Affinity Health Plan

  • Killing a Case of Head Lice

    October 12, 2015

    No child or parent wants to deal with head lice. But with an influx of children in schools and day care centers, catching head lice is an unwanted possibility.  Pediculus humanus capitis - (the clinical terminology) - are highly contagious but are not considered a health hazard since they don't carry disease. They are just pests.

    "We are more likely to see cases when they are together during the school year," says Dr. Avi Silber, Chief Medical Officer of The Greater Hudson Valley Family Health Center. He explains that it's because young children pass it to each other by direct head-to-head contact.

    National statistics are not kept on people afflicted with head lice.  But the Centers for Disease Control and Prevention (CDC) in Atlanta estimate that from 6 million to 12 million children between 3 to 11 years old are infested annually. While children are the most likely victims, anyone can get them. Head lice have thrived for centuries. While having them is unpleasant, it certainly does not mean that the afflicted person is unclean.

    Head lice can't jump, hop or fly.  They crawl, and they do crawl fast. That is how they are contracted, by crawling onto - or catching hold of - a single strand of hair.  These tenacious parasites do not live on dogs, cats, or household pets and cannot be caught from them.  They live solely on the human head and thrive by feeding on blood drawn from the scalp.  In the beginning, as nits, they are so tiny that they can be mistaken for dandruff.  But, head lice multiply exponentially. Within a few weeks, they become a full-blown infestation.

    Head lice have three stages of life:

    • The egg, called nits, are laid close to the scalp by the female and bound to the hair by the female lice.
    • The egg hatches into a nymph, the size of a pinhead. They cling onto hair shafts with claws, making them difficult to remove.
    • Within seven days they are adults, about the size of a sesame seed. The female can lay up to eight nits daily. Their life span is about 30 days.

    How you get them

    One point is undisputable. Head lice can be caught by hugging an afflicted person. Another way is to handle an infested person's hair, then touching your own hair before washing your hands.  It's also possible to contract them by using an infested person's combs, brushes and personal objects. But that is unlikely. "Head lice found on combs are likely to be injured or dead," Dr. Silber says, adding, "A louse (singular for lice) is not likely to leave a healthy head unless there is a heavy infestation." Although, it does make sense to avoid sharing combs, brushes, and other objects that touch the head, he says.

    The jury is out on catching head lice while taking a selfie. Teens and adults usually take them, and they are not the target age for lice. Some medical professionals argue that people don't hold their heads together long enough to catch them. While others say people take selfies at their own risk.

    An itchy scalp is the main symptom for head lice. But, after first contact, it can take weeks before that starts. If your child is scratching and says the scalp tickles that is a sign that an infestation has started. To check, part the hair into sections with a fine tooth comb and carefully search for them. Use a magnifying glass, if necessary. If they have taken hold, the lice can be visible behind the ears near the neckline.

    These parasites are most active at night, in the dark. If your child wakes up, itching, testy and complaining that something is touching or moving around on his or her head, check carefully. If you find them, don't panic. "They are just a nuisance and not dangerous," Dr. Silber says. He recommends purchasing an over-the-counter treatment such as Nix the next day. Treat your child, and comb out the nits, using a nit comb.

    If the lice aren't present and your child still complains, see a doctor.  "Seborrheic Dermatitis (dandruff), ring worm and other causes should be ruled out," he advises. If the over-the-counter treatment doesn't work, if more than one case is in the household, or if you are unsure as to whether your child has them, see a doctor or a health care provider.

    How to get rid of them

    Getting rid of them isn't so easy.  Once head lice are found, the entire household must be checked. Anyone with them must be treated. Also, anyone sharing a bed with someone who has it should be treated. Usually two treatments are needed about a week apart. Even then, it might not work. "Insects develop resistance to products over time," Dr. Silber explains. Your doctor will then prescribe alternative products.

    To be thorough, after the treatment begins wash the afflicted person's clothes, bedding, linens, towels, stuffed toys in hot water. Dry them in a hot dryer for five minutes or longer to kill the lice. Dry-clean anything that can't be laundered or bagged items in plastic for two weeks. Wash combs and brushes in hot water for at least five minutes. Vacuum the furniture and floors to remove all hairs.

    The good news is that head lice die shortly after being removed from the scalp. Without blood, nymphs (lice that have recently hatched) can survive only a few hours, adults, about one day. The nits live the longest, about a week, according to the CDC.

    Avi Silber, MD, FAAP, is the Chief Medical Officer forThe Greater Hudson Valley Family Health Center. His specialty is Pediatric and Adolescent Medicine. A graduate of Temple University School of Medicine, Dr. Silber is a member of the American Association of Pediatrics and the Orange County Medical Society. His last story was Poison Ivy is Always in Season.  He and the staff at The Greater Hudson Valley Family Health Center provide services to members of the Affinity Health Plan.


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