How Do You Get Lice?

Head lice have been a parasite of humans since recorded time. Many people associate lice with unclean people or homes. This is not true in the case of head lice. Frequent bathing or shampooing will not prevent lice nor eliminate them once they are established. Lice cannot jump or fly, and are usually transmitted by contact with infested persons, their clothing, or their comb or brush. Children should be warned against sharing hats, clothing or grooming aids with others. Household pets do not transmit lice.

What To Look For

Lice are small insects about the size of a sesame seed. They are usually light brown but can vary in color. They move quickly and shy away from the light, making them difficult to see. Diagnosis is more often made on the basis of finding nits (eggs). Nits are tiny, yellowish-white oval eggs attached to the hairshafts. Note: The old quarter-inch from the scalp rule has given way to new evidence suggesting that viable (live) nits may be found at any distance from the scalp. As she deposits her eggs (3-5 per day), the female louse cements them to the hairs, and unlike lint or dandruff, they will not wash off or blow away Haircasts or pseudo-nits are often mistaken for lice eggs. (Photo on reverse shows the difference.) Nits may be found throughout the hair, but are most often located at the nape of the neck, behind the ears, and at the crown. A magnifying glass and natural light may help when look for them. Distinguishing dead nits from live nits is non productive since the presence of ten dead nits does not guarantee that the eleventh won't be viable.

	Adult female louse on hair shafts - highly magnified.
	Enlarged photo of hair debris, nits and head lice. The nit is always oval-shaped and glued at an angle to the side of the hair shaft, Note the differences between hair debris and actual nits in the photo,

Symptoms of Infestation

The itching that occurs when lice bite and suck blood from the scalp is a primary symptom of infestation, although not everyone will experience the itching. Children seen scratching their heads should be examini at once. Often red bite marks or scratch marks can be seen on the scalp and neck. In severe infestations, a child may develop swollen glands in the neck or under the arms.

Treatment of the Individual

Safety must come first when using pesticides. Before on family member is treated, all should be examined. Only those showing evidence of infestation should be treated Treat them at the same time to prevent reinfestation from one family member to another. individual treatment involves the use of a pediculicidal product and the use of combing tool manufactured for the purpose of nit removal. Proceed as follows:

1. Remove child's shirt and provide a towel to protect the eyes. Do not treat in the bathtub or shower, but have the child lean over the sink (this confines the lice product to the scalp/neck.)
2. Use one of several louse remedies available at your pharmacy Some are available by prescription (note 1) some over the counter. Consult your pharmacist or physician if you are pregnant, nursing, have allergies, using medication, or discover lice/nits in the eyebrows or eyelashes. No pesticide should be used in the eye area. Avoid applying pesticides when there are open wound on the scalp of the person to be treated or on the ban of the person who will apply the product. DO NOT USE THESE PRODUCTS ON INFANTS.(note 2) AVOID PERSONAL AND ENVIRONMENTAL PESTICIDE SPRAYS. READ ALL PACKAGE INFORMATION BEFORE USING LICE-KILLING PRODUCTS!(note 3)
3. Although it can take time and sometimes be difficult, remove all nits to insure complete treatment and to comply with No Nit Policies (note 4). Louse products do not kill all the nits, and survivors will hatch into crawling lice within 7-10 days, generating a cycle of self-reinfestation. Even dead nits will cling to the hair and cause uncertainty about reinfestation. Nit removal can be accomplished with a special combing tool or by picking them out with the fingernails. Nits can also be cut out with small safety scissors. Note: Some so-called lice combs are actually cradle cap combs and are ineffective against nits. Nit combing is best accomplished with hair that is slightly damp. Note that even if your lice comb fails as a nit removal tool it can be used to screen for adult lice and is particularly helpful for the person screening him or herself.
4. Following nit removal, have child put on clean clothing and let hair air dry
5. A daily nit check is advisable for at least 10 days following treatment and then checking should become part of routine hygiene. You may have to retreat in 7-10 days if there is evidence of new nits or newly-hatched lice. (Regardless of precautions taken at home, reinfestation from others can still take place.) Treatment itself can cause itching; do not retreat on the basis of itchiness alone.
6. Based on increasing reports of possible insect resistan( on a national level, the NPA advises parents to discontinue the use of a chemical product at the earlier sign of treatment failure. Manual removal is the best option when a lice treatment product has failed

Treatment of Personal Articles and Environment

1. Machine wash all clothing and bed linens which have been in contact with the infested person during the last three days. Articles should be washed in hot water and dried in a hot dryer. Non-washables can be vacuumed or dry-cleaned.
2. "Bagging" is not necessary Rugs, upholstered furniture mattresses, and car seats (and any personal items that cannot be washed, e.g. stuffed animals, can be careful vacuumed to pick up living lice or nits attached to fallen hairs. The use of insecticidal sprays is not recommended and strongly discouraged by the NPA and the Centers For Disease Control because they may be harmful to family members and pets and are of questionable benefit.

Reporting Cases

Call the NPAIs National Registry at 1-800-446-4NPA to report:

• Lice and scabies outbreaks
• Adverse reactions to products
• Treatment failures

Notify your child's school, camp or child-care provider, so other parents can be alerted to a possible outbreak. Also notify your child's playmate's parents. Parental cooperation will help protect all children including your own.

Notes

1 Avoid the prescription product(s) containing the pesticide, lindane. Lindane has been associated with a variety of adverse reactions including aplastic anemia, seizure disorder, and death.

2 Manual/mechanical removal of lice and eggs is a non-pesticidal alternative for infants, pregnant women, nursing mothers, and for those who are inherently at risk.

3 All lice-killing products are pesticides, and must be used with caution.

4 The No Nit Policy is an administrative, public health policy for control and prevention of head lice outbreaks.

Derived from the National Pediculosis Association

Revised February 9th, 2006