Lice

Lice are tiny, highly contagious insects that infest human hair, eyebrows, or eyelashes, and are especially common among schoolchildren. Infestations can result in symptoms like itching and the appearance of red bumps on the skin. Effective management involves using a fine-toothed comb to remove lice eggs, thoroughly washing bedding and clothing, and applying specific lice treatments. These treatments include medications such as antiparasitic agents, cholinesterase inhibitors, pediculicides, and pyrethroids.

Causes

Lice are small, parasitic insects that survive by feeding on human blood, and they spread primarily through direct contact with an infested person. They can also be transmitted via shared personal items like clothing, bedding, and hair accessories. Three main types of lice can infest humans:

• Head Lice: Laying eggs on hair shafts, these lice are commonly transferred through head-to-head contact, often among children.

• Body Lice: While they inhabit clothing, body lice move to the skin to feed, thriving in conditions with poor personal hygiene, such as overcrowded living situations.

• Pubic Lice (Crabs): Typically spread through sexual contact, pubic lice can also sometimes spread via shared infested items, despite their inability to jump or fly.

Symptoms

Several symptoms can indicate the presence of lice:

• Itching: The most common symptom, caused by an allergic reaction to lice bites.

• Sensation of Movement: Some people may feel the sensation of something moving in their hair.

• Visible Signs on the Scalp: Small red bumps or sores may develop from frequent scratching.

• Swollen Lymph Nodes: Particularly in children, swollen lymph nodes around the neck can occur.

• Nits: Lice eggs, or nits, may appear attached to hair shafts, particularly near the ears and nape of the neck. They resemble dandruff but are difficult to remove.

• Secondary Skin Infections: Intense scratching can lead to skin infections, stressing the need for prompt attention.

It’s important to note that lice, though troublesome, do not transmit diseases.

Diagnosis

Lice are tiny, wingless parasites that cause significant itching and discomfort. Diagnosing a lice infestation involves detecting live lice or their eggs, known as nits, on the scalp. Nits, attached to hair shafts, are usually more noticeable than lice themselves. Using a fine-toothed comb on wet or conditioned hair can help reveal these eggs or lice. The presence of nits close to the scalp indicates a recent infestation, but finding live lice confirms an active problem. If identifying lice is challenging, consulting a healthcare provider or a school nurse can ensure an accurate diagnosis.

Treatments

Effectively dealing with lice requires a strategic approach. Start with over-the-counter shampoos or lotions that contain ingredients like Permethrin or pyrethrin, specifically designed to eliminate lice and their eggs (nits). Follow the package instructions closely for optimal results. If infestations persist, prescription treatments might be needed, including stronger solutions like Malathion or Benzyl Alcohol applied directly to the scalp and hair. Treatments should be repeated after seven to ten days to ensure all lice and nits are eradicated. Combining this with using a fine-toothed nit comb can physically remove lice and nits. During this period, wash clothing, bedding, and personal items in hot water to avoid re-infestation. Consulting a healthcare provider can help identify the most suitable treatment plan.

Medications

• Over-the-counter treatments are widely used for lice infestations, typically containing pyrethrins or Permethrin, which are insecticides that eliminate lice.

• Follow the medication instructions carefully, often applying it to dry hair and leaving it on for the designated time.

• If over-the-counter options fail, prescription treatments might be necessary. These can include medications containing Ivermectin or Spinosad recommended by a healthcare provider.

• A fine-toothed comb is effective for removing dead lice and nits post-treatment.

• Re-treatment after 7-10 days is usually required to eradicate all lice and nits.

• Always check for signs of lice after treatment completion and wash clothing, bedding, and personal items in hot water to prevent reinfestation.

Prevention

Consider the following practices to prevent the spread of lice:

• Avoid direct head-to-head contact with others, as lice mainly spread through this contact.

• Do not share personal items like combs, hats, and towels to minimize transmission risks.

• Be cautious during activities that draw heads together, such as sports or social gatherings.

• Regularly wash and dry clothing and bedding in hot water and high heat after contact with lice, as this kills remaining lice or nits.

• Routinely check for lice, especially in children frequently in close contact with others at school.

• Avoid using chemical treatments for prevention since they are ineffective and may pose health risks.