By Kathy Sinkin, RN, CDE
Years ago, my daughter and her neighborhood friend came home with severe cases of head lice. I read everything I could about lice, and did everything that was suggested. This included washing bed linens and clothes in hot water, drying clothes and linens in the dryer for at least 30 minutes, bagging all stuffed animals, and vacuuming constantly. I bought all kinds of over-the-counter treatments and combed through her hair with a metal comb, all to no avail. One day when my daughter got off the bus, she and her friend went over to their bikes and put on their bike helmets as they always did. Bingo! The bike helmets had lice in them! Once we threw the helmets away, the lice were no more!
Head lice are tiny, wingless parasitic insects that live among human hairs and feed on tiny amounts of blood drawn from the scalp. Lice are a very common problem, especially for kids. They’re contagious, annoying, and sometimes tough to get rid of, as I found out. But while they’re frustrating to deal with, lice aren’t dangerous. They don’t spread disease, although their bites can make a child’s scalp itchy and irritated, and scratching the scalp can lead to infection. It’s best to treat head lice quickly because they can spread easily from person to person.
Although they’re very small, lice can be seen by the naked eye. Look for lice eggs which are called nits. These look like tiny yellow, tan, or brown dots before they hatch. Lice lay nits on hair shafts close to the scalp, where the temperature is perfect for keeping the nits warm until they hatch. Nits look like dandruff, only they can’t be removed by brushing or shaking them off.
Unless the infestation is heavy, it’s more common to see nits in a child’s hair than it is to see live lice crawling on the scalp. Lice eggs hatch within 1 to 2 weeks after they’re laid. After hatching, the remaining shell looks white or clear, and stays firmly attached to the hair shaft. This is when it’s easiest to spot them, as the hair is growing longer and the egg shell is moving away from the scalp. Adult lice are no bigger than a sesame seed, and are grayish-white or tan. Nits are smaller and become adult lice about 1 to 2 weeks after they hatch. If head lice is not treated, this process repeats itself about every 3 weeks. Most lice feed on blood several times a day, and they can survive up to 2 days off the scalp.
Your doctor can recommend a medicated shampoo, cream rinse, or lotion to kill the lice. These may be over-the-counter (OTC) or prescription medications, depending on what treatments have already been tried. Medicated lice treatments usually kill the lice, but it may take a few days for the itching to stop. Lice bites cause itching and scratching, due to a reaction to the saliva of lice.
To remove lice and nits by hand, use a fine-tooth comb on your child’s wet, conditioned hair every 3 to 4 days for 3 weeks. Wetting the hair beforehand is recommended because it temporarily immobilizes the lice, and the conditioner makes it easier to move a comb through the hair. Try all these treatments and don’t forget to throw away the bicycle helmet!
Kathy Sinkin is a Registered Nurse and Certified Diabetes Educator with Cornell Cooperative Extension of Suffolk County’s Family Health and Wellness Program. She can be reached at kas239@cornell.edu