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The Informed Parent

Head Lice And Nits

by Peter W. Welty, M.D., F.A.A.P.
Published on Jan. 28, 2013

Once again that old leading childhood communicable disease is cropping up in our schools. The dreaded head lice! It is estimated that ten million children a year are affected. These pesky insects live on the bodies of their hosts and feed on their blood. The most common type occur mostly in children. They can infest the scalp, and occasionally can involve the eyelashes and eyebrows.

Transmission of the lice occurs by direct contact with the infested individual. Or contact can easily occur by borrowing that person’s comb, brush or hat. Lice do not jump or fly. And they do not survive longer than 48 hours off of their host. They cannot live on pets, and do not wash or blow away.

Parents most often become aware of lice by either finding them or their nits (eggs) in their children’s hair. Or the parent may receive a report from the school nurse. A common symptom is itching, occasionally causing the scalp to be red and tender. On the other hand, some children with head lice do not itch at all. This emphasizes the need to do periodic head checks. The lice are most often found at the nape of the neck, behind the ears, and at the crown. 

It is important to note that while some people may associate head lice with unclean people or unsanitary living conditions, this is absolutely untrue. People with clean hair as well are just as easily infested.

It is a good idea to check every member of the family of a person with head lice. Those with symptoms should be treated to prevent re-infestation. Treatment is to use a special shampoo, gel or rinse that kills the lice and nits. This shampoo is available by prescription or over-the-counter. These agents are pesticides; thus, they need to be used with care, and in conjunction with your doctor. This is particularly true for children under two years, or for pregnant or nursing mothers.

Severely ill patients on medication need special guidance from their physician before administering this shampoo. Lice-killing products are generally not recommended for the invasion of lice around the eyelashes or eyebrows. Further questions should be asked of your doctor.

Shaving your child’s head may also cure the infestation, but is less cosmetically appealing to most people.

The next step is to clean all of the child’s personal belongings and bedding.

Clothes worn in the last three days and bed linen should be washed in hot water and dried in a hot dryer. Combs and brushes should be washed in hot soapy water and soaked for ten minutes. Rugs and furniture should be vacuumed thoroughly. Remember, head lice do not live for very long off of their hosts, so dangerous chemicals and sprays are not needed or recommended.

After your child has undergone the shampoo treatment, the dead nits need to be removed from the hair. This can be done with the special comb that is often included in the treatment kit. Or they can be removed manually. All of the nits need to be removed, in order to avoid the possibility of an unkilled one causing another infestation. This is the reason many schools and preschools have a “no-nit” policy. They have an important role in screening for head lice to prevent others from becoming affected.

Head lice is not a serious condition, but its treatment can be rather time-consuming. It is a good idea to teach your child never to share personal items such as combs and brushes. Regular periodic head checks are also very important and will minimize an infestation.

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