Information

The head louse is a human parasite, and cannot exist away from humans. They can however survive for up to 2.5 days without a host. Children, especially girls, are susceptible to infestation. It is estimated that 6 to 10 million children are infested annually. The eggs hatch after a 8 day incubation period and require another 7-8 days to mature. They are barely visible to the naked eye, and are usually white to tan, turning red-brown after feeding. The itch is caused by salivary secretions and the bite itself. Infestation usually occurs by personal contact, putting on infested clothing, contact with upholstered chairs, or infested combs and brushes.

Nits are actually the eggs of the head louse, glued to your child's hairs. They are white tan particles seen on the hair-shafts about a half-inch up from the scalp. They are distinguished from dandruff by how difficult they are to remove from the hairs. They are usually found along the back of the neck and behind the ears. The nits will glow when a special light is used; your dermatologist can help you with this light if the itch persists after apparently adequate treatment. Live nits will glow; dead ones will not

Treatment

The treatment of choice is a solution or cream rinse containing permethrin 1% (Nix, others). Pyrethrin / piperonyl butoxide formulations are also effective. Both have very good safety records and there is no evidence that multiple treatments are harmful. Although pyrethrin has the possibility of causing a reaction in asthmatics or people sensitive to ragweed, it is extremely unusual. As with any prescription or over-the-counter medicine, read all instructions carefully, and follow them. More is definitely not better. Elimite (5% permethrin) and Kwell lotion have also been used in more resistant cases. Contact your dermatologist with any questions before you treat your child.

Permethrin's effect can last for up to 14 days, but a second treatment at 7 days is advisable because of the likelihood of reinfection at school. Persons in contact with your child should be examined closely and treated if necessary. Clothes, bed-clothes, and hats should be washed in hot water. Play areas, floors, and furniture should be well-vacuumed and sprayed with pyrethrin spray. Dry-cleaning is also effective. Brushes, combs, barrettes and other hair-care items can be soaked in rubbing alcohol for 1 hour. Stuffed animals should be sprayed, and put in a plastic bag for 1-2 weeks. White vinegar soaks to the hair followed by a towel saturated with vinegar wrapped around the head for an hour can help in the removal of the nits; the glue is softened by the vinegar. Don't forget to treat clothes kept in dress-up boxes or kept in knapsacks. Shaving the scalp is effective, but may be a bit drastic.

It is very important that you closely examine your child. If you find evidence of infestation, treat it appropriately and keep your child home for a day or two. You will keep your child from infesting others, and stop re-infestation as well. The information contained herein is meant for informational purposes only. Before treating your child, contact your dermatologist.

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