Oct 10, 2012
By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy
My 10 year old daughter Emily came home and announced she had started a business. This entrepreneurial grade 5 student has been making bracelets out of colorful string and beads for a few weeks. She told me she was going to sell them and donate the money to the Humane society. I thought the idea was cute and was prepared to buy one. Apparently selling to her parent is thinking too small for Emily Inc. Emily had already expanded her business. She had recruited a secretary, a marketing department and bracelet artisans from her class. In grade 5, I think I was grossing out girls with frogs. Kids today certainly seem to be more advanced than I was at their age.
A perpetual childhood problem, though, is head lice. Head lice are quite common. Having head lice doesnt mean someone has dirty hair. Lice actually seem to prefer clean hair. Children from 3 to 11 years old are the most affected age group. Girls seem to be more affected than boys. 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. Lice 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 attached to the base of a hair shaft every day. The eggs are called nits. Seven to ten days later, the nits hatch and are called nymphs. The whole life-cycle is about 20-30 days. 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). One of the new things I learned reading up on lice this time was the transmission rate. Apparently lice will only be transferred 10-30% of the time when someone is exposed. It is believed prolonged head to head contact, ie. over 30 seconds, is required for lice to move from one person to another. Quick head contact or transfer through inanimate objects like combs, brushes or hats is supposed to be uncommon. The other new thing I learned was how fast lice die when separated from human heads. Adult lice need us for their blood meal. Nits need our head warmth for incubation. Lice and nits die when away from us humans for 55 hours.
What are the symptoms of having lice? The most common symptom is itching, especially around the ears and back of the scalp. This itching is from a mild allergic reaction to the saliva of the louse when it feeds on us. There can be small sores 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 0.6 cm from the scalp have grown out with the hair and have either hatched or are dead. To know for sure that someone has lice, though, you have to see the live adult louse. Combing with a fine toothed comb is supposed to be 4 times more efficient and twice as fast for finding adult lice as just looking through the scalp.
One non-drug treatment that can be used to treat lice is wet combing. Wet combing every 3-4 days with a fine toothed comb can help get rid of lice. This might not work as well as the lice shampoos, but it is completely safe. Using vinegar with wet combing should be avoided if using wet combing in combination with one of the lice shampoos as the vinegar can inactivate the shampoo.
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. Since no lice treatment kills 100% of the nits, it is recommended that one uses the permethrin again in 7 to 10 days. Permethrin can cause allergic reactions in ragweed or chrysanthemum sensitive individuals
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 lice measures that Ive been telling people for years. 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. Vacuuming of carpets and furniture is also a good idea. Finally, I tell people that nit picking (i.e. actually combing the live and dead nits out of the hair) is very tedious, but very important. Apparently now that we think lice transmission is usually through head to head contact and not through inanimate objects, nit picking and cleaning may not be as important as we thought. Im not giving up my recommendations yet, though.
Childhood isnt all puppies, ice cream and hockey games. Into each childhood some lice must fall. The latest update on Emily Inc, is the enterprise has run into bureaucratic red tape. One of the parents of Emilys bracelet co-conspirators started asking questions and Emily had to visit the principle. She now has to fill out an application form for a permit for her fundraising venture. Emily shouldnt worry, though. As with head lice, bureaucratic red tape can be cured with a little time and patience and is nothing to be ashamed of.
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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