Head Lice
Head lice infection, also known as pediculosis, is very common and can occur at any age, to either sex and is not limited to the poor or certain racial or ethnic groups. However, children, females, Caucasians, and persons with long hair are more frequently affected. Learn how to recognize head lice infestation, how to treat it, and how to prevent it from coming back.
WHAT ARE HEAD LICE?
These tiny parasitic insects (Pediculus humanis capitis) live in human hair (not on pets) and require human blood for survival. They hatch from small eggs called nits, which are attached to the base of individual hairs. The nits hatch into nymphs in about 7-10 days. Nymphs reach maturity in another 9-12 days. The adult louse is about the size of a sesame seed with six legs and a color range from off-white to reddish-tan. Female lice can live up to 30 days. Mature females lay as many as 7-10 eggs a day. Lice can only crawl, they cannot hop, jump or fly. There are two other species of lice which infest humans, crab or pubic lice (Phthirus pubis) and body lice (Pediculus humanis corpus).
HOW DOES SOMEONE GET HEAD LICE?
The most common form of transmission is close contact with someone infested with head lice. Transmission may also occur by using an infected person's comb or brush, hats, ribbons, scarves or other head coverings. You can also get head lice by sharing towels or pillowcases, or lying on a bed, couch or carpet that has recently been in contact with a person's head infested with lice.
WHAT SIGNS SHOULD I LOOK FOR?
Persistent itching of the head and back of the neck can indicate head lice. Itching is caused by an allergic reaction to the saliva of the lice, and takes about two weeks to develop. You should also look for infected scratch marks or a rash on the scalp. Most important of all, look for nits attached to individual hairs. These can be seen with the naked eye, but you can probably identify them more easily with the aid of a magnifying glass under strong illumination. Pictures of lice can be found on the Internet.
Sometimes, small white specks in the hair such as dandruff or droplets of hair spray can be mistaken for nits. Try removing the specks from the hair shaft. Dandruff or hair spray will come off easily, but nits are difficult to remove. Also, nits are found at the very base of the hair shaft, so if something is seen 1/4 inch or higher off the scalp then it is probably not a live nit. Check with a health professional if you are not sure whether head lice are present.
TREATING HEAD LICE: THE SOONER, THE BETTER
Once head lice are found, the problem should be taken care of promptly to prevent it from spreading to others. The head does not need to be shaved in order to bring the problem under control. Several effective over-the-counter preparations are available at pharmacies, including McKinley Health Center, to treat head lice. Treatments such as olive oil, mayonnaise, kerosene, and gasoline are not recommended and may be toxic. Rarely, oral medication is used for resistant cases.
INSTRUCTIONS FOR TREATING INFESTATIONS USING NIX CRÈME RINSE
- Remove all clothing from the waist up.
- Wash your hair with regular shampoo, rinse with water and towel dry. Do not apply conditioner.
- Saturate hair and scalp with Nix Crème Rinse; avoid contact with your eyes, nose and mouth.
- Leave on your hair for ten minutes.
- Rinse with water and use a fresh towel to dry.
- Comb hair with a fine-tooth comb to remove any remaining lice and nits.
- Put on clean clothing.
- Comb hair every 1-3 days, continuing to check for lice for 2-3 weeks.
- A second application may be necessary in 7-10 days to target lice that hatch after the initial treatment. Do this only if live lice are still found.
- Wash brushes and combs in hot sudsy water for ten minutes, soak in a bleach solution of one part bleach to 10 parts water.
- If live lice are still found after the second treatment then consult a health care provider, do not continue to treat.
- Expect your scalp to continue to feel itchy after treatment because of the allergic reaction to the bites. Do not treat if the only symptom is itching. Treat only if live lice are seen.
YOUR RESIDENCE SHOULD BE TREATED TOO
Lice can survive in the environment off a human host for 1-2 days. To avoid reinfestation, take the following measures. All articles that may harbor lice or nits, such as recently worn clothing, towels and bed linens should be washed in hot water (140° F) and detergent, machine dried with heat, or dry-cleaned. Vacuum all upholstery, carpets, mattresses and your car. Wrap the vacuum bag and contents in a plastic bag and discard. Fumigation or room sprays are not recommended.
SHOULD OTHER FAMILY MEMBERS OR ROOMMATES BE CHECKED FOR HEAD LICE?
Yes. If one member of a residence has head lice, all members should be inspected every 2-3 days for two weeks. Treat only those who are found with lice.
HOW CAN I HELP PREVENT HEAD LICE IN THE FUTURE?
Avoid borrowing personal items - combs, brushes, hats, towels or clothing - from roommates and friends.
Other resources:
- National Library of Medicine (http://www.nlm.nih.gov/medlineplus/headlice.html, available in Spanish)
- Center for Disease Control and Prevention (http://www.cdc.gov/lice/)
Sources:
Goldstein, A. O., & Goldstein, B. G. (2010, July). Pediculosis capitis. Retrieved from http://www.uptodate.com/online/content/topic.do?topicKey=infectio/7225&selectedTitle=1%7E23&source=search_result
Harvard School of Public Health web site, http://www.hsph.harvard.edu/, search for head lice
Pediculosis and Scabies by DC Flinders, M.D., and P De Schweinitz, M.D. (American Family Physician, January 15, 2004).