National Pediculosis Prevention Month/ Head Lice Prevention Month

With the exception of the common cold, head lice affect more school-aged children than all other contagious childhood diseases combined. Head lice do not necessarily reflect unsanitary households or neglected children. Anyone can get head lice…mainly by head-to-head contact but also from sharing hats, brushes and headrests.

Introduction to Head Lice and Nits

• Head lice are small, wingless insects which feed on human blood. They need human blood in order to survive.
• Head lice are clear in color when newly hatched, but turn a reddish-brown color after feeding.
• Head lice are about the size of sesame seeds.
• Head lice have six legs equipped with claws to grasp the hair.
• Head lice are crawling insects. They cannot hop, jump, or fly.
• Head lice do not thrive on pets.
• Head lice live for approximately 30 days on a host and a female louse may lay up to 100 nits (eggs).
• Head lice off of their human hosts will starve. The National Pediculosis Association (NPA) suggests that, in most cases, a head louse will not survive for more than 24 hours off of its human host.
• Nits are tiny yellowish-white oval eggs firmly attached at an angle to the hair shaft. Contrary to some claims, nits found more than a quarter inch from the scalp are not necessarily dead. Viable nits can be found anywhere on the hair.
• Once laid, it takes 7-10 days for a nit to hatch, and another 7-10 days for the female to mature and begin laying her own eggs.

Screening and Early Detection

Early detection offers the best opportunity to manually remove head lice and nits instead of having to resort to chemical treatments / shampoos.

• Watch for signs of head lice, such as frequent head scratching.
• Check the scalp and hair of all family members for lice and nits at least once a week.
• Head lice move quickly away from light. For this reason, it is usually easier to see the attached nits than to find crawling lice.
• Be sure not to confuse nits with hair debris such as bright white irregularly-shaped clumps of dandruff stuck to the hair shaft or elongated segments of dandruff encircling the hair shaft that can be easily dislodged.
• Although nits may be more prevalent at the nape of the neck, around the ears and at the crown of the head, check the entire scalp since nits can be found anywhere in the hair.
• Head lice can also be found in the eyebrows and eyelashes. In this case children need to be examined by their physician. Pesticides found in most lice treatments should not be used on or near the eyes.
• Notify your child's school, camp, or child care provider if lice or nits are detected. Keep children home until treatment is complete and no more lice or nits can be found. This is the best way to protect your family and community from becoming reinfested.

Treatment

1. To assure total lice treatment, you need to remove all nits. Separate hair in sections and remove all attached nits with specialized comb, baby safety scissors or your fingernails.
2. Nits are tiny and can be difficult to remove. They are firmly attached to the hair shaft and cannot be brushed out or removed with a regular comb.
3. Your physician may also recommend an over-the-counter or prescription head lice treatment. The NPA advises parents to discontinue the use of these products at the earliest sign that the treatment is not working. Manual removal can be done with a specialized comb and is the best option whenever possible and especially when treatment products have failed.
4. Do not treat anybody who is not infested. Head lice treatments do nothing to prevent lice and their use in these cases would result in unnecessary chemical exposure.
5. Wash bedding and recently worn clothing in hot water and dry in a hot dryer. Combs and brushes may be soaked in hot water (not boiling) for 10 minutes.
6. Anything that can't be washed or dry-cleaned can be vacuumed. Vacuuming is the safest and best way to remove lice or fallen hairs with attached nits from upholstered furniture, rugs, stuffed animals and car seats. There is no need to use head lice sprays to disinfect these items, and the use of sprays can pose a risk to you or your child due to chemical exposure.

Pesticide Warning

Both over-the-counter and prescription lice-killing products are pesticides. These chemicals can be harmful to humans, so it is important to follow the directions carefully and use with caution. Use the product over the sink, not in the tub or shower to decrease the exposure of pesticides to the body and always keep eyes covered. There are no safe chemical treatments proven to be 100% effective against head lice and nits. Repeated use of these products will not change product performance and may risk children's health and contribute to more strains of resistant lice. Manual removal is the safe alternative and a necessary component to any head lice treatment regimen.

Chemical treatments may be especially dangerous for certain people. Those at high risk include:

• Women who are pregnant or nursing
• Anyone on medication or who has a pre-existing medical condition such as allergies, asthma, epilepsy, or cancer
• Children under two years of age
• Children who have been repeatedly exposed to chemical treatments

Early detection and manual removal of lice and nits can serve as a safe alternative to pesticidal lice treatment. Mechanical removal of head lice and nits is also less noxious and more likely to be successful than repeated chemical treatments.

Prevention

The following steps are the best and only prevention against head lice:

1. Discourage your children from sharing hats, brushes, towels, helmets, hair ties, pillows or clothing
2. Screen your child regularly
3. If lice are found, keep child at home until treatment is complete and lice and nits can no longer be found.

National Pediculosis Association (HeadLice.org)

Texas Agricultural Extension Service: Head Lice Information

The Centers for Disease Control and Prevention: Lice Information

Harvard School of Public Health: Head Lice Information

The Mayo Clinic: Lice Information