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Head Lice (Pediculosis) 

-by Jacquelyn Psoinos, MSN, CPNP
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Acute Illness Guide

 

 

 

ABOUT HEAD LICE

Head lice are small insects that live in human hair. Historically, lice have been associated with embarrassment and social stigma. However, they are HARMLESS, do not transmit disease and certainly are not related to hygiene or cleanliness. If your child has head lice, it just means they have been in close contact with another child with head lice.

IDENTIFYING HEAD LICE

Head Lice are about the size of a sesame seed and are tan to grayish in color. They will attach themselves to the scalp and lay eggs, 'nits' on the hair shaft. The nits are white & firmly attached to hair, about 1-2cm away from the scalp.

 

Tips for a Lice check

  • Part hair in several spots
  • Use a magnifying glass & a bright light
  • Lice move fast, identifying the white nits is often easier.
  • Nits can look like dandruff. Take your fingers & pull down the strand of hair, dandruff will come off easily - nits will not.
Check your child for Lice before and after they  share sleeping quarters with other children, for example: at camp.

TREATMENT  

There are several different over-the-counter (example RID & Nix) and prescription treatments available. Some Lice have become resistant to several medications available over-the-counter. Newer, non-resistant formulas available in prescription form may be necessary. Also, many over-the-counter products are approved for children two and older. A prescription may be necessary for those under two years of age. While alternative methods such as bathing the head in mayonnaise overnight is not harmful, there is little evidence such methods are effective. Other methods such as use of animal shampoos or other insecticides may be harmful & should be avoided.

Tips for Treatment

  • Use product exactly how directed on label/prescription or contact our office for specific instructions based on age & weight. Do NOT use more than directed.
  • Pay special attention to directions for how long to leave product on hair & how to wash off.
  • Do not wash hair with conditioner or crème rinse before treatment & do not wash hair for 1-2 days after application of treatment.
  • After removal of product use a fine tooth comb or special 'nit' comb to remove dead lice & nits.

*Comb out nits every 2-3days for up to 2-3weeks to prevent re-infestation.

  • Many prescription & non-prescription products call for a second treatment 7-10 days later; often the first treatment does not kill all nits. However, if you are not successful in treating the Lice after the 2nd application then contact our office; do not use more than 2 applications of the same product.

PREVENTION

Lice crawl. They do NOT jump. They can not jump from head to head. Lice also can not live off the body for a long period of time. You don't need to spend a lot of time or money on housecleaning activities. Follow these steps to help avoid re-infestation by lice that have recently fallen off the hair or crawled onto clothing or furniture:

  • Machine wash clothing & sheets used by the infected person in the past 48 hours. Use a hot water wash (130degrees) & hot dryer. Items unable to wash may be placed in a sealed plastic bag for 2 weeks.
  • Soak combs & brushes in hot water (130degrees) for 5-10 minutes.
  • Vacuum floor & furniture where the infected person may have laid in the past 48 hours.
Teach your children to avoid head-to-head contact when playing with friends & to avoid sharing clothing such as hats, scarves, helmets and hairbrushes.

NO to 'no nit' policies

In the past schools have adopted 'no nit' policies: children were not allowed back into school until every nit had disappeared. Many studies have shown that the presence of nits alone do not result in transmission of Lice. Recently, the American Academy of Pediatrics Committee on Infectious Diseases and the National Association of School Nurses have issued statements reiterating that Lice should not interrupt the education process and a child should be allowed back to school immediately following appropriate Lice treatment. For more information on Head Lice
please visit http://www.cdc.gov  or