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HEADLICE How to detect and treat head lice and nits

HEADLICE How to detect and treat head lice and nits

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Page 1: HEADLICE How to detect and treat head lice and nits

HEADLICE

How to detect and treat

head lice and nits

Page 2: HEADLICE How to detect and treat head lice and nits

2

What you need to know

• What are head lice

• How head lice spread

• Methods to detect head lice

• Products to treat head lice

• How to prevent re-infestation

Page 3: HEADLICE How to detect and treat head lice and nits

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What are head lice?

• Small, wingless insects• Feed on the scalp, often

found behind ears and near base of neck

• Females lay up to 8 eggs (nits) per day

• Not dangerous– do not carry disease– are not “caught” from pets

Page 4: HEADLICE How to detect and treat head lice and nits

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Life cycle of a louse

Nit

(egg)

Nymph

(newly hatched)

Louse

(Adult)

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Who gets head lice?

• Can occur in people of all ages, genders, race and backgrounds

• Not a sign of poor hygiene • Most common in primary school aged children

(5 -11 years)• More common in girls than boys

Page 6: HEADLICE How to detect and treat head lice and nits

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How do head lice spread?

• Do NOT fly or jump• Crawl from head to head by

direct contact• Can be transferred on

objects i.e. Hairbrushes, hats, scarfs

• May infest bedding, clothing etc.

Page 7: HEADLICE How to detect and treat head lice and nits

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Symptoms of infestation

• Itchy scalp

• Sensation of something moving in hair

• Red sores on the scalp cause by scratching

Page 8: HEADLICE How to detect and treat head lice and nits

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Detecting head lice

• Detection of a live louse is best way to confirm infestation– Check dry hair first– Live adult lice most commonly found at crown of head– “Conditioner and comb method”

• Presence of eggs or “nits” on hair shaft can also indicate infestation– Eggs most commonly found a nape of neck and behind ears– Eggs found within 6mm of scalp likely to indicate active

infestation– Egg found more than 1cm from scalp are hatched or dead

Page 9: HEADLICE How to detect and treat head lice and nits

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“Conditioner and Comb” method

• Apply conditioner to dry, brushed hair• Divide hair into 3-4 cm sections, and comb

each section using a fine tooth “nit” comb• After each stroke wipe comb with tissue or

paper towel, and look for live lice and eggs on the comb and towel

• Comb each section several times until no further lice or eggs are found

Page 10: HEADLICE How to detect and treat head lice and nits

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Head lice treatments

• Only treat if sign of active infestation are found

• Several treatment methods available– Insecticide treatments– Herbal products– Physical methods

Page 11: HEADLICE How to detect and treat head lice and nits

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Insecticide treatments

• Several products available– Pyrethrin (Banlice Mousse, Pyrenel Foam, Orange Medic Plus)– Permethrin (Pyrifoam Lice Breaker, Quellada)– Maldison (KP 24 Lotion and Shampoo, HL 7)

• Recommended contact time– 10-30 minutes for shampoos and foams– Overnight for lotions

• Adverse effects include contact dermatitis and anaphylaxis

• Refer – children <2– pregnant or breastfeeding women

• Repeat treatment is required after 7-10 days

Page 12: HEADLICE How to detect and treat head lice and nits

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How to apply a head lice treatment

Apply product

- Shampoo to wet hair

-Lotion to dry hair

Massage well, ensuring every hair is

coated

Leave product in the hair for the

recommended time

Comb hair well with a fine tooth “nit” comb

Check hair daily .

Repeat treatment in 7 days

Page 13: HEADLICE How to detect and treat head lice and nits

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Insecticides- WHAT, STOP, GO

• Who is the patient?• How long have the head lice been present?• Actual symptoms?• Treatment for this or other conditions? Allergies?

• Symptoms of side effects of other medications?• Totally sure? • Overuse/abuse?• Pharmacist only?

