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Oh no! My child has head lice

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Every school year millions of parents all around the world are horror struck when their child comes home from school with an itchy scalp caused by head lice. There are myths about head lice and what is says about a child or his or her family. This post is meant to help parents understand this common childhood experience to manage better both the stigma and the treatment.

Head lice is often transmitted between children at school, in day care centers, or sleep away camps because of close head-to-head contact in these locations. This is why younger children, age 3-12 years, are most often affected. Additionally, when one member of a family has head lice, it is common to find other members also affected.

Head lice transmission can happen to any child. “Being clean” or “being dirty” do not influence rates of head lice. Any child can be affected regardless of hygiene. The truth is that head lice do not discriminate – they like anyone with a warm body and hair. Girls generally have higher rates of head lice than boys because girls tend to share hair accessories that can transmit lice. Head lice infestations in a family DO NOT indicate a lower level of cleanliness or failure to keep children clean.

Head lice do not transmit disease but are irritating due to the feeling of movement on the scalp and itchiness. However, children may scratch their scalps so aggressively that they break the skin and cause redness or open sores. Skin infections can occur in these open cuts. This happens because dirt and germs underneath the fingernails get embedded in the open skin and cause an infection. For this reason it is important to treat head lice right away and not wait. The earlier the lice are killed and removed, the less time there is for your child to scratch and potentially create a skin infection.

The life cycle of head lice and treatment

The technical name of head lice is Pediculus humanus var capitis. They have a life cycle of 3 weeks. Female lice live 3-4 weeks and lay around 10 eggs (nits) every day. The eggs (nits) appear translucent on the hair shafts and are firmly attached with a glue-like substance. The heat from the human head provides warmth to the eggs during their incubation of 7-12 days. When hatched, the young lice (nymphs) mature for approximately 10 days, then mate and begin the cycle again.

This cycle is important to understand in order to properly treat head lice within the family and prevent re-infestation. An appropriate treatment should be selected based on your geographic region. Some head lice have become resistant to some pesticide shampoos. This means that the shampoo will not effectively kill the head lice. Therefore it is useful to consult with your healthcare provider or pharmacist to help select products that are effective and appropriate for your family.

Once initial treatment has been administered to all affected household members, it is important to re-treat everyone in 7-10 days. Why? because pesticides only work on lice, not on the eggs (nits). Due to the incubation period of the eggs, a re-treatment in 7-10 days is necessary to kill any lice that have hatched since the initial treatment. Parents should avoid re-treating earlier than 7-10 days because the eggs will still be incubating and will not be killed by the treatment. In this case, the parents will be using the pesticide shampoo with no effect on the lice, but will be exposing their child unnecessary to the pesticide contained in the shampoo. Waiting longer than 7-10 days to retreat will mean that some eggs may have hatched and had time to mature and begin laying eggs again. In this case, a re-infestation will occur with any new eggs that have been laid.

Supportive measures to prevent re-infestation of head lice

In addition to appropriately treating all family members affected with an effective treatment product, there are some supportive measures that will help families reduce the risk of treatment failure or re-infestation:

  • Wash and dry all bedding and towels on high heat.
  • Wash (if possible) and dry on high heat all pillows.
  • Completely vacuum mattresses, carpets, upholstered couches and chairs.
  • Boil combs, brushes, and hair accessories.
  • Wash hats, scarves and clothing with hoods.

Risk reduction

Although it is impossible to prevent head lice completely, it is possible to reduce the risk. Parents should teach their children in school, daycare, or camp environments:

  • Not to share hats and scarves.
  • Not to share hair accessories such as elastic bands, hair ribbons, headbands, etc.
  • Not to share combs and brushes.
  • Choose dress up toys without head coverings such as hoods, veils, hats.

Head lice infestations are common in childhood. Parents should not feel ashamed or embarrassed if their child comes home from daycare, school or camp with lice. It is better to focus on treating the lice early and effectively to minimize the discomfort to the child. Properly following treatment plans and using the supportive measures listed above will help families manage the situation quickly and effectively.

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