Nothing gives our favorite Connecticut parents the heebie jeebies like a case of head lice! Head lice (pediculosis capitis), while relatively harmless to children, causes great anxiety and stress to families who find themselves dealing with a lice infestation.
Before we get into the “nit-ty” (pun intended) gritty, there are two things we’d like to remind our Willows Pediatrics patients of: (1) that head lice is not a sign of poor hygiene and (2) head lice do not carry disease.
Head lice is most prevalent in school–aged children, kids 3-11 years of age. Although it is difficult to say how many children get lice each year, the CDC estimates that 6-12 million infestations occur annually in the U.S. The adult head louse is about the size of a sesame seed and is usually tan or grayish in color. Female lice can live up to 4 days and can lay up to 10 eggs a day, which attach to the base of the hair. The eggs are incubated by body heat and hatch between 8 and 12 days.
The good news is that lice cannot hop, fly or crawl. Transmission occurs most often via direct contact with the head of an infested individual. The AAP in a policy statement notes that “a healthy louse is not likely to leave a healthy head unless there is heavy infestation.” To support that, the AAP notes that one study found live lice on only 4% of pillowcases of infected individuals. Therefore, the major preventative strategy should be to reduce direct head-to-head contact.
Rarely, lice can be transmitted through use of that individual’s combs, brushes or hats. Because that form of transmission is so rare, we at Willows Pediatrics (and the AAP) advise that no child refuse to wear protective headgear because of fear of lice infestation.
The providers at Willows Pediatrics are happy to help a parent confirm the diagnosis of head lice. (Lice is often misdiagnosed by parents and school personnel, leading to “failures” of lice therapy.) Once a case of head lice has been confirmed, over-the-counter therapy is prescribed. This usually consists of two applications of one percent permethrin lotion (Nix) separated by 7-10 days, and daily nit-combing during that interval. True treatment failures due to resistance to permethrin may require prescription medication to eradicate the infestation; in these situations your provider at Willows can assist you. Children should not be excluded from school because of the presence of nits.
Itching or mild burning of the scalp caused by inflammation of the skin in response to topical therapeutic agents can persist for many days after lice are killed and is not a reason for re-treatment. Topical corticosteroids and oral antihistamines may be beneficial for relieving these signs and symptoms.
Enjoy the school year, and may it be a louse-free one!