Dealing with Lice

Head lice are common among children in all socioeconomic groups and are not a health hazard or sign of uncleanliness. Lice are the size of a sesame seed and feed on small amounts of blood. Lice lay oval-shaped eggs (nits) that are firmly attached to the hair shaft close to the scalp.

SIGNS AND SYMPTOMS:
• Itching behind the ears and above the neck
• Some people will show no symptoms

INCUBATION PERIOD:
• Nits hatch in 10-14 days. Adults live 3-4 weeks

HOW LICE SPREAD:
• Head lice are spread by direct contact with the head of an infested person or by contact with items used by an infested person (such as combs, brushes and hats). Lice cannot hop or fly.

TREATMENT:
• Over-the-counter and prescription treatments are available. Treatment instructions should be followed closely. Nits can survive treatment, so a second treatment is often needed 7 to 10 days after the first treatment. Removing nits from the hair using a nit comb is recommended.

PREVENTION/CONTROL:
• Do not share hats, combs, brushes, scarves or coats.
• Perform regular head checks of family members using a bright light and fine-tooth comb. A comprehensive, how-to video can be found at American Academy of Dermatology website
• Shampoo the child’s hair (and other infested family members) with an appropriate shampoo or cream rinse that is labeled for controlling lice. These and other products are available at your local drug store or may be prescribed by a doctor. Be sure to follow the instructions on the label!! Do not use remedies or products that are not labeled for controlling lice as these may not work and may even be harmful.
• Be sure to shampoo all affected family members at the same time! Any family member with nits (eggs) in their hair, or with an itchy scalp, should be treated.
• After shampooing, family members should change into clean clothes. Wash all dirty clothing, linens and towels in a hot or warm wash cycle. Non-washable items maybe dry-cleaned, or they may be vacuumed and sealed in plastic bags for 2 weeks.
• To better your chances for a successful treatment, take the time to remove nits from your child’s hair, preferably by using nit combs that are available at local drug stores. Nit removal is important as some of the eggs will survive the shampoo treatments.

• Soak combs, brushes, hair picks, etc. in hot (almost boiling) water for at least 15 minutes.
• Vacuum chairs, couches and other furniture where the children sit, sleep or play in order to pick up any loose nits or lice. You do not need to apply household pesticides.
• Be sure to shampoo everyone once again 7 to 10 days later. The timing is very important. In addition, remember to wash dirty clothes, vacuum furniture, and treat combs and brushes on the same day.
“Head lice usually survive for less than one day away from the scalp, and their eggs cannot hatch at temperatures lower than those near the scalp.” Reference Meiking, TA Infestions. Curr Probl Dermatol. 1999: 11: 73-120 (American Academy of Pediatrics).

Please click on the following sites for more information.

National Association of School Nurses 
Center of Disease Control and Prevention
American Academy of Pediatrics

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