There is nothing more unpleasant than receiving a phone call from your child’s school informing you that your kid has head lice. Head lice is frequently seen among children 3 to 12 years of age and, with the exception of the common cold, it affects a great number of elementary school students in North America than all other communicable diseases combined. In fact, according to the Centers for Disease Control and Prevention (CDC) , one of every four elementary level students in the US has been infested with the bug.
1. Head lice know no socioeconomic status or ethnic boundaries. Males appear to be less susceptible to lice than females and for unknown reasons; African-American children are affected much less frequently than white children and other groups. However, we do know that people do contract head lice as a result of sharing combs, hairbrushes, headphones, pillows, helmets, or friends’ clothing — especially garments that are pulled over one’s head. Head lice are neither a health hazard nor a sign of poor hygiene and, in contrast to body lice, are not responsible for the spread of any disease. Nevertheless, there is a considerable stigma attached to this issue.
2. Head lice are often without symptoms or can result in itching of the scalp especially behind the ears, at the crown of the head or nape of the neck. The diagnosis is actually made by visualization of live lice. These bugs look like sesame seeds and can be reddish or brown in color. Nits or eggs are smaller, appear silver or white in color as tiny deposits cemented to the shaft of hair near the scalp, yet are more easily discoverable than lice. Finding nits without lice does not imply an active infestation because nits may persist for months, even after successful treatment. According to the Centers for Disease Control and Prevention, active infection is suggested by the finding of many eggs within one-quarter inch of the scalp.
3. If you think you or your child has head lice, it is essential to check in with your doctor for an accurate diagnosis and proper treatment. When lice are detected, the first step is to treat the affected child or adult and all family members with over the counter 1 percent permethrin or pyrethrins (a type of medical insecticide — can be used on humans — as opposed to a household pesticide) that can be used for treatment of active infestations. Because current products do not always kill all the lice eggs, applying the product at least twice at proper intervals, typically 7 to 10 days after the first therapy, is recommended. Manual removal of nits immediately after treatment is recommended only if the nits are ¼ inch or less away from the scalp.
4. Not all products kill the eggs. If lice are unaffected by treatment; if the patient is too young; or if the parent does not wish to use permethrins, consider recommending wet combing by using petroleum jelly, emphasizing careful technique and repeating for at least two weekly cycles which basically suffocates the lice. More intense treatments and prescribed oral medications can be used for kids older than two years of age who have resistant forms of lice.
5. Housekeeping measures are also an essential part of treatment, which means washing clothing, bedding, stuffed animals and towels in hot water and dried in an electric dryer on the hot setting. Dry cleaning is also effective. You can use a vacuum to clean furniture, carpets and car seats. Any objects that cannot be washed need to be bagged for two weeks as this serves to suffocate the bugs.
It is essential that school personnel be informed of any new diagnosis of head lice as the entire classroom need to be inspected and treated. Discuss the diagnosis openly with family, friends, relatives, babysitters, sports teams, carpools, and tutors. If everyone knows what’s going on and what to do, the risk of infestation can be cut in half.
Tips to deal with head Lice.
6. Your child’s school needs to be informed if your child has been diagnosed as they need to implement preventative measures in the classroom. School policies differ about who at the school needs to be informed. A confidential call or visit with a school nurse is probably the best policy. Some schools have a “no nit” policy that prevents a child from returning until no nits are found. In 2010, the American Academy of Pediatrics noted that head lice is not a health hazard or sign of poor hygiene, and no healthy child should be excluded from or miss school because of head lice, and “no nit” policies to return to school should be abandoned.
7. It is important to keep calm when told of the diagnosis of head lice. Although head lice are a nuisance, they do not spread disease.
8. Teach your children not to share items that touch their heads and check your child’s hair on a routine basis.
9. Never discriminate against anyone with lice as it can affect anybody regardless of age, hygiene or socioeconomic circumstances.
Dr. Joseph Sirven is a first-generation Cuban-American. He is Professor and Chairman of the Department of Neurology and was past Director of Education for Mayo Clinic Arizona. He is editor-in-chief of epilepsy.com and has served U.S. and global governmental agencies including the Institute of Medicine, NASA, FAA, NIH and CDC.