and actual lice. Occasionally, staph infections may occur secondarily and really complicate the picture. Neck and scalp lymph glands may enlarge.

The good news is that head lice do not spread disease. The best approach is always PREVENTION – see below.

But once identified, DON’T PANIC - head lice can be treated [1, 2]. Reassure your child and everyone else that it was not caused by being “unclean.” There are 2 approaches to treatment: topical pediculicides and natural alternatives. Common to both approaches is the use of a specially designed FINE –TOOTH COMB used to remove both live lice and the nits - manual removal by “wet combing” can be used alone or in concert with topical treatments [pediculicides or natural home treatments]. The other important step is to repeat the treatment in 8 days when remaining live nits hatch.

There are a number of topical pediculicides – it’s probably best to consult with your medical provider to see which one he/she prefers and which are safer for each age group. You need to follow instructions carefully for each brand. If head lice are particularly resistant to treatment, your provider may then prescribe an alternative approach.

Then there are the natural alternatives – their benefit is the avoidance of a pesticide. Home treatments tend to messy but can be quite effective [2], the Cetaphil Cleansing Lotion method as an example [3]. The internet has much to offer, but be skeptical – read the attached reviews.

Call your local school district to find out what is the local head lice policy. “Both the American Academy of Pediatrics (AAP) and the National Association of School Nurses (NASN) advocate that “no-nit” policies … that require a child to be free of nits before they can return to schools should be discontinued.” [4]

PREVENTION is key! The CDC has an excellent website for addressing both treatment [1] and prevention [5]. As usual, it’s a matter of doing some homework beforehand…

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