While head lice, also called pediculosis capitis, is not necessarily dangerous to us, there is some physical discomfort associated with having these little parasites on us and there is a significant amount of social stigma associated with having an infestation. Having lice is about as close to having "cooties" as many people, particularly children experience.
Head lice occur throughout the world and affect individuals of all social and economic backgrounds, particularly children. Females seem to be more affected than boys, and white children more affected than black children.
Lice are transmitted by direct contact with the head of a person infected with them. This is the primary method of getting them. There is some suggestion that it is possible to transfer lice through sharing combs, brushes, hairdryers, hats, and towels. But this method of transfer is felt to be rare. Socially there is a lot of unnecessary fear about being near someone with lice. One thing is known for sure: lice do NOT jump, fly, or travel on pets between people.
Did I hear the word "itchy" pop into your head? Even writing this post increased my itch level. But it is true that the most common symptom is itching, also known as pruritus. This itching is from an allergic reaction to the saliva of the lice during their feeding. Additionally, from the itching, people may scratch themselves so much that they cause little cuts in the skin. And rarely, some bacteria from the skin can get under the skin either from the feeding of the lice or from scratches on the skin. This can lead to small zit-like pustules cropping up often from staph bacteria or it can lead to a spreading red and warm-to-touch skin infection.
Lice should be considered in anyone with a very itchy scalp, particularly in children. Seeing scratches around the back of the ears and neck should also make you wonder if lice could be to blame.
The actual diagnosis is generally made by simply inspecting the scalp closely and finding nits, which are the eggs at the base of the hair shaft, or actual lice. Inspection is best done with a fine tooth nit comb through hair that has been moistened, often with conditioner. This wet-combing technique in one study has been shown to detect lice about 90% of the time compared to only about 30% of the time with simply looking through the hair. If one member of the household is found to be infested, all other members should be examined to determine if they are too.
HOW TO PERFORM WET COMBING FOR LICE:
Treatment of pediculosis capitis or head lice is recommended once the diagnosis is made. However, it is recommended that the diagnosis is actually made before starting treatment. Particularly when it is known that there are one or more cases of head lice going around a school, there is a tendency to assume that every kid that scratches their head has it. But there are potential side effects to some of the treatments, so it is best to confirm the diagnosis before submitting someone to the treatment.
TREATMENT OPTIONS:
It is unlikely that any of the lice can survive off of their human host for more than 2 days. But it reasonable to wash clothing and bedding used by the person with head lice in hot water and/or drying these articles in a high-heat dryer. An alternative method is to store them in a sealed plastic bag for up to two weeks(although as stated above, they generally cannot last more than 2 days once off the scalp). Spraying the entire room or home with a liquid lice treatment is not recommended.
Children should NOT be excluded from school due to the presence of head lice. Children should be treated as soon as possible after the lice are found, but they may remain in school with the caveat of avoiding direct head-to-head contact and not sharing articles of clothing that go on the head or around the neck like hats and scarves.
Here is a link to more information about this recommendation from the Centers for Disease Control and backed up by the American Academy of Pediatrics and the National Association of School Nurses.
As you can tell, many of the treatments require a prescription. At Care on Location, while it may be difficult for us to definitively make the diagnosis over the video connection, we certainly can help prescribe one of the several treatment options if you have already made the diagnosis and over-the-counter treatment has failed. We are also more than happy to answer any questions you may have regarding head lice.
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