Getting down to the nitty gritty
What can you do when your child brings a case of head lice home from school? Siobhan Mulholland guides you through the facts and the fiction
For parents of young children, alongside a knowledge of the national curriculum, comes a knowledge of head lice. You quickly learn the facts: the very young are especially prone, vigorous head scratching is a good sign you’ve got them, they’re very contagious, and they thrive amongst intimate groups of people such as young children playing together.
What nits are not a sign of is lack of hygiene. And it’s this last point that is hammered home to the paranoid parent in us all: even those children from gleaming showrooms of homes, with anti-bacterial scrub in every bathroom and a domestic goddess of a mother running the place, can contract them.
But none of this really helps. If a child has nits it’s not something his or her parents tendto shout about.
It doesn’t matter what other parents tell you, or what teachers say to reassure you, or even what the science reveals to be the truth about these tiny parasites; most parents – especially mothers, regard them as a bit of an embarrassment and dread the day their child comes home from school with the news they’ve got nits. Maybe it’s the way the news is told that causes such upset; the way poor unsuspecting parents find out their progeny has a head full of blood sucking parasites. The “gentlest” method is via a rather pompous pseudo medical letter from the school informing you your child has nits please deal with, slightly more shocking is darling little Annabel running across the playground screeching “mummy I’ve got nits”, or perhaps most brutal of all – darling Annabel’s best friend Amelia coming screaming “Bella’s got nits”.
All three are like a kick in the head. And you know that despite the best efforts of all adults involved, news that a child has nits spreads quicker than the nits themselves. For young children it’s almost like a badge of honour when one of their classmates has been discovered with a head full of them. For them this is not something to be hidden. Children arrive home exclaiming that so and so has nits with the same sort of awed voice they use for proclaiming that little Lottie has a spanking new Barbie bike.
The head louse is a tiny, wingless parasitic insect that lives among human hairs and feeds on extremely small amounts of blood drawn from the scalp. Although they may sound revolting, lice (the plural of louse) are a very common problem, especially for kids ages three years to 12 years (girls more often than boys).
Lice aren’t dangerous and they don’t spread disease, but they are contagious and can just be downright annoying. Their bites may cause your child’s scalp to become itchy and inflamed and persistent scratching may lead to skin irritation and even infection.
How can I tell if my child has lice?
Although very small, lice can be seen by the naked eye. What you or your child’s doctor might see by thoroughly examining your child’s head:
Lice eggs (called nits), which look like tiny, oval white (to yellow) dots. Lice lay nits on hair shafts close to the skin’s surface, where the temperature is perfect for keeping warm until they hatch. Nits look like dandruff, only they can’t be removed by brushing or shaking them off. Unless the infestation is heavy, it’s more common to see nits in a child’s hair than it is to see live lice crawling on the scalp. Lice eggs hatch within one to two weeks after they’re laid.
Adult lice and nymphs (baby lice): The adult louse is no bigger than a sesame seed and is brownish tan (although lice may look darker on people with dark hair). Nymphs are smaller and become adult lice about seven days after they hatch. Most lice feed on blood about every four to six hours, but they can survive up to three days off the scalp.
Scratching: With lice bites come itching and scratching. However, the itching may not always start right away – that depends on how sensitive your child’s skin is to the lice. It can sometimes take weeks for kids with lice to start scratching. They may complain, though, of things moving around on or tickling their heads.
Small, red bumps or sores from scratching: For some kids, the irritation is mild; for others, a more bothersome rash with crusting and oozing may develop. It’s also not unusual for kids to develop some swelling of their lymph glands. Excessive scratching can also lead to a bacterial infection (the skin would become red and tender around the bite area). If your child’s doctor thinks this is the case, he or she may treat the infection with a topical or an oral antibiotic.
You may be able to see the lice or nits by parting your child’s hair into small sections and checking for lice and nits on the scalp, behind the ears, and around the nape of the neck (it’s rare for them to be found on eyelashes or eyebrows). A magnifying glass and bright light may help. But it can be tough to find a nymph or adult louse – often, there aren’t many of them and they’re able to move fast.
Call your child’s doctor if your child is constantly scratching his or her skin or complains of itches that don’t go away, especially on parts of the body that are covered with hair. The doctor should be able to tell you if your child is infested with lice and needs to be treated. Also be sure to check with your child’s school nurse or child-care centre director to see if other children have recently been treated for lice. If you discover that your child does, indeed, have lice or nits, contact the staff at your child’s school to let them know about it.
Are lice contagious?
Lice are highly contagious and can spread quickly from person to person, especially in group settings (schools, child-care centres, slumber parties, sports activities, camps, and even playgrounds). Alhough they can’t fly or jump, these tiny parasites have specially-adapted claws that allow them to crawl and cling firmly to hair. They spread mainly through headto- head contact, but sharing clothing, bed linens, combs, brushes and hats can also help pass them along. Children and teens are most prone to catching lice because they tend to have close physical contact with each other and often share personal items.
