Going Head to Head with Head
by A. Dixon, RN
Head lice can happen to anyone! They don't discriminate according
to race, age, sex, or social status. Having head lice is not a sign of
uncleanliness. These lice are always looking for a warm scalp to live on
and once they find it, they spread through an entire family - or a whole
school - in no time at all. It has been estimated that each year 6 to
12 million people get head lice. That is an average of 22,000 cases
each day! Luckily, head lice are not known to transmit disease - just
discomfort and inconvenience. It is wise to learn how to recognize head
lice infestation, how to treat it, and how to prevent it from coming back.
A head louse is a flat, wingless insect the size of a sesame seed that
lives off blood from the human scalp. Head lice do not live on dogs, cats,
or any other animals - only on humans. After the louse bites and feeds,
it drops a small amount of saliva into the scalp, which usually causes
itching. Itching is the most common sign of lice infestation. The head
louse spends its entire life (about one month) on the human scalp. Once
in the hair, the female louse mates and, a day later, lays four or five
eggs (also called "nits"). These eggs are attached to the hair shaft
with a glue-like secretion, so that ordinary washing, combing and brushing,
or drying can not remove them. The eggs are attached to the hair shaft
close to the scalp. Incubated by human body heat, they hatch in 7 to
10 days. A week or two later, the new lice mature, mate, and - if left
untreated - the cycle repeats itself.
A single louse can lay as many as 300 eggs during its lifetime. So, in
one month, an untreated infestation can mean hundreds of lice on the scalp.
Even though lice do not jump or fly, they do get around quickly by crawling.
The most common way lice are transmitted is through direct head-to-head
contact. Indirectly, head lice can be transmitted by using a comb or brush
from a person who has lice, sharing personal items with someone who has
lice such as towels, clothes, hairclips, hats, helmets, earphones,
blankets or pillows, or coming in contact with infested stuffed animals,
dolls, cloth-covered toys, cushions, or carpet. Even a stray hair that
has nits on it can transmit head lice. Lice can live up to four of five
days without feeding.
Although lice are difficult to see, they are easy to recognize, provided
you are actually looking for them. You should suspect an infestation if
someone is experiencing a persistent itch of the scalp, usually behind
the ears and at the nape of the neck. When you look closely, you may
notice rash-like red marks. But be aware: lice can be present even
without any itching or rash.
Head lice are almost impossible to spot with the naked eye because
they shy away from light, moving quickly toward warmth and darkness.
Eggs or nits are easier to see. Live nits are greyish-whitish, oval
specs that look like a grain of white sugar, about the size of the
period at the end of this sentence. A dead nit looks brown, and an
empty nit (one that has hatched) is white or see-through. A magnifying
glass will help you see them better. Sometimes, small white specks
in the hair such as dandruff or droplets of hair spray can be confused
with nits. When trying to remove the specks from the hair shaft,
dandruff and hair spray will come off easily, while nits are very
difficult to remove.
When looking for lice, examine the hair shaft close to the scalp.
Spotting lice and nits requires time and patience. If you find even
one nit, you can be sure that lice are also present. If lice are
found in even one person, the whole family and/or classroom should
be checked and possibly treated.
Once head lice are found, the problem should be taken care of promptly
in order to prevent it from spreading. There are many over-the-counter
preparations that can be bought for the treatment of head lice.
Instructions may vary for each individual product so it is important
to read the product information before using the product. Home remedies
such as vinegar and water washes or applying petroleum jelly to the hair
may help in the removal of the nits but should not be substituted for the
treatment of head lice with FDA approved products bought at any local
It has been noted in some professional journals that some lice have
become resistant to over-the-counter treatments. If the lice
are not effectively killed by an over-the-counter product, it may be
necessary to consult with your doctor. There are some strong lice
treatments that have to be prescribed and are not available over-the-
Medical resources have revealed that after correct treatment of lice,
if nits are found more than 1/2" inch away from the scalp, they are
considered dead and no longer a threat for reinfestation. However, if
left in the hair, nits can cause the patient unnecessary embarrassment
and rejection. Some schools may even have a "no nit policy" which means
that before a child can be readmitted to a school all nits must be
removed from the hair.
Even after all lice are removed from the hair and scalp, the danger
of reinfestation may still exist because lice can live in the environment.
Nits can lie dormant for several weeks, then hatch to reinfest unsuspecting
individuals. Considering how easily lice spread, it is understandable that
treating your house or classroom is an important step to avoid reinfestation.
All clothing, towels, sheets, bedclothes, and cloth toys that have come
in contact with any infested person should be washed in hot water,
preferably 130 degrees. Any article that can not be washed but can
be dried should be put in a hot dryer for at least 20 minutes. Otherwise,
dry-clean or put items that can not be machine-washed or dried into a
sealed plastic bag and leave in a cool, dry place for one month.
Soak all combs and brushes in hot water or in a solution made from the
over-the-counter products for ten minutes after each use. Carefully
vacuum mattresses, carpets, and furniture frequently to pick up any
remaining live lice or nits.
A key step to controlling lice is teaching children how to avoid getting
them. Without frightening your child, make sure he or she understands
not to borrow or use personal articles such as combs, brushes, hats,
helmets, or hairbows from other children. Do not stack coats or hats
with others. Hang coats and hats so they do not touch another person's
coat or hat. And remember, not reporting a lice infestation because you
do not think it is important or because you are embarrassed is a big
mistake. It could lead to an outbreak.
Lice are a statistic - not a stigma. If you have an infestation, don't
panic or feel embarrassed. If you're not sure if you or a family member
has an infestation, you can come to the Fayette County Health Department
for a head lice head exam. The cost is $5. Call (770) 461-1178, ext. 5416.
For furthur information, visit the National
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