Lice

Head lice are tiny, wingless bugs that live on the scalp. They're often found at the back of the neck and behind the ears. You might see them as tiny, grayish-white specks that look a bit like dandruff flakes. These are actually the lice eggs, called nits. They cling to the hair shafts.

Head lice feed on human blood. They spread from person to person by close contact, like when people are very close together. They can also spread through shared items like hats, scarves, and combs.

There are three types of lice that can affect humans:

• Head lice: These are the ones that live on the scalp, as described above, and are most commonly found at the back of the neck and behind the ears.

• Body lice: These live in clothing and bedding. They move to the skin to feed on blood. Body lice tend to affect people who don't have regular access to clean clothes and baths, like those experiencing homelessness.

• Pubic lice (crabs): These lice live on the hair and skin of the genital area. Sometimes, they can be found on other coarse body hair, like chest hair, eyebrows, or eyelashes.

If head lice aren't treated correctly, they can come back again and again. Consistent treatment is important to get rid of them completely.

Head lice are tiny insects that cause intense itching, especially on the scalp, but also possibly on the body or genitals. You might feel a tickling sensation as they move through your hair.

You might see the lice themselves, which are about the size of a sesame seed. They can be found on your scalp, body, clothing, or pubic hair.

Tiny, almost invisible eggs called nits are also a sign of head lice. These are often found clustered around the ears and the back of the neck. They're stuck firmly to the hair shaft, unlike dandruff, which can be brushed away. Nits are very small and can sometimes be mistaken for dandruff, hair product residue, small pieces of dead hair, scabs, dirt, or other debris.

Scratching from the itching can cause sores on the scalp, neck, and shoulders. These sores can become infected with bacteria. You might also see bite marks, particularly around the waist, groin, upper thighs, and pubic area.

If you think you or your child might have head lice, it's important to see a doctor or other healthcare professional.

If you think you or your child might have head lice, see a doctor. Many things can look like lice eggs (nits), so it's important to get a professional opinion. These look-alikes include:

• Dandruff: This is a common, flaky skin condition on the scalp. It often appears as small white flakes.

• Hair product residue: Styling products like gels, mousses, and hairspray can leave behind a buildup that might look like nits.

• Dead hair tissue: Sometimes, small pieces of dead hair can clump together on the hair shaft, resembling nits. This is a natural occurrence.

• Scabs, dirt, or debris: Small scabs, dirt, or other bits of debris can get caught in the hair and look like nits.

• Other small bugs: Sometimes, other tiny insects, like very small mites or insects, can be present in the hair and might be mistaken for lice.

It's crucial to get an accurate diagnosis from a healthcare professional to ensure proper treatment if needed.

Head lice, body lice, and pubic lice are tiny insects that live on humans. They feed on our blood. These insects are found on different parts of the body: the head, the body (clothing), and the pubic area.

Female lice produce a special glue-like substance to stick their eggs (nits) to the base of hairs. These eggs usually hatch in about 6 to 9 days, and then the baby lice start to feed.

You can get lice by touching someone who has them, or by touching things they've touched. Lice can't jump or fly. Instead, they spread in a few ways:

• Direct contact: Close head-to-head or body-to-body contact, like when children play or family members are close together. This is a common way lice spread.

• Shared items: Lice can spread through items shared between people, such as clothing, hats, headphones, hairbrushes, combs, towels, blankets, pillows, and stuffed animals. If these items have lice or nits on them, you can get infected by touching them. Make sure to wash and dry items on a high heat setting.

• Contaminated surfaces: Lice can survive for a day or two away from a person. So, if someone with lice has recently used a bed, a couch, or other upholstered furniture, you could get lice by touching these surfaces.

• Sexual contact: Pubic lice are most often spread through sexual contact. They are usually found in adults. If a child has pubic lice, it's important to talk to a doctor or other trusted adult. It could be a sign of something that needs attention.

It's important to remember that lice are not a sign of poor hygiene. Anyone can get them, and they are easily treated.

Head lice are a common problem in schools and childcare centers, spreading easily because of the close contact between children and their belongings. Having head lice doesn't mean a child's family is unhygienic, nor is it a sign of poor parenting.

Some products claim to prevent head lice, often using ingredients like coconut, olive, rosemary, and tea tree oil. While some small studies suggest these natural oils might help, these products aren't regulated by the FDA (Food and Drug Administration) in the same way as other treatments. This means their safety and effectiveness haven't been thoroughly tested and proven.

