Treating head lice

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I never expected to have to deal with this problem, but that’s life. I guess if hundreds of millions of people get it every year, I shouldn’t expect to escape unscathed through my kids’ childhood.

Head lice infestation, also known as pediculosis, commonly affects children between the ages of 3-10. This is the age of nursery through primary school. For whatever reason, it is less common in older children. However, exposure to the younger population will put you at risk. That is, unless you are bald, in which case, you are unlikely to ever get head lice.

Head lice only infects those with hair. That is because they attach themselves, as well their eggs, to the strands of hair, using their very sticky saliva. There is a common misconception that only those with poor hygiene will get head lice. However, lice prefer clean hair, as it is easier to attach. Having said that, they would readily climb onto any hair they find available. They do not like oils, as it makes it difficult for them to attach; so, those with greasy hair may have an advantage.

Lice do not fly or jump. They walk between hairs, so they can only be passed between close contacts. It is uncommonly passed simply by sharing combs or clothing. Lice quickly die in the absence of a host to provide warmth and food. Since they feed on the scalp, they do not survive long once removed from the head. Therefore, the treatment of head lice does not require washing of clothes or bedsheets exposed to them. This is different to body lice which does require boiling of the clothes and bedsheets, or burning, if boiling is not practical.

Suspicion is raised when a child scratches his/her head. This is because itching is the most common symptom. The itching is caused by irritation when a louse bites the scalp to suck the blood. As it does so, it releases its saliva and the body’s reaction to the saliva causes the itching. However, some people do not experience a reaction, therefore, they do not itch. By the time the itching occurs, the head may have been infected for several weeks.

Examination of the head for lice is very important. Most often, lice can be found behind the ears or at the nape of the neck. They may be difficult to find if the hair is thick. Sometimes, you may be able to see the red bite marks, or the black lice droppings. More often, you can find nits (empty shells of lice eggs) attached to the hair. Nits can be distinguished from dead hair cells by their strong attachment. Usually dead hair cells will fall off when you shake the hair.

There are several methods for treating head lice. No treatment is 100% effective. There are pesticidal and non-pesticidal chemical treatment, as well as “natural” therapy. The pesticidal treatments often require a doctor’s prescription, whereas, the non-pesticidal will be sold over-the-counter. You should ask your local pharmacist for help on this. The problem with pesticidal treatments is that the lice often form resistance to the agents. Natural therapies include the simple wet-combing method, tea tree oil and other natural products (some examples include olive oil, aniseed and coconut), and hot air.

The wet-combing method involves washing the hair with shampoo, followed by an application of conditioner. Then, comb the hair using a regular comb to get the tangles out. After this, use the nit comb to go over the hair to remove lice and nits. The comb should be rinsed to remove the lice and nits between combings. To be thorough, this process should take about 30 minutes. The wet-combing method should be used, regardless of whether a chemical treatment is used or not.

It is recommended that chemical treatments not be used unless a live lice is detected on head exam. When using the chemical treatments, you should ensure that the eyes are protected by using a towel to prevent dripping of the chemical onto the face. Rinse the eyes well if any of the chemical does go in. Because no treatment is 100% guaranteed to work, repeat treatment is often necessary. Chemical treatments may kill lice, but not the eggs, which incubate for 6-9 days. Therefore, after about 10 days, the process should be repeated to kill the lice that hatches. It is also recommended that the wet-combing method be used in between the two treatments. Experts suggest checking for lice every two days with the nit comb and if it is negative for 10 consecutive days, then the child can be declared lice-free.

Hot air is another non-chemical treatment. However, it requires a special machine to deliver the right amount of heat to destroy the lice and eggs. There are other treatments that people resort to that are considered dangerous and, therefore, strongly recommended not to use, such as gasoline or kerosene. And, there are newer products in development that show promise and do not rely on pesticides.

Unfortunately, there is no way to prevent head lice. You can reduce the risk of acquiring lice by tying long hair back so that it reduces the likelihood of coming into contact with other people’s hair. Though shaving the head is one way of reducing the risk, it is not recommended because of the psychological impact on the child. However, if the infestation is severe enough to cause matting of the hair, cutting or shaving the hair may be necessary.

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