Head lice infestations are common in children. Lice are tiny insects that feed on small amounts of blood ingested through the scalp. Although lice are a nuisance, they do not cause any serious illness or carry any diseases. A common misconception is that head lice are a sign of poor hygiene. Anyone can get head lice, now matter how clean you keep your home or hair. They are most common in preschool and elementary aged children. Lice are crawling insects and spread through close, head to head contact or less commonly through sharing of brushes, combs, hats, etc. They do not fly or jump from one person to another. The lice are about the size of a sesame seed and are usually pale in color. They live for about 28 days and can multiply rapidly, laying up to 10 eggs (also called nits) per day. The nits are tiny, oval, yellow to white colored eggs that strongly attach to the hair close to the scalp. These eggs hatch after about 12 days and the cycle continues.
Symptoms of head lice
• Itchy scalp: this is the most common symptom. It can take weeks after infestation to present and can persist for weeks after the lice are gone. Itching can also be caused by dandruff, eczema or reaction to hair products.
• Seeing live lice or nits in the hair
How to check:
• Sit your child in a room with good lighting
• Part the hair and look for lice
• Live lice are less often seen
• Look for nits. The easiest place to find them is behind the ears or the back of the hairline. They can be distinguished from other small particles because they are very difficult to remove from the hair shaft.
• Wet the hair and use a fine tooth comb to comb through small sections of hair; wipe the comb with a wet paper towel and examine the hair, comb and towel for nits or lice.
How to treat head lice
• Elimination of infestation
• Follow all manufacturers directions.
• Only adults should apply and handle medications and they should be kept locked away from children.
• Do not apply medicine if you are pregnant or nursing without checking with your doctor first.
• Check with the doctor before using on a child <2 years old.
• Check with the doctor before applying a second or third treatment.
• Over the counter medications; follow treatment with removal of all nits.
• Topical permethrin
• Brand name example: Nix
• Topical pyrethrum/piperonyl butoxide
• Brand name example: Rid
• Prescription medications
• Call the office if proper treatment with over the counter medications has failed.
• Treatment of personal items
• Wash clothes, towels, linens, other soft items in hot water and dry on high heat if your child has been in contact with these items in the few days before lice detection.
• Items that cannot be washed can be dry cleaned or placed in a sealed plastic bag for 2 weeks.
• Household contacts
• Should be checked and treated as necessary.