The Mayo News

Head lice – pesky passengers


Nuturing
Sabine Hiller

School has started, and it’s that time of year again when head lice rear their ugly little heads… So, how do you know your kids have them, are they a health hazard and what can you do about them?

Symptoms
The main symptom of a head lice infestation is an itchy scalp. In addition, children with head lice will have grey or reddish-brown live head lice scurrying around their scalp. Adult head lice are about the size of a sesame seed, and although head lice don’t fly or hop, they can crawl very fast, making them hard to spot. You may find some of the oval-shaped eggs (nits) that the female hair louse cements onto hair shafts, but they can be difficult to make out. It’s mostly the empty egg-case that’s left after the louse nymph has emerged that people see.

Health issues
It is important to know that head lice rarely (if ever) cause direct harm. They don’t transmit infectious agents from person-to-person and usually should not, therefore,  be considered a medical or public health problem. 
However, head lice are annoying, they can cause itching and loss of sleep. The louse’s excretions may sensitise people to their bites, which can worsen the irritation and lead to increased itching and scratching. Excessive scratching in turn can cause the bites to become infected and appear red or crusty. Sometimes, such secondary infections can be associated with swollen lymph nodes in the neck.
Clearly, a long-term infestation combined with poor general health can lead to further health problems. However, nowadays the main issue is not to panic and worry if you discover these little passengers on your child’s head! Panicking won’t kill the head lice and will likely lead to over-treatment and anxiety in your child, who may be concerned that they have ‘bugs’ in their hair.

Treatment
So, relax, take out your lice comb and get some quality time with your child combing their hair! Do not apply toxic head-lice treatments onto your child’s head just because they complain of an itchy scalp or because you think you saw ‘something moving’. Sometimes what is taken to be ‘lice and nits’, turns out to be simple things, such as dandruff, hairspray droplets, scabs, dirt or other insects (like aphids blown around by the wind that get caught in the hair). Make sure you have actually identified a live louse before applying treatments.
The greatest harm associated with head lice results not from the lice themselves, but from the well-intentioned but misguided use of caustic or toxic substances to eliminate the lice.
An infestation may be eliminated by combing each day to remove the live lice (including those that have hatched since the previous day). You need to thoroughly comb daily with a good louse comb, until no live lice are discovered for about two weeks.
Although the hair may appear ‘peppered’ with eggs, there generally are fewer than a dozen active lice on the head at any time. Adult female lice usually cement each egg to the base of a hair shaft near the skin. As the hair grows, these attached eggs are transported away from the scalp. Eggs more than half an inch away from the scalp are nearly always hatched and do not, by themselves, indicate an active infestation. 
Choose a comb fine enough to remove juvenile as well as adult lice. Some parents find that water, vegetable oils or hair conditioners help lubricate the hair and ease the combing. 
There are various herbs that can help eliminate head lice – external applications containing neem oil, quassia bark (Picrasma excelsa), tea tree oil and several other essential oils have all been shown to be safe and effective – in some cases as effective as pyrethrine-based treatments. As some lice seem to have become resistant to pyrethrine (and many parents want to avoid using it in the first place), these herbs may provide good alternatives. In any case, try to stay away from the stronger insecticide treatments containing lindane or malathion.

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