About Families Online

Feature Articles for September, 2003

by Angela Maizlish
Thinking about back-to-school causes Sandy Harnick, a mother of four in Plantation, Florida, to break out into a cold sweat. “My skin literally starts to crawl as I wonder how many times I will have to comb, wash, and hunt down the lice that always seem to attach themselves to one of my kids. When one gets it, we all get it.”

According to the U.S. Centers for Disease Control and Prevention (CDC), head lice will infest over ten to twelve million people this year, most of them school age children. The fall usually breeds a higher occurrence due to the proximity of children and school related activities. Parents try numerous over-the-counter and “natural” remedies hoping to outsmart these annoying creatures, but frequently these remedies are no more effective the gamble of tossing dice.

Head lice have been around unchanged for millions of years, and are determined to survive. The small, wingless insects, feeding on human blood, do not hop or crawl long distances. They prefer to stay close to the scalp (1/8 inch) and lay eggs, called nits. The National Pediculosis Association (NPA), a non-profit organization incorporated specifically for lice issues, states that the spreading occurs when people’s heads touch or when they share hats and other clothing, combs, brushes, headbands, barrettes, and bedding (like sheets, blankets, pillowcases, and sleeping bags). If a louse (or lice) is stuck on any of these things and that item touches another person’s head, that person may also get lice.

While there is much evidence that lice are becoming resistant to the effects of chemical shampoos, Dr. Charles S. Apperson, Professor and Extension Entomologist at North Carolina State University, feels the most common reason for treatments not to work is failure to remove all of the nits from the hair. “Frequently, the same children are found to be infested because the original infestation was not eliminated and parents/guardians do not inspect children frequently and carefully enough to detect a resurgence.”

So, what is a parent to do once these annoying critters take up residence in your child’s hair?
First, identify head lice. Many people do not have symptoms, making it difficult to know if they are infected. Itching and scratching especially around the ears and bottom of the neck may occur, but often the most reliable method of detection is for the parent to look at the child’s head. Have at least two people check an infested person. Use a strong light and look on the hair shafts. Equip yourself and your helpers with a magnifying glass, tweezers, safety scissors, and a nit-removal comb. When screening for lice, it may be helpful to dip the comb into water and clean it before going to the next section of hair.

• Nits are always the same shape and never fuzzy or encircling the hair. Newly laid eggs are usually within 1.5 cm of the scalp while older eggs are lower on the hair. If you are not sure whether an object you find is a head louse egg, try sliding it up the hair shaft using your fingers. Eggs are difficult to move, whereas dirt and other items slide easily. You can visit the NPA’s web site www.headlice.org for a free Critter Card, featuring actual-size images of lice. Cutting or shaving your child’s hair only causes them embarrassment.

• Doctors recommend using a lice killing product like RID or NIX to kill the live lice and unhatched nits. Follow the directions exactly, and do not use RID when the hair is wet. It will not work because the nits close up not allowing the RID to penetrate. Most over-the-counter products that contain Permephrin are effective. Gels, foams, and lotions usually work better than shampoo, since they bond to the hair. In addition, not using conditioner before applying the lice treatment can help the medicine adhere better. (Many doctors warn about the ingredient Lindane, a prescription drug, which can cause, in some cases, toxicity to the nervous system.)

• The shampoo, cream, or lotion usually kills the lice right away. The itching disappears within days, but repeating the treatment in 7 to 10 days kills any new lice that hatched since the first treatment. Do not use a hair dryer on your hair after washing with the medicated shampoo, lotion, or cream because they can contain flammable ingredients.

• Head lice need human blood to survive. Do not become an obsessive-compulsive cleaner! They do not live off their human host for more than 24-36 hours. Brushes and combs should be washed thoroughly in hot water (more than 130º·F) while clothing, bed linens, and other personal items should be washed in hot soapy water and dried for at least 20 minutes.

• Use the most effective tool for removal - your sense of humor. Maria Bonaiuto, RN, Medical School Nurse and School Health Director for Mecklenburg County Health Department of North Carolina, feels that children sense parents’ reaction to a frustrating situation, and react accordingly. “Teaming up with your child to get rid of the lice, without making him feel dirty, guilty, or frightened is the best way to go.”

Lice are with us and are not likely to disappear, but with routine screening and early detection combined with thorough manual removal, parents can “head” off any repeat performances. As part of your back-to-school routine, make head checks part of your nightly bed checks.

Angela Maizlish is a free lance writer living in Plantation, FL with her husband and two small children. For more information, contact her at writer2kids@yahoo.com.