What To Do If Your Child Has Head Lice

What To Do If Your Child Has Head Lice

TREATING THIS COMMON CHILDHOOD CONDITION

by Cathleen A. Hanson

The evening before Thanksgiving, while I was drying my seven-year-old daughter’s hair, I noticed something small and gray moving on her scalp, where her hair parted. Thinking it was a small insect from her school’s playground, or an optical illusion, I told her to stand still while I picked at it. It was too slippery-quick for my fingers, so I got a pair of tweezers and removed the ugly gray silver-fish-looking thing. Within two minutes I found another one of these critters and then another, and soon I realized that my daughter had what I surmised could be none other than a full-blown case of head lice.

And so began my battle with the lice. Two treatments of Nix–an over-the-counter product (containing pyrethin, a pesticide)–didn’t kill the buggers. Cranking the hot water to 140_ F and daily laundering of every item of clothing or bedding that came in contact with my daughter didn’t deter them. Putting away everything (in sealed plastic bags) that couldn’t be washed didn’t help. Vacuuming every square inch of upholstery, carpet and the interior of the car was to no avail. Even picking through my daughter’s head for one to two hours each day didn’t keep the lice at bay. Thus, as I was immersed in battle (fatigued and frustrated–but determined), I began to do some research about the notorious little beasts. What follows are my questions and the answers that I discovered as I attempted to rid my daughter of the lice.

HOW DOES A CHILD GET HEAD LICE?

Head lice know no social or cultural barriers and are presently in epidemic proportion in preschools and elementary schools in this country. THE LICE-BUSTER BOOK (Authentic Pictures, 1995) points out that 10-12 million children in the United States get lice each year, with infestations as much as 40% of non-black children in some areas. Other than the common cold, lice is a more common condition than all of the childhood communicable diseases combined. It is most likely that my daughter picked up her head lice from her elementary school. (Once we told my daughter’s school of our head lice infestation, the school nurse sifted through heads of other students and found scores of cases of head lice throughout the school.)

My research told me that lice are primarily spread by head-to-head contact. They don’t jump or fly, but rather scamper from one child’s head to another. They are particularly prevalent among young children, with lice outbreaks rare in children older than grade six, because there is less contact among the children. Girls appear to be more susceptible than boys, and there are two speculations as to why. One thought is that girls tend to spend more time than boys in closer contact, and the other theory says that girls tend to have more hair mass which makes it more difficult to find the lice or nits (lice eggs). From my experience, my guess is that it’s probably a combination of both of these factors. Interestingly, lice seem to prefer clean hair to dirty hair.

WHAT’S A LOUSE DOING ON MY CHILD?

According to the BRITISH MEDICAL JOURNAL (9/95), head lice are one of the most common human ectoparasites. The Nonprescription Drug Manufacturers Association describes head lice in the following manner: “Head lice are small insects, about the size of a sesame seed. They live on the scalp and feed by sucking blood. Head lice may turn colors from white or grey to red or dark brown when they are filled with blood. After the female louse mates, she lays four or five nits which are glued so strongly to the hair shafts that ordinary washing and brushing of the hair will not remove them.

“After seven to ten days the nits hatch. New lice mature, mate, and begin the cycle of infestation all over again, if not treated. A single louse can lay as many as 150 eggs during its typical 30-day life span. Hundreds of nits many be found on the head of an infested child. . . . You can tell nits from dandruff, normal scalp scales or hair spray globules because they look like tiny tear drops glued to the hairs and are difficult to dislodge.”

DID THIS COME FROM MY PET?

As we were in the midst of our head lice battle, despite our best efforts, the head lice were not relenting. At that point, we began to look at our cat suspiciously. Did he have some of those little buggers buried beneath his fur, we wondered. The answer was no. Head lice are specific to the heads of humans. Pets are not to blame.

WHAT’S THE HARM OF HEAD LICE?

Though head lice is presumed to be innocuous–it’s thought to be itchy at worst–there is some evidence that points to secondary infections from the scratching of the lice bites.

WHAT ARE THE SIGNS OF HEAD LICE?

