Q & A HEAD LICE
BY Queen City Physicians Staff

What are head lice?

Head lice are small mites that only live on human beings. The "bugs" are approximately 1/16 inch long and are gray in color. Each louse can lay 50-300 eggs (nits) which are white or yellow in color and are firmly attached to hairs. Unlike dandruff or other scalp debris, nits cannot be shaken off.

Are head lice a sign of poor hygiene?

No. Lice are an infestation that occurs in all socioeconomic groups and is not due to being dirty or unhygienic.

How is it spread?

Lice are spread from person to person in close contact. Contrary to popular belief, lice are not capable of leaping from head to head. They have very short legs and therefore require head-to-head contact in order to spread. Although it is not likely, lice may spread from combs, brushes or hats which are used immediately after an infested person has used them.

How will I know if my child or I have lice?

There is usually itching of the scalp especially at the back of the neck and behind the ears. The louse itself is difficult to see because of its small size and ability to scurry quickly under hairshafts when they are parted. The nits however, are usually very easily seen and are unique from dandruff in that the nits must be literally pulled off the hairshaft in order to be removed. The nits are usually located within a few millimeters from the scalp. Nits that are noted farther away from the scalp are usually nonviable or have already hatched.

Can lice carry other diseases or cause long lasting problems later on?

No, they do not carry other diseases nor do they cause any lasting problems.

How do I get rid of lice?

There are many over the counter anti-lice preparations but they must be used with caution as they do have potential side effects and toxicities (check the label as some are not recommended for infants). The same holds true for prescription anti-lice shampoos. Most drugstores carry Nix® or Rid® shampoo which is lathered into the hair for 20-30 minutes before being rinsed thoroughly. Since young nits are not susceptible to this treatment, it is a good idea to repeat this shampoo treatment 1 week later in order to kill the remaining viable nits. An even safer and perhaps more effective treatment method for resistant infestations is smothering the lice with a fatty substance such as mayonnaise or mineral oil. The substance is massaged thoroughly into the hair and covered with a shower cap for 1 hour. White vinegar can also be mixed with equal parts mineral oil before treating. The vinegar helps break down the nits for easier removal. After these substances or lice shampoo have been washed out of the hair the nits must be removed with a "nit" comb which has very closely spaced teeth. Most schools will not let a child return to the classroom until all the nits are removed, however, remember to pay special attention to the nits that are within 3-4 mm of the scalp as these are usually the only viable nits. If these treatments fail, call your physician for alternative treatment.

Do I need to clean my house after treating my family and myself for lice?

It is a good idea to wash all linens (bedsheets, blankets and clothing worn in the last few days). You may want to put aside difficult to wash items such as a coat or fine washables in a plastic bag for a few days as lice can only survive off the human body for 3 days. Also, it is a good idea to vacuum the common areas of the house.