Head lice can be very embarrassing and mentally exhausting at the same time. A few years back, I had a client who suffered from this pernicious hair infection. She could barely enjoy new hairstyles or confidently hang out with peers.
These insects are so tiny, they hardly can be seen with the human eyes, additionally, they feed on blood from the human scalp. Head lice are mostly affected by children. The insects usually spread through direct transfer from sharing of combs or hair pieces of equipment, or even the hair of one person to the hair of another.
However, having head lice isn’t a sign or indication of poor personal hygiene or an unclean living environment for the affected individuals. Head lice don’t also carry bacterial or viral diseases.
conversely, most people also use several home or natural remedies to get rid of head lice. But there is little to no clinical evidence to show how effective these remedies are.
Common Symptoms of Head lice
Common signs and symptoms of head lice may include:
- Frequent Itching of scalp: This is the most common symptom of head lice, itching on the scalp, neck and ears. This is an allergic reaction to louse bites. When a person has head lice for the first time, itching may not occur for 4 to 6 weeks.
- Noticeable Lice on scalp: Often times, you may be able to see the lice, but they are often hard to spot because they are very tiny, avoidant to light and they move quickly.
- Lice eggs or nits on hair shafts. Nits cling to hair roots and can be difficult to see due to their small size. They are most visible around the ears and the hairline of the neck. Empty nits may be easier to spot because they are lighter in color and located further away from the scalp. However, the presence of nits does not imply the presence of live lice.
- Irritable Sores on the scalp, neck, and shoulders: Scratching can lead to small, red bumps or inflammation that may sometimes get infected with bacteria.
Things often mistaken for nits include:
- Dandruff
- Residue from hair products
- Beads of dead hair tissue on a hair shaft
- Scabs, dirt or other debris
- Other small insects found in the hair
Brief Summary of the Head Louse
A head louse is a comparatively tiny, pale skin or greyish insect with the size of a strawberry seed. It is a pest that feeds on the host by consuming blood from the scalp while making its host uncomfortable. Each egg is firmly attached to the base of a hair shaft less than 1/4 inch (5 millimeters) from the scalp by a sticky substance produced by the female louse.
The life cycle of a louse
A louse goes through three stages:
- Eggs that hatch after 6 to 9 days.
- Nymphs, immature forms of the louse that become mature adults after 9 to 12 days.
- Adult lice, which can live for 3 to 4 weeks. The female louse lays 6 to 10 eggs a day.
How do Transfer from Person to Person
Head lice usually crawl, they can’t however jump or fly. Head lice often spread from one person to another through direct head-to-head contact, usually among family members, spouses, or children who have close contact at school or play.
It is less common for head lice to spread without direct contact. But the insects may spread from one person to another through personal items, such as:
- Sharing of Hats and scarves
- Usage of someone else’s brushes and combs
- Lending of hair accessories
- Sharing headphones
- Pillows, towels and upholstery
Head lice may also spread when items of clothing are stored together. For example, hats or scarves hung on the same hook or stored in the same school locker could serve as vehicles for spreading lice.
Nevertheless, Household pets, such as dogs and cats, don’t play a role in spreading head lice.
Where do lice come from?
Frankly, the exact estimate of where and how many people get head lice per year is hard to pin down.
The Centers for Disease Control and Prevention (CDC) estimates that there are about 6 to 12 million cases each year in the United States among children ages 3 to 11.
Since lice can only crawl and survive outside your head for 24 hours, most infestations come from direct head-to-head contact. If someone you know has lice, it’s likely they got it from a friend, family member, or stranger with whom they had close contact. Shared items like hats or brushes can also facilitate an infestation.
Frequent situations that can lead to the transmission of lice include:
- being in school, for children
- sitting close to others
- sleeping in the same bed, like during a slumber party
- sharing combs, brushes, or towels
A national survey asked moms about removing lice and found that most didn’t have accurate facts. Almost 90 percent of moms believe they need to remove eggs (nits,) and half of moms thought they should apply multiple treatments for head lice.