According to Health News (2/96), itching starts a week or two after infestation. This is a reaction to the lice bites. In my daughter’s case, I noticed her scratching her head about two to three days before I found the first louse. At the first sign of itching, I had looked quickly through her hair and found nothing. Now, I know that I should have looked for nits. Lice move quickly and are nearly impossible to detect with a quick inspection. An itching child needs to be put under a bright light and carefully examined by going through the hair section by section. It may take a half-hour to find the first nit. Look for a pinhead-sized tear shaped object that is fixed to the shaft of the child’s hair.

HOW DO I GET RID OF THEM?

Head lice are treated by nit picking, nit combing, and by using pesticides on your child’s head. The nit picking is done in conjunction with the application of the lice killing products. In our home my husband and I spent one to two hours a day picking nits and lice off of our daughter. When the lice infestation was at its worst, we did this twice a day. Consider putting your child’s favorite video tape on during this process. As well, remind your child how nice it feels to have someone’s fingers run through his or her hair.

WHAT AM I PUTTING ON MY CHILD’S HEAD?

A popular over the counter treatment is to apply a pyrethrin, which is a chrysanthemum extract (or synthetic derivative) that is used as an insecticide. Common brand names are Nix and Rid. The Lice-Buster Book points out that pyrethrins may aggravate asthma and allergies, and can provoke serious reactions in highly sensitive children.

Another common treatment is the application of a prescription product that contains lindane, which has been used primarily to control insects that infest corn, avocados and evergreen trees. The use of lindane has sparked some controversy. Opponents of lindane treatments for head lice feel it should be banned and point out that it has been implicated in some adverse reactions, including seizures. Lindane’s proponents say it’s safe when used properly and that it’s more effective on difficult cases.

WHAT IF THE PESTICIDE DOESN’T WORK?

Unfortunately some strains of head-lice are becoming resistant to one or the other of the pesticides. Resistance to lindane is most common, according to Mitchell A. Goldstein, M.D. at The Johns Hopkins Children’s Center. So there is a chance that you will need to switch products after an initial application or in cases of cross resistance, you may need to use a different preparation. However, this is not something you should do without consulting a knowledgeable physician. Goldstein suggests that you contact a pediatric dermatologist if your child has what appears to be a resistant case of head lice.

WHY DO I HAVE TO KEEP NIT PICKING AFTER I’VE APPLIED A PRODUCT ON MY CHILD’S HAIR?

It is imperative that nits are picked out of your child’s hair even after using the pesticide. Treatment may not kill all of the eggs and they can begin hatching even as late as 10 days after treatment.

WHAT ELSE CAN I DO?

To rid your child of lice it is recommended that all clothing and bed linen be washed at 130_ F. Items which come into contact with your child that cannot bewashed need to be put in sealed bags for two weeks. Rugs and car and home upholstery should be vacuumed. Combs and brushes should be soaked in hot water for ten minutes or shampooed in a lice treatment product. All of this is done in an attempt to kill any lice or nits that have found their way off the body. One report I read in HEALTH NEWS (2/96) indicated this time consuming process of washing and cleaning may, in fact, be unnecessary. The report stated, “Despite sparse evidence, many continue to believe that lice spread by sharing items such as hairbrushes, towels, hats, scarves or combs. But studies do not find that lice get around much that way. For one thing, lice are not likely to abandon the warmth of the scalp and hop onto a scarf or towel. For another, lice cannot live away from theirhuman hosts for more than one hour. They do not lurk in clothing, furniture or bed linen.”

WHAT CAN I DO TO STOP THE SPREAD OF HEAD LICE?

The best thing any single person can do to stop lice is to stop your own case of lice before your child goes back to a school, daycare center, or other place where children gather. If you find head lice on your child, call your school or other center where your child spends time, and tell the school nurse or other authority of the presence of head lice on your child. By getting the ball rolling and helping to identify the lice within a particular location, you will ultimately help your own child not get reinfested again.

Note: After experiencing resistance to Nix, the author’s daughter was treated with lindane and was lice free in early December. By January first, the author had her own full-blown case of head-lice. After much consultation with her physician, and three applications of lindane, the author was finally rid of head lice. Her husband (he is bald) did not become afflicted with head lice-but became an expert nitpicker. Her family is presently lice-free.