Your health with Pharmacist Advice

Children's Health - Head Lice

DEFINITION

Head Lice is the common name of the Pediculus capitis parasite. The lice infest hair on the scalp, but may also spread to eyebrows, eyelashes and beards(1). Infestation is not a sign of poor hygiene and can happen to anyone(2).

DESCRIPTION

Head Lice are often first seen as small, greyish-white specks, called "nits" which attach themselves to the hairs(3). These nits are the eggs. The lice themselves are wingless with stubby claws, 3 to 4mm in length (males are slightly smaller) and are greyish-white(4). They move with astonishing speed and are usually found in the back part of the head.

Because there are usually only a few adult lice present, they may be hard to see. Lice usually try to hide, but their greyish-white eggs are a sure sign of their presence. Lice feed on blood from the scalp. The female louse lays its eggs in the warmest areas close to the scalp. The eggs can be seen fixed to the hair shaft, often in great numbers and cannot be easily removed as they attach with a strong glue-like substance. The eggs hatch after 7 to 10 days, and leave empty shells on the hair. Empty nits grow out with the hair, so any found more than 1cm away from the scalp have already hatched. The adult lice live for 40 days.(5) Head Lice are spread from person-to-person by head-to-head contact, personal items such as hats, towels, brushes, combs, hair ties, helmets and possibly pillows and head rests. Head Lice do not jump or fly (they crawl) and generally cannot survive longer than 24 hours off the host.(6)

SIGNS AND SYMPTOMS

Lice feed on human blood and spill their saliva onto the hair and into the scalp. The patient then develops an allergic reaction to the saliva, which causes itching and discomfort. In cases where the head lice have been detected early, the above process may not have yet occurred and itching may not be present(7).

HEALTH MANAGEMENT

A Doctor's consultation is usually not necessary unless the scalp becomes infected or the dermatitis is severe. Your Pharmacist is able to help you with Head Lice treatment as most products are available over-the-counter. (8)

DETECTION AND TREATMENT

Using the Conditioner and Combing Technique is the best menthod of detecting Head Lice and can also be helpful in treating mild cases. For the Conditioner and Combing Technique you will need :

  • White coloured hair conditioner
  • An ordinary and fine toothed comb
  • Hair clips
  • White tissues
  • Good light
  • Magnifying glass
  • A mirror if combing your own hair
  • A plastic container
  • An old toothbrush or dental floss(9)

CONDITIONER AND COMBING TECHNIQUE

  1. Untangle dry hair with an ordinary comb.
  2. Apply conditioner to dry hair. Use enough conditioner to cover the entire scalp and all hair from roots to tips.
  3. Use the ordinary comb to evenly distribute the conditioner. Using the hair clips, divided the hair into four or more sections. If you are combing your own hair a mirror will help.
  4. Change to a Head Lice comb.
  5. Start with a section of hair at the back of the head. Place the teeth of the Head Lice comb flat against the scalp. Comb the hair from the roots through to the tips.
  6. Wipe the comb on the tissue after each stroke. In good light, check for Head Lice and eggs. Adult lice are easier to see - young lice can be difficult to detect. Using a magnifying glass will help you detect smaller lice.
  7. Comb each section twice until you have combed the whole head. If the comb becomes clogged, use the old toothbrush or dental floss to remove the Head Lice or eggs.
  8. Keep combing until all the conditioner is removed from the hair.
  9. Repeat the Conditioner and Combing Technique every 2 days until you find no lice for 10 consecutive days. By doing this you will be removing all the adult lice and any young lice that hatch from undetected eggs(10).

CLEANING UP

  1. Place all the tissues you have used in a plastic bag, tie the top and put it in the bin.
  2. Wash your hands normally.
  3. Soak combs in hot soapy water (just after boiling) for at least 30 seconds to ensure that head lice are killed. This should be done by an adult because the water is very hot. When the water has cooled, use an old toothbrush to remove debris(11)

PHARMACIST

Ask your Pharmacist for advice.

  1. Advise children not to share hats or brushes/combs.
  2. See the Conditioner and Combing Technique under the Health Management section in this topic.
  3. Use a Head Lice treatment to kill Head Lice. Ask your Pharmacist for a suitable brand and how to use it. Check the hair after 7 to 10 days.
  4. Lice are often resistance to some over-the-counter treatments.(12) If the first attempt at treatment is unsuccessful, ask your Pharmacist for another brand with different active ingredients and repeat the process.
  5. Head Lice treatment kills the adult lice but will not remove nits. Use a special fine-toothed comb, from your Pharmacy, to remove nits after treatment. Repeated combing of wet hair, after conditioner has been added, is required to remove both lice and nits(13).
  6. If your child has Head Lice, wash any hats, combs, brushes, towels and pillow cases in hot water and leave in the sun to dry or put it all into a plastic bag for 3 to 4 days(14). Head Lice need to feed on blood to stay alive, so putting them in a plastic bag will starve and kill them.
  7. Ask your Pharmacist about chemical-free headlice treatments. Robi Comb is a product that kills adult lice by sending out an electronic pulse. It requires daily use for 2 weeks to treat an infestation. To prevent reinfestation, continued use at least twice a week is suggested(15).
  8. There are also a number of herbal treatments available to kill headlice. These products often contain tea tree oil (a powerful antiseptic)(16). Ask your Pharmacist for advice.
  9. Treat all family members at the same time to prevent cross-infection.(17).