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Medical Edge Newspaper Column from Mayo Clinic
THE FOUR STEPS FOR GETTING RID OF HEAD LICE
DEAR MAYO CLINIC: Last year, my first grade daughter got head
lice the third week of school. My 3-year-old son got them from her before
we actually knew what was going on, so he took them to day care and spread
them around. I got them too.
By Halloween we were a wreck from all the washing, spraying, combing and
cutting. My son’s head was buzz cut. My daughter has long hair and we
tried everything so we wouldn’t have to cut it, including sleeping with
it soaked in olive oil under a shower cap for a week. Please help me prepare
for the notes in the backpacks about lice that will be coming home soon.
I dread it. — Indianapolis
ANSWER: Back to school can also mean back to “nit-picking,” because
large numbers of children in close quarters promote the spread of head
lice — regardless of socioeconomic class and how clean your home is. Nearly
every family experiences them at some point. They don’t transmit disease,
but they are both a shock and a nuisance.
Head lice are gray-brown, wingless insects that crawl from person to person.
They can’t fly and they can’t hop. Each adult louse is about as big as
a grain of rice. Lice lay eggs (called nits) that attach to the base of
the hair shaft by using a highly adhesive secretion. The nits can be removed
by special combs with closely-spaced teeth (called nit combs) that are
available at most pharmacies and beauty supply stores.
The first sign of head lice is frequent itching, often at the nape of
the neck and behind the ears. In order to survive, lice must bite and
suck blood from the host. Itching occurs at the site of the bite.
To check for lice, use a clean Popsicle stick or similar aid to push the
hair up and expose a section of scalp. Then comb the section beneath it
with the nit comb. Work the entire head this way, sectioning as you go,
examining the entire scalp under a bright light. Reading glasses that
magnify may help.
Nits look like translucent yellowish drops of glue, about the size of
a sesame seed. Hold the nit comb up to the light and you’ll see the nits
lodged at the base of the comb’s teeth. Don’t panic: You’ll also remove
many things that are NOT nits, such as bits of dandruff and debris, which
is why magnification and bright light help to sort it all out.
Finding a nit indicates you need to kill both the adult that is laying
the eggs and the egg itself, so it doesn’t hatch into an egg-laying adult.
Delousing involves four steps:
1. TREAT. Ask your pharmacist to recommend over-the-counter, lice-killing
lotions and shampoos, and follow the directions. Medicated shampoos are
almost always effective, and most people find them easier to use than
the smothering-oil technique you tried with your daughter. True resistance
to treatment is very unusual. Infections that persist are usually due
to either inadequate removal of nits or reinfection from an incomplete
treatment.
2. COMB. Keep combing the entire scalp (ITALICS) daily (END ITALICS) with
a nit comb, removing nits with the comb; otherwise they’ll hatch and lay
eggs. Nits come off more easily if the hair is rinsed in a solution of
half vinegar and half water before the combing. After you’re done, clean
the comb thoroughly with hot soapy water, soak it in rubbing alcohol for
an hour, or boil metal combs.
3. DECONTAMINATE. All bedding, clothing, hats, pillows, brushes and other
contaminated items must be washed in hot water, and if possible, dried
on high in a drier. Put contaminated items that can’t be washed — such
as stuffed animals — in a freezer or an airtight plastic container for
10 days. Thoroughly vacuum mattresses and upholstery — including car seats.
4. KEEP COMBING for a week or more: Continued vigilance is your best assurance
against reinfestation.
Lice and delousing are usually hardest on the parents. Try to keep a sense
of humor about it. Parents can consult a physician if the lice keep coming
back or if the parents have any other concerns.
Phil Fischer, M.D., Pediatrics, Mayo Clinic, Rochester, Minn.
Additional Resources:
Treating Head
Lice
Appointment
Information
More
Information on Head Lice
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Medical Edge from Mayo Clinic is an educational resource and doesn’t
replace regular medical care. To e-mail a question, go to www.mayoclinic.org,
or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite
114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.
© 2004 TRIBUNE MEDIA SERVICES, INC.
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