Though there is a certain stigma attached to getting head lice, it is not as bad as you think. It is not a sign of poor hygiene; it is not limited to certain racial or ethnic groups. Head lice have often been mis-associated with poverty.

The truth is any human head is susceptible to lice if exposed through person to person contact. Head lice can occur at any age and to either sex . . . it could happen to your family. So it is wise to learn how to recognize and treat head lice infestation and how to prevent re-infestation.

WHAT ARE HEAD LICE?

The head louse (plural lice) is a type of insect known as Pediculus capitis. They can be gray, brown or black in color. It has six claw-like legs, a pointed head and a flat, elongated and wingless body.

The head louse is a parasite--meaning it needs a (person's) head for nourishment. Once lice make their way to the scalp, lice begin to feed. They live by biting and sucking blood from the scalp. Their feeding causes itching. Lice can live up to 48 hours off the human body. Head lice do not jump or fly. They do crawl rather rapidly--up to 12 inches per minute.

Lice lay their eggs (nits) on the hair shaft usually less than half inch from the scalp. It takes about six days for the nits to hatch. Nits can survive up to 30 days off the human head. Once the eggs hatch, the lice reach adulthood in seven to ten days. When fully mature, they multiply quickly. During their one month life cycle, females can lay between 150 - 300 eggs.

Nits are oval shaped and are strongly attached to the hair. Most often they can be seen in the hair behind the ears or the nape of the neck.

Head lice are not a reportable public health problem, but researchers estimate that approximately three million Americans are affected each year. Nearly all public health officials concur that this incidence is increasing.

With the exception of the common cold, head lice probably affect more children in the United States each year than all other communicable diseases combined.

Animals do not carry human head lice, so there is no need to treat family pets.

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SYMPTOMS

Persistent itching of the scalp and back of the neck is the most common symptom. Scratching can lead to skin sores and infection.

You should look for nits attached to individual hairs. These can be seen with the naked eye, but you could probably identify them more easily with the aid of a magnifying glass under good lighting. Sometimes dandruff or droplets of hair spray can be confused with nits. Try removing the specks from the hair shaft. Dandruff or hair spray will come off easily whereas nits are very difficult to remove.

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HOW ARE HEAD LICE SPREAD?

Infestation with head lice is a problem unique to human (the insect does not live on other animals) and is most common among school-age children. This is because children spend so much time in close proximity to each other.

Since lice are so contagious, even the cleanest person can become infested by person to person contact with another person who has lice (most likely way), by wearing another person's hat or clothing, by using another person's comb, brush, or bedding, or by placing clothing worn by someone who has lice in a shared clothing storage compartment (cubbies), locker, or cloak room.

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HOW CAN LICE OUTBREAKS BE PREVENTED?

Check your children's hair WEEKLY for lice or nits and treat the hair right away if you find them.

Provide separate storage areas for clothing and other personal articles. Assign cubby hole areas for each child in school or child care settings. (Place personal articles in individual bins or sacks) . Assign sleeping mats and bedding to only one person and store these separately.

Teach all family members to stop sharing personal items such as hair brushes, hats, hair ribbons, barrettes, head bands, combs, etc., whether at home, school or work. If your child lives in two households, moving back and forth between parents and other relatives, those households also need to be checked for lice and go through a complete cleaning process as directed in section "What Else Do I Need to do?".

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HOW DO I TREAT HAIR TO GET RID OF LICE?

Once head lice are found, the problem should be taken care of quickly in order to prevent it from spreading to others. One such treatment to safely eliminate lice and their eggs, is with a lice crème rinse, Nix*, that can be purchased without a prescription from any drug store. It is the most effective of the available treatments.

1. Wash the hair with a mild shampoo that contains NO CONDITIONER. Apply Nix crème rinse taking care to keep it out of the eyes, nose and mouth. Let it remain on the hair for 10 minutes. If Nix gets in the eyes, flush it out with water immediately.

2. Rinse the hair with water. After towel drying the head with a clean towel, do not reuse the towel, put it in the laundry.

3. Use a comb to divide the hair into four equal parts (quarters). Select one "quarter" in which to begin combing. Lift up a portion of the hair approximately one inch wide out of the quarter selected.

4. Starting at the top of the scalp, using a firm and even motion toward the end of the hair strand, use your fingernails to remove the nits. A LiceMeister™ brand comb may be used to help remove lice and nits (to order, call toll-free 1-888-542-3634).

5. Pin back each one inch portion of hair with a bobby pin or hair clip. Continue this procedure until the first "quarter" is completed. Do not drop the nits on the floor, put them in the garbage.

6. Repeat the above procedure for the remaining three "quarters" until all of the hair has been picked and pinned.

7. Remove all hair pins and thoroughly rinse the entire head of hair with water. Do not re-use the hair pins until washed in hot soapy water.

8. After hair has dried, recheck entire head for stray nits and remove any remaining nits. Remember, you may have to repeat this procedure more than once.

9. Examine all family members for the next three weeks. If any live lice are seen, repeat treatment. You may use Nix again after 7-10 days, but this is not usually necessary. The product, if directions are followed, is at least 95% effective at getting rid of the lice and its lice killing effects continue to work for up to 14 days.

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CAUTION!

• NEVER mix Nix with other lice treatments.

• DO NOT USE any other crème rinse, shampoo containing crème rinse, hair spray, mousses, gels, mayonnaise, nor vinegar on the hair for at least one week AFTER using Nix because they may weaken the action of Nix.

• Do not use Nix on children who are less than two months old. (Pregnant and breastfeeding women should consult their health care provider before using Nix).

• Chlorine in pool water may also deactivate Nix leading to some treatment failures.

• Never use Nix on eyebrows and eyelashes. Lice may be removed from these sites by plucking them off with the hands or tweezers or by applying an ophthalmic grade petrolatum ointment twice daily for 8 to 10 days.

• Never use Nix more often than recommended as it is an insecticide and can be poisonous. Overuse of any lice medication may result in side effects such as contact dermatitis (skin inflammation/rash) and other medical problems.

• Never use dog or cat flea and tick spray on your child.

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WHAT ELSE DO I NEED TO DO?

Check other household members for lice. Treat other family members who have lice. Do not treat someone if you do not see lice or nits in their hair unless they are the infested person's bed-mate.

Notify your child's school and child care program if your child has lice.

Launder all clothing (including coats, hats, scarves) and bedding used by the infested person in the 48 hours prior to the treatment. To launder these items, do ANY of the following:

• Wash the items at temperatures exceeding 130⁰ F for at least 20 minutes.

• Dry in a hot dryer for at least 30 minutes.

• Dry clean the items that cannot stand high temperatures.

• Pack the items in a sealed plastic bag for a minimum of two weeks. (This also works for small items such as barrettes, headbands, ball caps, hair ribbons, head gear, transistor earphones, head phones, etc.)

• Every day, change beds and wash the bedding. Keep children in their own beds at home.

• Every day, wash hair with regular shampoo and (most important) go through hair to remove any nits found. Wash all combs and brushes used by the person. These may be cleaned by washing them in hot soapy water (temperature greater than 128⁰ F) for at least 10 minutes every day for a week.

• Vacuum, vacuum, vacuum. Vacuum upholstered furniture, pillow, carpets, bicycle helmets, sports helmets, and upholstered care seats every day for a week. Change vacuum cleaner bag after use.

• There is no evidence that lice sprays are necessary or effective. They may cause allergic reactions. The health department does not provide or recommend them.

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ADDITIONAL INFORMATION

Each school district and child care program sets their own head lice control policy. Please consult them if you have questions about their policy.

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*Nix is a registered trademark of the Warner-Wellcome company.