How to deal with and get rid of head lice

Bugs living in your hair may sound like something out of a science fiction movie, but if you or your child suddenly has an excessively itchy scalp, you may have lice.

According to Jennifer Lavallee, APRN, of Merrimack Valley Pediatrics in Nashua, head lice or pediculosis capitus are an ectoparasite that lives on the human scalp. They are spread as a result of person-to-person contact or through contaminated hats, clothing, combs or linens.

“Lice are not dangerous and do not spread disease, but they are a nuisance,” Lavallee said. “The most common symptoms are itching, which may be worse at night and cause trouble sleeping. They are typically found on the back part of the scalp and in the hair behind the ears. Notifying potential contacts of someone with lice is extremely important to control the spread. All exposed individuals should be examined regularly and treated if infested.”

Lice are extremely common in the United States, with more than 12 million people affected each year, she adds. Girls ages 3 to 11 are at the highest risk for getting lice, and outbreaks are more common in late summer and early fall. The condition is seen most in Caucasians or Asians, and in close or crowded living conditions and schools. Poor hygiene is not a risk factor, and pets don’t get head lice, so if there’s an outbreak in your family, don’t worry about Fido.

The adult louse is small—about the size of a sesame seed—and is grayish white in color. Lice don’t have wings and can’t jump or fly. They lay eggs called nits that are white and tend to be found attached to the hair, close to the scalp. Adult lice can only survive for one to two days detached from the human scalp, while nits can live free of the human head for about 10 days.

So how do you treat this pesky problem? First, don’t panic. There are simple and effective ways to get these pests out of your hair.

Typically, the most common medicines used are topical shampoos or creams, said Dr. Gus Emmick of Elliot Pediatrics and Primary Care at Riverside in Hooksett. There are a variety of topical pediculicides, or substances used to treat head lice. The most common used are pyrethrins, natural organic compounds that have potent insecticidal activity, such as RID or Pronto.

“These medicines are neurotoxic for lice, but generally considered very safe for humans,” Emmick said. “There are a variety of other topical medicines available by prescription, including those with Malathion, Ivermectin or benzyl alcohol. There have been an increasing number of medicines due to the increasing resistance of head lice, especially to the pyretherins.”

The Centers for Disease Control and Prevention estimates six million to 12 million head lice infestations per year in children 3 to 11 years old, according to Emmick. It is more common in children due to close contact and sharing of personal items. The most common age group is between 5 and 11 years of age. Prevalence is typically between one and three percent in industrialized countries, but infestations can lead to much higher percentiles in schools.

Although lice resistance has grown, he adds, the most common reason for failed treatment is incomplete treatment, such as not removing or killing the lice entirely, not treating clothing or bedding, or not treating other family members who may have become infected.

Treatment of lice is very effective when done appropriately, Lavallee said. “A fine tooth or nit comb should be used to remove nits after treatment, since most treatments kill lice but not nits. It is for this reason that treatments should often be repeated after seven to 10 days, the time it takes for nits to hatch. In addition to over-the-counter treatments, there are many prescription topical and oral treatments for lice if there is resistance.”

Lavallee also emphasizes that, aside from topical treatments and special combs to remove nits, an important aspect of treating lice involves environmental measures. This includes washing towels, bedding, hats, and toys in hot water and drying on the highest heat setting. Dry cleaning is also effective at killing lice and nits. Items that cannot be laundered should be sealed in plastic bags for two weeks. Carpets, couches and other fabrics in the home should also be vacuumed thoroughly. Lastly, any combs or brushes used should be discarded or treated with a pediculicide to keep the bugs at bay.

Julia K. Agresto is a freelance writer based in New Hampshire.

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