Are Head Lice Bugging Your Child?

These stubborn bugs live on the scalp for up to 30 days. Here's a how-to guide for preventing and treating head lice in children.

Around 6 to 12 million cases of pediculosis capitis, or head lice, occur every year in the United States in 3- to 11-year-old children. Parents of children in elementary school and day care centers in particular should be ready to handle this widespread problem. People of any age can be exposed to head lice, though, so it is important for everyone to be knowledgeable.

Head Lice Basics

Head lice cannot fly or jump. They have claws that allow them to live on the scalp by clinging firmly to hair. Adult head lice are roughly the size of a sesame seed, can live for up to 30 days on a person’s head, and are tan to grayish-white in color.

These stubborn bugs lay eggs, called “nits,” on the hair follicle. Nits can look very similar to dandruff flakes, making head lice difficult to diagnose. The noticeable difference is that head lice will usually stay put on the scalp, but dandruff is merely skin flakes and will easily fall off.

Head lice themselves aren’t dangerous, but they are highly contagious, which can make them a major nuisance. These parasites are typically spread by coming in close contact (usually direct head-to-head contact) with a person who has lice or by using personal items such as hats, combs, brushes, or towels of someone who has lice.

Having head lice does not mean you are dirty or that you have poor hygiene. If children with head lice understand this, it can help them overcome any social or emotional issues that may come with an outbreak.

Head lice are not known to carry bacteria or viruses, so they are not typically associated with other medical conditions or infectious diseases. However, excessive itching and scratching may cause skin to break or tear, which can lead to a skin infection.

Symptoms of Head Lice

The classic symptom of head lice infestation is itching. This can lead to irritation and inflammation of the scalp. The itching is caused by these tiny insects biting into your skin to get blood, on which they must feed to survive. Without blood, a louse will die within 1 to 2 days.

Before itching occurs, you may feel a crawling or tickling sensation on the scalp from the lice moving around. Other signs of head lice include finding tiny white specks on the bottom of a hair follicle and small red bumps on the scalp that may become crusty.

Treating an Outbreak

There are many OTC treatment options for head lice, the most common being shampoos, creams, and lotions. These work in a variety of ways, typically through either suffocating or paralyzing the lice.

Most of these OTC products are applied twice. The first application is to kill live lice, and the second is to kill remaining nits that may be resistant to certain toxins or chemicals. This treatment strategy catches the lice early so that they are unable to reproduce and their nits are unable to hatch.

It is important to closely follow treatment directions, because another outbreak can occur if the lice are not completely gone. Also, if left untreated for long enough, lice can spread to other parts of the body. Medications for treating lice may differ slightly. It is very important that you follow the instructions exactly as printed on the bottle to ensure safe and effective usage.

Topical or oral antihistamines can be used to relieve itching from lice. To protect skin that has torn or broken from infection, OTC antibiotic creams or ointments are available. Moisturizing products can also help to soothe damaged areas and aid in the healing process. Talk to your physician or pharmacist to determine which products are appropriate and safe to use based on your individual situation. If OTC treatment options do not work, there are prescription medications available. Check with your doctor or pharmacist to see if these options are appropriate.

Prevention Tips

• Tell your child to avoid headto-head contact with others at home, school, day care, or anywhere else where there is the potential for lice to spread.
• Make sure your child does not share any personal items, such as hats, combs, brushes, or towels, with anyone else.
• Wash all clothes and bed linens that have been used by someone infested with head lice in hot water.
• If a family member has been infested with head lice, it is important to periodically check everyone in your household.
• It is important to minimize outbreaks by immediately contacting your child’s school or day care center if your child has head lice (their policy may be that your child has to stay home until treatment has been completed).

Mr. Fox is a PharmD candidate at Raabe College of Pharmacy, Ohio Northern University. Dr. Prescott is senior vice president of clinical and scientific affairs for Pharmacy Times.