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Head Lice Are No Reason for Shame

Don't panic if your child has head lice. They are common and are more of a nuisance than a health risk.

Head lice, also called Pediculus humanus capitis, are parasites found on the heads of people. They can also be found on eyebrows and eyelashes. There are three forms of lice: the nit (head lice eggs found on hair shafts); the nymph (a baby louse that matures to an adult stage in about 9-12 days); and an adult louse (about the size of a sesame seed, tan to grey in color; they can live up to 30 days on a person's head). Nymph and adult head lice must feed on blood to live.

Hygiene has nothing to do with the spread of head lice. Lice is spread by contact with contaminated clothing, combs, or other personal belongings, and by lying on a bed, couch, pillow, carpet, or stuffed animal that has recently been in contact with an infested person. The Centers for Disease Control says that preschool and elementary-age children, 3-11, and their families are infested most often. In the United States, African-Americans rarely get head lice due to the hair type.

If you suspect a problem, look for live lice on the scalp behind the ears and near the neckline at the back of the neck. They live in the hair and suck blood from the scalp. Louse eggs (nits) are tiny and pearl colored and cling to the hair. The nits look like dandruff, but unlike dandruff, they cannot be easily brushed off the hair. The nits hatch in 8 to 10 days. Children may complain of tickling or itching of the scalp. 

People often mistake other insects for lice and dirt and debris for nits. Dead and hatched nits can hang on to hair for months, but live eggs are rare if they're more than half an inch from the scalp.

How can you deal with lice?

The Centers for Disease Control and Prevention offer these tips:Wash clothes and bed linens used by the infested person in the two-day period just before starting treatment.

  • Application of a medicated cream rinse or shampoo is usually effective treatment for head and/or pubic lice. Specific instructions need to be followed. Discuss this with your doctor. Examples of medicated cream rinses or shampoos include the following:

    • Prescription strength: malathion (Ovide)

    • Prescription strength: lindane

    • Over-the-counter: pyrethrins (RID, Triple-X, A-200, Pronto, R&C)

    • Over-the-counter: permethrin cream rinse (Nix)

  • Nits need to be removed from the hair with a fine-tooth comb.

  • Buy a thin-toothed metal louse comb at a pharmacy. Clean and brush hair to clear tangles. Use an over-the-counter product to make removing nits easier.

  • Do not use conditioner or a shampoo/conditioner combination.  

  • Do not rewash hair for one to two days after treatment. If some live lice are found eight to 12 hours after treatment, but are moving more slowly than they were, continue to comb dead and remaining lice out of the hair. If no dead lice are found and live lice are still visible and active, the medicine may not be working. In that case, contact your healthcare provider and follow treatment recommendations. Soak combs and brushes for one hour in rubbing alcohol, Lysol, or wash with soap and hot (130 degrees Fahrenheit) water. Wash hair accessories each day. After treatment, continue to check hair and comb with a nit comb every two to three days to remove nits and lice. Check for two to three weeks to make sure all lice are gone. Wash and dry pillowcases, sheets, nightclothes, towels and stuffed animals that the infested person used two days before the treatment. Use hot water (130 degrees Fahrenheit), soapy water.

  • After washing, dry laundry using high heat for at least 20 minutes.

  • Check all family members' hair every two to three days for two weeks.

  • Store all clothing, stuffed animals, comforters, etc., that cannot be washed or dry cleaned into a plastic bag; seal for 2 weeks.

  • Vacuum the floor and furniture. The risk of getting reinfested from a louse that has fallen onto the furniture or carpet is quite small. Do not use fumigant sprays; they can be toxic if inhaled or absorbed through the skin.