Joel Schlessinger MD FAQ - Head Lice

Joel Schlessinger, MD

FREQUENTLY ASKED QUESTIONS ABOUT HEAD LICE

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Head lice are tiny, wingless parasitic insects that cling to the hair and scalp and feed on tiny amounts of human blood. More rarely, they may be found in the eyebrows, eyelashes and body. Lice lay eggs (nits) at the top of the hair shaft near the scalp. Nits hatch about one to two weeks after they are initially laid, and then grow into adult lice one to two weeks later. While head lice are frustrating to deal with, they are not dangerous and they do not spread disease. Though head lice carry a social stigma of being “unclean,” they affect people from all social classes and walks of life.

What are head lice?

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Head lice can be hard to spot, but they are visible to the naked eye. There are three forms of lice: the nit, the nymph and the adult louse.

What do head lice look like?

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Nits are lice eggs. They are about the size of a pinhead, oval in shape and usually yellow, white, tan or brown. They’re often confused with dandruff or hairspray, but while flakey skin and product buildup can be lightly brushed away, nits are sticky and adhere to the hair shaft.

The nit

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Nymphs are recently hatched nits that appear as smaller versions of adult lice. Due to their brown to gray color, they blend easily with the hair, making them extremely difficult to spot. Since they have not matured, they are not capable of laying eggs until about one to two weeks after they’ve hatched.

The nymph

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Adult lice are six-legged insects about the size of sesame seeds. They are tan to grayish-white in color, but they may appear darker in people with dark hair. Females lay nits and are usually larger. An adult louse can only live for two days without a human host.

The adult

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Head lice are spread through close human contact, usually head-to-head. They cannot jump or fly. Lice can only live for a short period of time without a human host, but they may be spread through the sharing of personal belongings like combs, brushes, hats and other clothing. They may also be contracted from lying on a bed, couch, carpet or pillow that has recently been in contact with an infected person.

How are head lice spread?

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An infection of head lice is called pediculosis. Anyone can get head lice, but they are most common in children who attend daycare, preschool or elementary school. It is estimated that one in ten school-aged children will experience head lice. Adults who live with children have a higher risk of getting head lice, and women and girls are more likely to contract them than men and boys.

Who gets head lice?

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Some people have no noticeable symptoms aside from visible head lice. Itching on the scalp, neck and ears caused by an allergic reaction to the bites is most common, though this symptom may not appear until weeks or even months after the initial infestation. A tickling feeling of something moving in the hair may also be felt, and sores from bites and excessive scratching may be visible on the scalp.

What are the symptoms of head lice?

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If you notice your child scratching his or her head frequently, you should check for lice. It’s best to check under bright, natural light. Have your child sit down, then part the hair to examine the scalp for nits and live lice. Lice are known to be especially prevalent behind the ears and at the nape of the neck, and most nits are found close to the root of the hair where it is warmest. Be sure to examine from multiple angles since freshly-laid nits can be transparent and easily missed. A magnifying glass may be especially helpful. You’ll want to check your entire family and have another adult check you as well.

How do I check for head lice?

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There are countless home remedies for head lice that are passed around on the Internet and through word of mouth. Most of these involve using essential oils, mayonnaise and other common household materials to smother lice. None have been scientifically proven to be effective. Dr. Schlessinger recommends using extreme caution when it comes to natural treatments. Just because an ingredient is natural or edible, doesn’t mean it’s good for the scalp and hair. Certain essential oils, particularly tea tree oil, can pose a higher risk for allergic reaction. Other essential oils are toxic in large doses. Additionally, many natural treatments require the hair to be saturated in a substance and then wrapped in plastic or a shower cap overnight, which could pose a suffocation hazard for children.

Can I use a natural method to treat head lice?

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Prescription and over-the-counter medications are available to treat lice. These usually come in the form of spray and wash-out treatments that contain natural or synthetic extracts of chrysanthemums. They are considered safe when used as directed, but may contain harsh ingredients. They are not designed to kill nits, only lice, and stronger medication may be required if lice do not respond. If you’d like to avoid a chemical treatment for your child, The National Pediculosis Association advocates the comb-out method.

Prescription and over-the-counter treatments

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The most crucial aspect of getting rid of head lice is to diligently comb out all nits and lice. You can buy a special fine-toothed comb from the drugstore for this purpose. Wet and condition your child’s hair and then work to comb all visible nits and lice out of the wet strands. This may be time-consuming. Afterward, wash the hair with regular shampoo and then wash it once more. Repeat this practice every second or third day, taking care to check every day for new nits or lice. If you see signs of re-infestation after two weeks of combing and washing, consult your physician.

The comb-out method

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While head lice infect people, not homes, cleaning the soft surfaces of your home (especially if they have been in contact with the infected individual within 48 hours), will give you peace of mind and help prevent spreading. o Machine wash all clothing and bedding that the infected

person has used or touched on the hot cycle. o Soak all combs, brushes, hair clips, barrettes and hair ties in

rubbing alcohol, Lysol or hot, soapy water and then place them in a bag in the freezer for at least two days. You may also opt to throw these items away, as they are relatively inexpensive to replace and the soaking treatment could damage them.

o Thoroughly vacuum the carpets and furniture. It won’t be necessary to use fumigant sprays or call in a pest control company.

o Unless you see nits or live lice on another family member’s head, it won’t be necessary to treat everyone with medication as a precaution.

Do I need to treat the house?

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You will not need to treat your household pets for head lice. Head lice only infect people, not animals. Using pesticides, over-the-counter treatments or natural remedies could be hazardous to your pet’s health.

Do I need to treat my pets?

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o If you’ve been made aware of a head lice infestation at your child’s school or another place he or she frequents, check your entire family as soon as possible.

o Teach your children not to share personal belongings, especially those that come into contact with the head.

o Use shampoos that don’t contain fragrance, since this could attract lice if an unknown infestation is underway.

o Avoid sports and games with head-to-head contact.

How can my family and I avoid getting head lice?

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Health & Medicine

Joel Schlessinger MD FAQ - Head Lice