And you may wonder if your pets may be catching the pests and passing them on to your family. But rest assured that pets can’t catch head lice and pass them on to people or the other way around.
How are lice treated?
Your child’s doctor or a pharmacist can recommend a medicated shampoo, cream or lotion to kill the lice. These may be overthe- counter or prescription medications, depending on what treatments have already been tried. It isn’t uncommon for treatments to be unsuccessful because of incorrect use or because the lice may be resistant to the chemical in the shampoo.
It’s important to follow the directions exactly because these products are insecticides. Applying these medications too much or too frequently can increase the risk of causing harm. Following the directions on the product label is also important to ensure that the treatment works properly. Your child’s doctor may also suggest a special rinse to use on your child’s hair that makes it easier to comb out the nits using a fine-tooth comb.
Medicated lice treatments can usually kill the lice and nits, but it may take a few days for the itching to stop. Your child’s doctor may recommend repeating treatment in seven to 10 days to make sure all the nits have been killed, because even one nit left behind can lead to a reinfestation. If your child is two years old or under, you should not use medicated lice treatments. You’ll need to remove the nits and lice by combing.
In addition to medicated treatments, a whole range of natural remedies are available – again, ask your pharmacist for advice as many of these are available over-thecounter. As with medicated treatments, natural remedies also need to be used with caution.
No matter what your child’s age, here are some other things you can do that may help get rid of the lice and their eggs:
Use a fine-tooth comb on your child’s hair after regular shampooing every three to four days for two weeks. Wetting the hair thoroughly beforehand is recommended because it temporarily immobilises the lice. Appyling conditioner to the hair and leaving it in also makes combing easier.
Wash all bed linens and clothing that’s been recently used by anyone in your home who’s infested in very hot water (130 degrees Fahrenheit, or 60 degrees Celsius) then put them in the hot cycle of the dryer for at least 20 minutes.
Have bed linens, clothing, and stuffed animals and plush toys that can’t be washed, dry-cleaned. Or put them in airtight bags for two weeks.
Vacuum carpets and any upholstered furniture (in your home or car).
Soak hair-care items like combs, barrettes, hair ties or bands, headbands and brushes in rubbing alcohol or medicated shampoo for one hour. You can also wash them in hot water or just throw them away.
Because lice are easily passed from person to person in the same house, other infested family members will also need treatment to prevent the lice from coming back. In your efforts to get rid of the bugs, there are some things you shouldn’t do. Some don’ts of head lice treatment include:
Don’t use a hair dryer on your child’s hair after applying any of the currently available scalp treatments, because some contain flammable ingredients.
Don’t use a cream rinse or shampoo/conditioner combination before applying lice medication.
Don’t wash your child’s hair for one to two days after using a medicated treatment.
Don’t use sprays or hire a pest control company to try to get rid of the lice, as they can be harmful.
Don’t use the same medication more than three times on one person. If it doesn’t seem to be working, your child’s doctor may recommend another medication.
Don’t use more than one head lice medication at a time.
Can lice be prevented?
Having head lice is not a sign of uncleanliness or poor hygiene. The pesky little bugs can be a problem for kids of all ages and socioeconomic levels, no matter how often they do – or don’t – clean their hair or bathe.
However, you can help to prevent your child from getting lice – or from becoming reinfested with lice – by taking the following precautions:
Tell your child to try to avoid headto- head contact at school (in gym, on the playground, or during sports) and while playing at home with other children
Tell your child not to share combs, brushes, hats, scarves, bandanas, ribbons, barrettes, hair ties or bands, towels, helmets, or other personal care items with anyone else, whether they may have lice or not
Tell your child not to lie on bedding, pillows and carpets that have recently been used by someone with lice
Examine members of your household who have had close contact with a person who has lice every three or four days. Treat those who have lice or nits close to the scalp
Will they ever be gone?
Lice infestation can be a persistent nuisance, especially in group settings. If you feel like you’re following every recommendation and your child still has lice, it may be because of one or more of the following:
There are still some nits left behind
Your child is still being exposed to someone with lice
The treatment isn’t effective
There’s no doubt that they can be hard bugs to get rid of. If your child still has lice for two weeks after you started treatment or if your child’s scalp looks infected (with pus or sores), call your child’s doctor. No matter how long the problem lasts, be sure to emphasise to your child that although having lice can certainly be embarrassing, anyone can get them. It’s important for kids to understand that having lice doesn’t make them dirty. And reassure your child that as aggravating as getting rid of the annoying insects can be, there is light at the end of the tunnel.
Be patient and follow the treatments and preventative tips as directed by your child’s doctor for keeping the bugs at bay, and you’ll be well on your way to keeping your family lice-free.
Siobhan Mulholland is a journalist and BBC producer.