The CDC says that complete removal of nits is unnecessary, though using a lice comb can help. And when it comes to treatment, you should use only one product at a time.
Risk Factors
If your child scratches an itchy scalp due to head lice, the skin can break and develop an infection.
How to Prevent Hair Lice
Because of the close contact, it is difficult to prevent the spread of head lice among children in childcare facilities and schools.
The likelihood of indirect spread from personal items is low. However, to help prevent the spread of head lice, you can instruct your child to:
- Hang clothes on a different hook than other children’s clothes.
- Share combs, brushes, hats, and scarves as little as possible.
- Avoid sleeping on beds, couches, or pillows that have been in contact with head lice carriers.
When it comes to sports and bicycling, it is not necessary to avoid sharing protective headgear.
Treatments
| Treatment | Application | Nit combing? | Caution |
| Malathion (Ovide) | Apply this medication to your hair and then rub it into your hair and scalp. A second treatment may be necessary if lice are seen seven to nine days after treatment. | ✓ | Extremely flammable and should only be used for pregnant or breastfeeding women in consultation with a doctor. Not for children less than 6 years of age. |
| Ivermectin lotion (Sklice) | Apply to dry hair and scalp. Rinse after 10 minutes with water. It’s effective with only one treatment. | X | Not for children under 6 months. |
| Spinosad topical suspension (Natroba) | Apply to dry hair and scalp. Rinse after 10 minutes with water. Repeated treatment is typically not necessary. | Not necessary | Not for children under 6 months of age. |
| Benzyl alcohol lotion (Ulesfia) | Apply this lotion to your scalp and dry hair for 10 minutes, completely saturating the scalp and hair. Rinse with water. Repeat treatment is needed, as it kills the lice but not the eggs. | ✓ | Not for children under 6 months. Safe in pregnancy and breastfeeding. |
| Lindane | Apply shampoo to dry hair and scalp. Leave for four minutes before adding water for a lather. Rinse afterward. Retreatment should be avoided. | X | Lindane causes serious side effects. Use only if other prescriptions fail. Not for premature infants, those with HIV, women who are pregnant or breastfeeding, children, the elderly, or those weighing less than 110 pounds. |
Over-the-counter treatments for head lice
If you are actively looking at over-the-counter (OTC) treatments for lice, keep an eye out for these ingredients:
Pyrethrins: This is a natural chrysanthemum extract. It is suitable for children aged 2 and higher. However, this ingredient only kills live lice and not their nits. If the existing eggs hatch, you will need a second treatment in about nine to ten days. Individuals who are allergic to chrysanthemums or ragweed should not use this.
Permethrin lotion, 1 percent (Nix): This is a synthetic treatment that works in the same way as natural pyrethrins. It is effective against both live lice and their nits. Permethrin also leaves a residue on the hair that is intended to kill any newly hatched lice that are the result of eggs that were not killed in the initial application. Shampoos and conditioners may reduce the effectiveness of this residue, so if live lice are found, you may need to repeat the treatment after 7-10 days. Permethrin is not harmful to children over the age of two months. If you still have lice after full treatment, consult your doctor. Your doctor may prescribe something more effective.
OTC treatments for kids
If you have children younger than 2 years, it is best advised not to use most OTC lice-removal products, so try simply using a fine-toothed comb or a special nit comb when your child’s hair is wet. Metal combs are more effective than plastic. Repeat this combing procedure every three to four days for at least two weeks. Inquire with your pediatrician about the use of combing in conjunction with other treatments for your young child.
After Each Treatments
It is important to
- remove dead or live lice with a fine-toothed comb eight to 12 hours after treatment
- avoid using regular shampoo one to two days after
- continue checking for two to three weeks for nits and lice
- soak combs and brushes in boiling water for five to 10 minutes
References;
“The Centers for Disease Control and Prevention“
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