Dec 13, 2011
By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy
Some parenting moments are special. Like when your six year old son cuddles up next you on the couch, puts his arms around you and says, Dad, you have a big belly. You should lose some weight. Or when you are at the Dauphin Clinic Pharmacy Cashspiel and your nine year old daughter announces to strangers, My mom made my dad lose that ugly moustache. Next she is going to make him lose some weight. Hes really too fat. I love those kids of mine. I cant wait for the time when they come home from school with head lice and I get to say, Eww. You have bugs in your hair!
Of course if or when my children get head lice, I will be the adult and not make fun of them. Head lice are actually quite common. Having head lice doesnt mean someone has dirty hair. Lice actually seem to prefer clean hair. Children from 3 to 10 years old are the most affected age group. However, anyone can get lice, regardless of sex, race, age, hair length or socio-economic status.
What are lice? Head lice are parasites that live in humans hair. The scientific name for them is Pediculus Humanus capitis, and they are wingless insects with six legs and range in color from white to brown to dark grey. They dont fly and they dont jump. A young louse matures in 10-12 days and the adult is 2-4mm long. They multiply very quickly. Females lay 7 to 10 oval and whitish eggs called nits every day. Seven to ten days later, the nits hatch and are called nymphs. So the whole life-cycle is about 20-30 days. Adults can only survive 1-2 days without a blood meal. Lice are transmitted in two main ways. Lice can be transmitted directly by close contact from one infested scalp to another (e.g. touching heads together). They can also be transmitted indirectly by sharing personal articles that come in contact with the head (e.g. brushes, hats, etc).
What are the symptoms of having lice? The most common symptom is itching, especially around the ears and back of the scalp. There can be small sores, or small scabs on the persons scalp or neck. If these sores get infected, there can be pus. How do you recognize head lice? First you should see nits (the eggs) attached to the base of the hair shafts on the warmer parts of the scalp (the back and sides). The egg or nit is oval and glued to the hair. Nits are laid close to the scalp for warmth, usually around the ears and the nape of the neck. Live nits are brownish in color, and dead ones are whitish. Nits found more than 1.0 cm from the scalp have grown out with the hair and have either hatched or are dead.
The main product used to treat head lice is permethrin (one of the brand names is Nix). It stays in the hair for up to ten days after use to kill any more lice that hatch. It is generally the product of first choice because is very good at killing lice, it has low toxicity and it sticks around for about 10 days. Although it is not absolutely necessary to do a repeat application, it is often recommended that one uses the permethrin again in 7 to 10 days. Permethrin can cause allergic reactions in ragweed or chrysanthemum sensitive individuals. There are older products on the market that contain lindane. Lindane is not as good as permethrin at killing lice. It doesnt stick around so you must do a second application in 7-10 days for it to be effective. About 10% of the lindane actually goes into the rest of your body and it can accumulate with repeated exposure. It can cause seizures and other neurologic disorders so lindane is not my favorite product.
There has been talk over the last few years about resistance to treatments like permethrin. Although resistance has been found in the US and the UK, the Canadian Pediatric Society says none has been proven in Canada. Because of the resistance fears, there have been new products developed that dont work like permethrin. One of these is called Resultz. It contains isopropyl myristate. The permethrin in Nix attacks the nervous system of the louse. Isopropyl myristate is more like a soap. It dissolves the waxy outer coating on the louse and the louse dehydrates. The claim is that Resultz kills the louse within ten minutes. The down side to Resultz is it does not kill the nits or eggs in the hair. So you absolutely need to do the second treatment in one week. On the positive side, there is no documented resistance to Resultz. There were small studies where Resultz killed more lice than permetherin. One of these small trials was even done in Winnipeg, MB! I dont know if I am ready to say Resultz is definitely better than permetherin yet, but it is nice to have another tool in the tool box.
Im obviously biased, but my favorite alternative to permethrin is called Nice N Natural lice treatment. We compound Nice N Nature lice treatment at the Dauphin Clinic Pharmacy with a variety of natural oils. It coats the hair and suffocates the lice. It smells really nice and customers tell us it works really well.
There are some non-medication measures that should be taken when a family member gets lice. Combs and brushes should be soaked in alcohol or Lysol for one hour; or they can be soaked in water 65oC or hotter for 10 minutes. Bedding, towels, and clothing should be washed in hot water and dried in a dryer for 20 minutes to an hour. It is actually the heat from the dryer that kills the lice. Items that cant be put in the dryer may be dry-cleaned or stored in a sealed plastic bag for 2 weeks. Lice cant live away from human contact for very long, so the two weeks allows the eggs to hatch and the new lice to die. Some people have even stored these plastic bags full of teddy-bears etc. in the freezer. Vacuuming of carpets and furniture is also a good idea. Finally, nit picking (actually combing the live and dead nits out of the hair) is very tedious, but very important.
If you or your children get head lice, it is nothing to be ashamed of. It is a bit tedious to treat with all the nit picking that is required, but treatment with a medicated shampoo, nit picking and cleaning are usually very successful. And I guess I shouldnt wish lice upon my children. Revenge is a dish best served cold. I think Ill just wait until my kids start dating and tell their future boyfriends and girlfriends embarrassing stories. Thatll work.
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.
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As always if you have any questions or concerns about these products, ask your pharmacist.