Nitpicky about lice

By DR. DAN BRENNAN — Dec. 11, 2009

L-I-C-E is a four-letter word. Just thinking about it makes my scalp itch. This year, more than any year that I can remember, our schools seem to be crawling with these little buggers.

What are lice?

Head lice are tiny parasitic, grey bugs (1/16-inch long) that cause an itchy scalp, move quickly and are difficult to see with the naked eye. Adult lice can live for 3 weeks on your scalp and up to 24 hours off of your scalp.

What are nits?

Nits are white colored eggs that are attached to hair shafts close to the scalp and are not easily removed. These eggs may be easier to see than lice because they are larger in size and very abundant.

Nits hatch into creepy-crawly lice after about one week. Off of the scalp, nits can survive for up to 2 weeks, an important fact that can affect cleaning and contagiousness.

Generally, nits found >1cm from the scalp are already hatched and appear very white in color.

Taking the lice out of your life

So what should you do if your child is sent home from school with lice?

After scratching your head, take a trip down to your local drug store to pick up an over the counter permethrin lice shampoo, such as Nix. Follow the instructions carefully and consider repeating the shampoo treatment one week later to kill any nits that were missed.

Eight hours after the treatment, the shampoo has had time to permeate and kill the nits. Now it’s time to loosen the nits from the hair shafts by applying a mixture of half vinegar and half warm water, under a towel wrap for 30 minutes.

Finally, it is time to be a nitpicker and carefully remove the nits one-by-one by backcombing the hair with a special nit comb or your fingernails. A lighted magnifying glass may help you find the darker, un-hatched nits close to the scalp.

Resistant lice

If nits or lice persist after two treatments of lice shampoo, you may have resistant lice. In this case, your doctor may need to give you a prescription strength shampoo. An oral medication, ivermectin, may also be used when lice are resistant to the prescription-strength shampoos.

Cleaning the house

To reduce contagiousness, avoid sharing hats and combs. Carefully check other family members for nits. Wash all bedding and clothes in hot water, >140 degrees, to kill nits and lice. Any items that cannot be washed should be sealed in plastic bags for 2 weeks, the length of time that nits can survive off the scalp. Vacuum your floors and soak combs and brushes in lice shampoo for at least one hour.

Do home remedies work?

Instead of using permethrin shampoo treatments, some parents experiment with products that are intended to smother lice and prevent them from breathing. Olive, peppermint and tea tree oils, Vaseline and mayonnaise have uncertain benefit in treating lice and may not kill the nits.

Choosing to use one of these products instead of the recommended shampoos may be a common reason for a prolonged or persistent lice infestation, but at least have the added benefit of lice that smell minty fresh.

The lice po-lice

Every school and day care center will have their own rules about when kids can return. In most cases, children should no longer be contagious after one treatment, but check with your school since many have a “no-nit” return policy.

I’m telling you no “lice”

By being nit-picky with your shampoo treatments, house cleaning and nit monitoring, most cases of head lice should be easy to control. Recurrent cases of lice may indicate ongoing contact with an infected person, improper shampoo or cleaning techniques or possibly having a case of resistant lice.

For more lice advice, please contact your favorite white-coated crusader.

Dr. Dan Brennan is a board certified pediatrician and proud father of two boys. His column can be found on alternating Fridays in the Daily Sound. To contact Dr. Brennan, please call 563-6211 or visit www.SBPediatrics.com.

Comment on this article

Subject:

Body:

Poster:

Enter text seen above: