Head Lice

With the back to school season in full swing, many parents of young children face a common source of panic: the human head louse. Lice, which live very close to the warm scalp and feed on our blood, have co-existed with people since before the dawn of civilization. The good news, is that they do not carry diseases and thus, pose no actual danger to our general health. The worst possibility is secondary infection due to excessive scratching. The bad news is that these parasites may cause a very itchy scalp and much distress, as they can be difficult to detect and even harder to eradicate. An estimated 6 to 12 million Americans are infested annually, and many myths and misconceptions often circulate among those of which are at risk or involved.

First off, let’s cover the facts. Lice have three life stages: the egg (nit), nymph, and adult. Nits are very small and hard to see with the naked eye. Adult female lice may lay up to eight nits per day, which become firmly attached to the base of the hair shaft. Nits are white or light brown in color, and they hatch into nymphs after about one week. A pinhead-sized nymph leaves behind a more easily visible open egg shell, which is frequently misidentified as a viable nit. Adult lice vary in color between grayish-white and light brown and are about the size of a sesame seed. Adult lice live about one month and feed several times each day during their life span. Lice must remain in close contact with their human host to survive. They will die after about 1 to 2 days without a blood meal.

Unfortunately, as with any issue that is prone to cause people distress (or in some cases, hysteria), many myths and mistruths abound regarding head lice. First and perhaps foremost, catching lice has nothing to do with poor personal hygiene or lack of cleanliness. In fact, anyone with hair (even short hair) is at risk, including adults. The most likely way to catch lice is through headto- head contact. It is much less likely to catch lice through the sharing of hats, combs, or brushes, though it makes good sense to not share such items in the case of known infestation. Close personal contact is by far the greatest risk factor, thus increasing risk for young children and their parents. Given this fact, any time lice is discovered, all members of the household should be examined to rule out additional cases. Finally, lice cannot jump or fly through the air from person to person. Fleas may be experts at jumping, but lice don’t have the ability to jump or fly.

Once a case of lice is identified, a quick online search will yield many dozens of treatments. One will find a myriad of natural treatments, several over-the-counter (OTC) shampoos, and a few prescription medications available to eradicate lice. Some non-drug approaches have produced some promising results in studies, but others such as mayonnaise or olive oil application, high heat blow drying, or water immersion may produce little to no effect. OTC drug treatments are often effective, but some lice have become resistant to OTC shampoos and applications. Finally, there are a handful of prescription topical and oral treatments that will effectively eradicate lice, though patient age, general health, and risk factors must be considered when choosing certain prescription treatment options. Regardless of treatment choice, a nit comb is required. This is a very fine-toothed metal or plastic comb that is essential for wet-combing to dislodge live nits, nymphs, and adult lice. It is a key tool to aid in the eradication of lice. If you know or suspect you are dealing with a lice infestation, please feel free to contact Advanced Dermatology to schedule an appointment with a provider for a thorough scalp exam and discussion regarding treatment options if necessary.