• GO

Page 14: HEADLICE How to detect and treat head lice and nits

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Insecticides- CARER

• C – CHECK– Who is the patient– What are the symptoms– What has been tried– How long have symptoms been

present– Other medications– Other conditions

• A – ASSESS – Diagnosis clear– Medication therapy most

appropriate– Possible interactions– Trained and confident

R – RESPOND ─Recommend therapy if appropriate─Refer if uncertain─Reconsider if medication inappropriate

E – EXPLAIN─Verbal directions─Written support─What to do if not improved─Reasons for referral

R – RECORD ─If legally required─Provide ongoing care─If referred─If misuse/abuse suspected

Page 15: HEADLICE How to detect and treat head lice and nits

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Insecticides - What to tell the customer

• Do not treat unless active infestation is confirmed• Always check the directions on the label before use• Ensure bedding, clothing, brushes etc are treated with

heat• Always retreat in 7-10 days• In between treatment use the “conditioner and comb”

method to remove eggs• Itching may persist for several days after lice have been

eliminated • Consult the pharmacist if there is a history of adverse

reaction

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Herbal treatments

• More than 20 herbal head lice products available in Australia– Tea tree oil– Eucalyptus oil– Lavender oil– Rosemary oil

• Only MOOV Head Lice Solution has been proven effective– Contact time: 10 Minutes– Repeat treatment TWICE after 7

and 14 days

Page 17: HEADLICE How to detect and treat head lice and nits

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Physical methods

• “Conditioner and Comb” method• May be effective if less than 5 lice are found in initial inspection• Complete every 2nd day until no lice are found for 10 consecutive

days • Recommended treatment for children under 2 years of age

• Heat• Use hair dryer to apply heat to small section of hair for 1-3 minutes• More effective at killing eggs than lice

• Electronic Combs (RobiComb, Licetec Opticomb)

• Suffocating Agents• Do not use Kerosene

Page 18: HEADLICE How to detect and treat head lice and nits

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Treatment Failure

• Inadequate application– Every hair not covered– Too short contact time

• Failure to re-treat– Second treatment after 7-10 days necessary to kill newly

hatched lice

• Insecticide resistance– Increasingly common due to ineffective product use– Should retreat with different product or use physical method

• Reinfestation

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When to refer to the pharmacist

• Children <2 years of age• Pregnant or breastfeeding women• People with asthma, skin rashes or

allergies• People with previous adverse reaction

to treatment• Persistence infestations despite

appropriate treatment• People with symptoms but

unconfirmed diagnosis• Severe infestations• Eyelash infestations

Page 20: HEADLICE How to detect and treat head lice and nits

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Preventing recurrence

• Notify school if head lice are found• Ensure all family and close contacts are checked and treated if

infestation is confirmed• Wash all bedding, towels, clothing etc in hot water or place in a

clothes dryer• Soak all brushes and combs in hot water (>60ºC) for 30 seconds• Keep long hair tied back• Avoid sharing hats, hats, hairbrushes and accessories, towels or

pillows• Carry out regular head checks using conditioner and comb

method– Weekly on regular basis– After sleep overs– Daily during outbreaks at school

Page 21: HEADLICE How to detect and treat head lice and nits

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Case Study

Mrs Smith, a regular customer, comes into the pharmacy to purchase two bottles of KP 24 shampoo. When asked, she tells you that her 7 year old daughter Sarah has come home from school with “nits”. This is the third time this year Sarah has had nits, and Mrs Smith is very upset and embarrassed. She also plans to treat her 1 year old son James to be sure that she gets rid of the problem once and for all.

How should you respond to Mrs Smith request for KP 24? What concerns might you have about the frequency of Sarah’s head lice? What advice can you give Mrs Smith about preventing reinfestation?

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Summary

• Head lice is a common condition, especially in school aged children, and is not a sign of poor hygiene

• Customers requesting head lice products should be advised to confirm infestation before treating

• WHAT STOP GO or CARER protocols can be used to respond to treatment requests

• All insecticide treatments need to be repeated after 7-10 days• Recurrence is common, especially if measures to prevent

reinfestation are not taken• Severe or recurrent cases or treatment of children <2 or

pregnant or breastfeeding women require referral to the pharmacist