Currently, the best way to deal with head lice is to treat them promptly if found. Here are some steps to help prevent the spread of lice:

• Limit head-to-head contact: Encourage your child to avoid touching heads during playtime or other activities.
• Don't share personal items: Make sure your child doesn't share hats, scarves, coats, combs, brushes, hair accessories, headphones, or other personal items.
• Avoid shared spaces with shared items: If possible, avoid areas where multiple students share hats or clothing on the same hooks or in the same lockers.

It's impossible to completely eliminate all contact that could spread lice, but these precautions can help.

Even if you only find a few tiny eggs (nits) attached to your child's hair, it's important to treat them. Empty eggs are sometimes found, but nits that are close to the scalp (within about 1/4 inch or 6 millimeters) should be treated, even if there's only one, to prevent them from hatching into live lice.

Doctors and nurses use several methods to check for lice.

Checking for Head Lice:

To find head lice, a healthcare professional might use a magnifying glass to look closely at the hair and scalp. They might also use a special light called a Wood's lamp. This light makes the tiny eggs (nits) that lice lay on hair look pale blue, making them easier to see. A diagnosis of head lice is usually made when a live louse (either a young or grown-up louse) is found in the hair or on the scalp. Alternatively, finding one or more nits attached to hair strands within about a quarter of an inch of the scalp can also signal a head lice infestation.

Checking for Body Lice:

Body lice are typically found in the seams of clothing or on bedding. These lice lay their eggs in these places, too. Sometimes, a body louse will crawl onto the skin to feed, making it possible to spot them directly on the skin. A healthcare professional will diagnose body lice if they find either eggs or live lice in these locations.

Checking for Pubic Lice:

Pubic lice, also known as crabs, are usually found in the pubic hair. However, they can also be found on other coarse hairs like chest hair, eyebrows, or eyelashes. A healthcare professional will look for moving lice or nits (eggs) in these areas. If either live lice or nits are seen, a diagnosis of pubic lice is likely.

Treating Head Lice: A Simple Guide

Head lice are tiny insects that live on the scalp. Using lice treatments correctly is important. Following the directions carefully is crucial to avoid skin irritation. Applying too much of any treatment can cause redness and irritation.

Several options are available for treating head lice:

Over-the-Counter (OTC) Treatments:

• Permethrin (Nix): This is a common first-line treatment. Permethrin is a chemical derived from chrysanthemums that kills lice. It's usually found in shampoos. Carefully follow the instructions on the product label.

• Ivermectin (Sklice): This is an OTC lotion. It's safe for children six months and older. Apply the lotion to dry hair, let it sit for 10 minutes, and then rinse. Only use it once. Don't reapply without checking with a doctor. Possible side effects include eye irritation, redness, dandruff, dry skin, or a burning feeling where you apply it.

• Important Note: In some areas, lice have developed resistance to these OTC treatments. If the OTC treatment doesn't work, a doctor can prescribe a different type of shampoo or lotion.

Prescription Treatments:

• Ivermectin (Stromectol): This is a pill taken by mouth. It's usually a last resort if other treatments haven't worked. It's given in two doses, eight days apart. Children need to weigh at least 33 pounds to take this medication. Possible side effects include nausea and vomiting.

• Malathion: This is a liquid applied to the hair and scalp. It's important to keep it away from heat sources, like hair dryers, curling irons, or cigarettes, because it's flammable. If you are pregnant or breastfeeding, or have a child under the age of 2, talk to your doctor before using this treatment. It may not be safe for children aged 2-6.

• Spinosad (Natroba): This is a newer treatment that's applied to dry hair and scalp for 10 minutes, then rinsed. It usually only needs one application, but can be repeated in seven days if lice are still present. Side effects include skin or eye irritation. This medication isn't typically recommended for children under 4.

Treating Body Lice:

If you have body lice, first wash the affected areas with soap and water. Then apply permethrin to the affected areas before bed and shower in the morning. Repeat this process nine days later.

Important Steps for All Lice:

• Removing Nits: It's crucial to remove not only the live lice but also the tiny eggs (nits) that they lay. These eggs can hatch and cause re-infestation.

• Cleaning: Wash all clothing, bedding, personal items, and potentially contaminated furniture with hot, soapy water (at least 130°F or 54°C) and dry them on high heat for at least 20 minutes. Vacuum surfaces. Seal unwashable items in airtight bags for two weeks to prevent the spread of lice.

Pubic Lice:

Pubic lice can be treated with similar OTC and prescription treatments as head lice. Follow package directions carefully.

General Advice:

Most people can effectively treat head lice at home. The main challenge is getting rid of all the nits and preventing re-infection through contact with other lice at home or school. If you have concerns about treatment, talk to your doctor.