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Head Lice: Recognize, Identify and Treat

By: Gary Fancher, P.D.

Two things increase in January each year – credit card debt and a surge in head lice cases. We at Collier Drug aren’t able to fix the first, but we can help you with treating head lice.

Head lice are the result of contact with someone with head lice so do not blame the victim (it is not their fault).This time of year usually kids are wearing coats or scarves or head gear that come in contact with each other and can help spread lice. We can do our best to encourage kids not to share items of clothing, but kids are playing games or doing activities where they are in close contact. They also may share combs, head bands or other hair items where lice transfer can occur.

Recognize the Signs

To reduce spread, do head checks when your children come home from school or any activity where your child is interacting with other children and you suspect there could be a problem. This is important if your child is scratching their head consistently. Some people who are less allergic do not have itching for up to 3 or 4 weeks after being infested. Check in several places by parting the hair and looking at the scalp for lice and by using a bright light to check hair for nits, or lice eggs. Lice nits on the hair strand do not come off easily, so what you think are nits may be dandruff or dead skin clumps if it comes off easily. The use of a bright light or blue light (available as a small flashlight or fluorescent tube) may help spot lice and nits as they will fluoresce, or glow.  Again, don’t mistake dandruff as lice.

Identify the Problem

Here’s what to look for when doing a head check:

  • Dandruff-like spots that don’t easily brush away – could be louse nits
  • White or yellowish bits – empty louse egg casings
  • Beige or brown spots – live eggs with larva

Treat the Patient

shutterstock_252224824We have over the counter products as the first line treatment. Just ask one of our pharmacists and we will make a recommendation for you. If these products don’t solve the problem, there are prescription products your doctor may want to write for you, depending on age and resistance to head lice. The majority of cases are treatable with non-prescription products if used properly.

To treat most cases of head lice, follow the instructions on the over the counter product you choose. Also, you will need a box of Kleenex or toilet paper, waste basket with liner or plastic bag, bobby pens and a ton of patience. Use the product as directed.

  1. Start by separating the hair and comb with a nit comb. Be very careful not to get too much hair as it will hurt and you can actually pull out hair.
  2. Lay comb on tissue and separate combed hair with bobby pens. Use the tissue to wipe off comb and then put tissue in plastic bag. This process will have to be done for the entire head.
  3. Inspect hair as you go as nits are difficult to remove and to make sure your technique is working. The bright light will help you to check for nit removal.
  4. When finished, remove bobby pens and put in hot water as well as the comb. Close plastic bag and discard.
  5. Inspect head daily and re-comb if necessary. Sometimes a re-treatment in a week or 10 days is necessary if there is evidence of lice or nits.
  6. Every person in the housed should be checked and treated if they show evidence of lice or nits.

Lice can move fast and may be hard to see unless you part the hair and have good lighting. Look close at hair line and around ears. Lice live on excreted body fluids and they bite and suck blood (which causes the intense itching) and must have a human host to survive. That is why it is usually not necessary to use sprays to treat objects. Launder all items you can in hot water and put in dryer on high heat. Temperatures of 130 degrees will kill lice and nits. Vacuum all furniture and chairs and mattress and any item you can’t launder or vacuum may be sealed in a plastic bag for two weeks. Any head lice not on a human or on an item close to body temperature will die in 1 or 2 days.

If you choose to use fumigant spray on furniture, flooring and mattresses, be careful and follow package instructions. Make sure others are out of the room and allow objects to dry before anyone is allowed in the room and on the items sprayed.

Give all the participants encouragement as this is a project no one wants to repeat. Grandparents need to do head checks when kids visit as a second line of defense. Treating head lice is time consuming and expensive so everyone in the family needs to watch for reemergence.

Remember, an ounce of prevention is worth a pound of cure, so avoiding and teaching your children to avoid sharing hats, head bands, brushes, combs, and other hair items will go a long way in helping to prevent a visit from certain unwanted guests.