Head Lice

Head lice are a very common problem. This article explains the symptoms, causes, risk factors, diagnosis, treatments and preventions.

Head lice affect millions of people every year, making them a very common problem.  They especially affect preschool and elementary school-aged children and those who come into close contact, e.g. other family members.  Head lice are wingless, tiny parasitic insects which  feed and live on the blood from the scalp.

Symptoms of Head Lice
The common signs and symptoms of head lice can include the following:

Intense itching.  Itchy red bumps on the scalp, neck and shoulders may result from an allergic reaction to the saliva which lice inject when they feed.  Some people do not experience itching.  This is especially true if it is their first infestation of head lice.

Adult lice on scalp.  Behind the ears and along the back of the neck are the most common areas to find adult lice.  Lice are very small, around the size of a strawberry seed but they can also be up to 3 millimeters in size.

Lice eggs on the hair shafts.  Lice eggs are more commonly known as nits.  Nits look similar to tiny pussy willow buds.  It is possible to mistake them for dandruff but they can not be brushed out of the hair easily, unlike dandruff.

Causes of Head Lice
Head lice are unable to jump or fly and they can not be transmitted by pets.  Head lice spread via contact with contaminated personal belongings or home furnishings or by head-to-head contact.

Sharing personal items.  This is a less common form of transmission.  Head lice can be transmitted via items such as:

Brushes and combs

Hats, caps and scarves

Hair decorations


Home furnishings.  Head lice may be contracted by coming into contact with the following if they are contaminated:





Upholstered furniture

Head-to-head contact.  This mode of transmission is the most common and it can occur as children or family members interact or play closely together.

Risk factors
Despite common thought, personal hygiene and cleanliness have small bearing on whether you get lice.  Coming into contact with someone who has lice already is the greatest risk factor for getting head lice. 

Those most prone to infestation are young children, preschool through elementary age.  The lice often transfer to the family members of the child.  Head lice are more common in females than males.

The eggs from lice are cemented firmly onto the base of hair shafts, very close to the scalp.  Nits have already hatched or are not going to hatch if they are found over a quarter of an inch away from the scalp.  Therefore, finding nits is not proof of an active infestation.  Finding a living, moving louse is the clearest sign of having head lice.  The best way of doing this is by combing wet hair with a fine-toothed comb.

Treatments for Head Lice
Over-the-counter products.  The first option to combat infestations of head lice is normally shampoos that contain either pyrethrin or permethrin.  It is important to follow the directions very closely for these to work best.

Head lice have grown resistant to the ingredients in over-the-counter lice treatments in some geographical areas.  Your doctor can prescribe shampoos or lotions which contain different ingredients if over-the-counter products are not successful.

Prescription medications.  Medication which is prescribed by doctors to treat head lice include:

Malathion (Ovide).  Malathion should not be used by sone under the age of 6 years old.  It is applied to the hair and then rubbed into the hair and scalp.  It needs to be kept away from sources of heat, e.g. cigarettes, hair dryers and electric curlers because it is flammable.  You should talk to your doctor before using this product if you are pregnant or beats feeding because it may affect your baby.

Lindane.  Lindane is a prescription medication that is available in lotion, cream or shampoo form.  If you weigh less than 110 pounds, are pregnant or breast-feeding, have HIV infection or have seizures, your doctor may not recommend it.  Side effects of lindane can include seizures and skin irritation.

Benzyl alcohol lotion.  This is a newer treatment and should not be use din children who are aged younger than 6 months.  Side effects can include irritations of the skin, scalp and eyes.  Serious side effects, e.g. coma, seizures or death can occur if it is used on premature infants, according to the Food and Drug Administration.

A fine-toothed or not comb can physically remove the lice from wet hair if you do not want to use insecticides.  This should be done for at least two weeks, every three to four days.  his method of treatment is recommended as the first line treatment in children who are less than 2 years old.

Prevention of Head Lice
It is difficult to stop head lice spreading among children in child care and in school.  The lice can easily spread because there is much close contact among children and their possessions.  It is important to remember that it is no reflection on your own or your child’s hygiene habits if your child gets head lice and does reflect on you badly as a parent.

You can ask your child to avoid sharing hats, coats, scarves, brushes, combs, hair accessories and other personal belongings with friends.  However, it is unrealistic to expect that all types of contact which may cause the spread of head lice can be eliminated.

Ensuring that you take thorough steps to get rid of the lice and their eggs so that you do not have to deal with more lice, is the best approach to head lice prevention. 

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