Mommy My Head Itches--Could it be Head Lice?
Contributed by: Erin Smith, R.Ph.
     Hen House Pharmacy--Lee's Summit

Volume 1, Issue 6

As the weather turns colder, your children may bring more than a case of the sniffles home with them from school.  Between six and twelve million Americans get head lice annually, the majority of these cases are in preschool or lower elementary students.  Lice can be a tremendous nuisance, but are no reason to panic.  They do not indicate poor personal hygiene or unsanitary living conditions.  They can happen in any family regardless of social or economic status.  Would you know what to do if it happens to you?
Lice is spread through direct contact with an infected person (cuddling, roughhousing, etc.) or from sharing the belongings of an infected person (hats, scarves, combs, brushes, pillows, daycare cot).  Contrary to popular belief, lice cannot fly or jump from person to person.  Lice cannot live on pets.
Since lice are very tiny and difficult to see, you must look for nits (eggs) in the hair.  Nits are tiny, white, oval shells that stick to the hair shaft close to the scalp, behind the ears, in the hair, or in the back of the neck.  Nits may look similar to dandruff flakes or hairspray residue but will stick to the hair shaft and are not easily removed.  Lice can cause an itchy scalp and your child may feel like things are tickling the head or crawling through the hair.
Lice can be treated with medicated shampoo or by combing.  While there have been recent reports of lice becoming resistant to the common over-the-counter products, most cases can still be treated this way.  Only treat if you are sure the child has lice, it is never a good idea to treat "just in case."  If your child is under two, consult a physician before treating. 
You should begin treatment with a medicated shampoo containing 1% permethrin (common brands are Nix, Rid, Pronto). The shampoo should kill any live lice in the child's hair. It is very important to specifically follow the manufacturer's instructions as different products have different instructions. Most shampoos

require retreatment in seven to ten days to kill any remaining nits that may have hatched since the initial application. Do not use an over-the-counter shampoo more than three times.  If the problem persists after repeat applications it is best to contact your physician.  For particularly tenacious cases, prescription shampoos are available.
The shampoo should be followed with a nit-removal rinse.  This can be purchased at your pharmacy or you can make your own solution of diluted white vinegar (one part vinegar to one part water).  Comb hair thoroughly with a fine tooth comb.    The least painful method is to separate the child's hair into small sections and comb small areas toward the scalp.  If necessary you can also remove nits with your fingers or tweezers.  You should continue to check your child's head for nits in case of reinfestation.  Typically nits closer than 3/8 of an inch to the scalp indicate a new infection, nits further down the hair shaft than that indicate an old infection.  Usually, children can return to school the day after treatment but you should consult your individual district regarding their policy.
To prevent the spread of lice to others, encourage your child not to share personal items (pillows, brushes, hats).  Lice can be killed by washing items in hot water for fifteen minutes or in a hot dryer for 30 minutes.  Items that cannot be washed can be sealed in a plastic bag for 10-14 days.  Floors and furniture can be vacuumed.  It is not necessary to spray bug spray or other chemicals in your home.  Lice can only live for 1-2 days away from body heat and the chemicals can be dangerous to your health.
For more information on lice and their treatment, contact your Pharmacist or your physician.

December 2002

Co-edited by:
John Witt, Pharm.D.
Sarah Kerner, Pharm.D.

Inside this issue: