Lice

Head lice can affect everyone, regardless of socio-economic background. In fact, head lice affect more children than all other childhood communicable diseases combined, with the exception of the common cold. Parents become embarrassed and upset when they discover their child has lice.

Lice spread easily among children in close contact through shared hats, headphones, brushes and even jackets hung close together at school. Teach your child never to share any of the above items.

Lice are more common in daycare and school settings where there is closer contact between children.

Parents may receive a note from school informing them that a case of lice has been diagnosed. These notices are intended to have parents check their child. If your child does not have lice, treating at this time will not prevent lice.

How Do I Tell If My Child Has Lice?

Head lice, like mosquitos, look for a host. They live only on humans where the adult lice lay eggs (nits) in hair. Eggs hatch in a week and the problem rapidly multiplies. A lice infestation is often recognized by uncomfortable itching of the scalp.

Examine your child's hairline behind the ears: If lice are present, you will see small oval-shaped whitish or grayish nits (eggs) attached to the individual hairs close to the scalp. Nits are about the size of a sesame seed and are cemented to the hair shaft.

Dandruff (peeling scalp) can be confused with lice. If you are able to easily comb out what appears to be nits, then they are not nits. Because nits are cemented to the hair shaft, they are not easy to comb out.

Lice are usually found on the scalp but can be found on the eyelashes. This is a different form of lice.

How Do I Kill Lice?

• There are many of these pediculicides (pesticides) available in drug stores. Used properly, they can be effective. However, even when effective in killing the lice, the nits will remain in the hair. Pediculicides do not remove these nits (see below).
• Lice are easily spread among family members and the whole family should be treated.
• Head lice infestations are manageable. Treatment products are targeted at killing the lice and their nits.
• Underclothes and bedding should be cleaned in hot water.
• Dry cleaning will destroy all nits and lice.
• Use a hot iron to press wool clothing - be sure to iron the seams.
• Clothing that cannot be cleaned, can be placed in a sealed plastic bag for 3-5 days. Lice cannot live off the human body and will die in the bag.

How Do I Tell Old Nits From New Nits?

• As eggs (nits) are laid, they will be found very close to the scalp (less than 1/8 inch).
• As the hair shaft grows, dead nits will remain at the same spot on the hair shaft, but will now be seen further out on the hair shaft.
• As the hair shaft continues to grow over the next 7 days, the nit will be found even further out on the hair shaft and will be easier to comb out.

Shampoos and Lotions Used To Treat Lice

Nix Creme Rinse (over the counter)

• Do not use a cream rinse before using Nix. This coats hair and prevents Nix from working as effectively.
• Wash hair with regular shampoo, rinse, and towel dry.
• Apply enough Nix to saturate hair and scalp (1-2 oz).
• Leave on scalp for 10 minutes and rinse with water.
• Can be repeated in one week.

RID or R&C Shampoo (over the counter)

• Just as effective.
• Apply undiluted to hair and scalp.
• Leave on for 10 minutes only.
• Wash thoroughly with warm water and then shampoo.
• 2 ounces needed for each person.

Kwell

Kwell is a lindane product that has been used for years in the treatment of head lice. It is absorbed through the scalp into the brain and can cause damage to your child’s nervous system. Because the other available products are as effective in treating head lice, most pediatricians will no longer use Kwell as a first line treatment. Kwell is only available as a prescription. When it is used, you should follow the directions and only apply one time.

Ovide (malathion)

Ovide lotion 0.5%, is now available by prescription for treatment of resistant head lice. It has an excellent safety profile and high cure rate.

Instructions for use:

1. Apply Ovide lotion on DRY hair in an amount just sufficient to thoroughly wet the hair and scalp. Pay particular attention to the back of the head and neck while applying Ovide lotion. Wash your hands after applying Ovide lotion.
2. Allow hair to dry naturally and keep hair uncovered.
3. Do not use a hair dryer!
4. Shampoo the hair after 8-12 hours.
5. Rinse and use a fine-toothed nit comb to remove dead lice and eggs.
6. If lice are present after 7-9 days, repeat with a second application of Ovide lotion.
7. It is available in 2 ounce bottles.
8. Ovide lotion is flammable. Keep away from heat and open flame (lighters).

Mayonnaise: Can It Be Used To Treat Lice?

Mayonnaise works by smothering the lice. You must use regular mayonnaise, not fat-free. Work into your child’s scalp, cover with a shower cap, and leave on for 8 hours (overnight). You may need to repeat this several days in a row.

In most cases, the above treatments will kill the nits. After washing hair, the nits may still be present even though they are dead. As the hair shaft grows over the next week, the nit will be found further from the scalp. If the nits are found close to the scalp (I /8 in.) 7 days later, then these are probably new nits.

If you feel that the lice are still present after 7 days from the first treatment, another treatment can be applied, except if using Kwell. It takes about 7 days for any live nits to hatch.

It is not necessary for us to see a child with lice, unless treatment has been unsuccessful. If you are upset or unsure of whether Iice are really present, call our office and we would be happy to see your child.

Why Is It Necessary To Get Rid Of All The Nits?

Since it is not possible to tell which child has been treated for lice, schools usually want children to be nit-free in order for children to return to class. Most nit combs are only marginally effective.

Nits can be identified best on the crown of the head and by the hairline behind the ears and at the nape of the neck. Use of a magnifying glass makes it easier to see the nits. Nit removal by hand--called "nit-picking"--can take hours and cause hair-pulling anxiety.

How Do I Get The Nits Out Of My Child’s Hair?

• Use a fine tooth comb or tweezer. Special nit combs are available.
• White vinegar helps loosen the glue that is holding the nits on the hair shafts.
• Dip the comb in vinegar and comb nits out one at a time.
• Vinegar can also be placed directly on hair.

Clear is a cleansing concentrate that helps to eliminate the nit-picking chore. Clear contains enzymes that safely loosen the tough bond between nit and hair shaft. The cleansing concentrate also helps to eliminate the unwanted residue left on the hair from pesticide products.

Clear cleansing concentrate is a targeted enzyme system derived from vegetable material. It works very quickly by biodegrading complex organic structures such as nit glue. This system will not react to the basic hair structure, the skin or mucous membranes. The enzymes are harmless, totally biodegradable and unrelated to available biocides, or synthetic dry enzymes.

Apply cleansing concentrate after use of a lice-killing product. Use a pesticide product to kill the lice and eggs. Use Clear after pyrethrin or lindane (Kwell) pesticides, but before permethrin (Nix).

How Do I Use Clear?

1. Apply to wet hair directly from the tube. Spread over affected areas, especially behind ears and at nape of neck. Work into hair until a light foam appears.
2. Wait 3 minutes for Clear concentrate to loosen the nit glue.
3. Comb tangles out of hair with a regular comb.
4. While hair is still wet with Clear concentrate, divide hair into small sections. (When applying before Nix brand, rinse Clear remover out first, then use the pediculicide and comb out nits last).
5. Start as close to the scalp as possible. Hold the special nit comb at an angle. Slide through each section to remove lice nits. Always keep the teeth of the comb deeply embedded into the hair strands as you proceed.
6. Using hair clips or pins, fasten areas of the hair that have already been combed.
7. Periodically wipe comb contents onto paper towel for easy disposal. Repeat as necessary to remove all nits.
8. When nit removal is complete, rinse your child’s hair with warm water.