Head lice, pediculosis capitis, may infest any person but is frequently seen in children. The head louse is 1 to 2 mm long, wingless and white or gray in color, living an average of 30 days. Head lice spread most often by head to head contact, but can also spread by indirect contact. Spreading of lice can occur via the patient's hair brush, bedding, helmet or hair accessories.
Lice
According to "Dermatology Nursing" the louse inserts its mouth parts into the skin to feed on the blood of the human host every 4 to 6 hours. When its mouth is inserted into the patient it releases saliva which will cause inflammation and itching for the person. Head lice move by grasping hair. The female louse lays eggs at night and can produce as many as 10 eggs per day. Eggs are most often found along the hairline at the back of the head and neck area.
Identification
Itching is the most common symptom associated with head lice. Other symptoms may include fever, general tiredness, and excoriation of the skin from itching. The diagnosis of head lice is made by either seeing the lice on the scalp or the lice eggs on a comb. The head louse can crawl rapidly and likes to avoid light which can make it difficult to see the lice on the scalp.
Treatment
Treatment for head lice is recommended for patients with an active infestation and also for the immediate members of the household. Treatment for everyone should be done at the same time to decrease the potential of recurrent infestations.
Shampoos and Lotions
Treating lice requires the application of shampoos or lotions. Some treatments are available over the counter and others require a prescription. Over-the-counter (OTC) treatments that do not require a prescription are Nix and Rid. Nix is a solution applied to damp hair after shampooing, left on for 10 minutes and rinsed out. Nix is repeated in 7 to 10 days. Rid is applied to dry hair and left on for 10 minutes. Rid is also repeated in 10 days.
Prescription treatments include Lindane 1% shampoo, Ulesfia and Ovide. Lindane is applied to dry hair and left on for 4 minutes and then rinsed. It is a one-time procedure. Ulesfia is applied to dry hair, left on for 10 minutes, rinsed and repeated in 7 days. Ovide is applied to dry hair, left on 8 to 12 hours, rinsed and repeated in 7 to 10 days.
Use prescription and OTC treatments only as directed. Some treatments are not recommended in young children or pregnant women. Side effects can range from mild irritation to seizures.
Use a comb to daily remove lice and their nits from the hair.
Petroleum Jelly or Olive Oil
Alternative treatments for lice include petroleum jelly and olive oil which are usually left on overnight and then rinsed out. These products are thought to suffocate the lice, but lice have been known to evade these agents making the treatment unsuccessful.
Laundering
Launder clothing and bed linen used by the infected patient. "Dermatology Nursing" recommends washable clothing be laundered with a minimum water temperature of 50 degree Celsius and items that are not washable be sealed in plastic bags for 2 weeks or dry cleaned.
References
- "Head Lice: Diagnosis & Treatment"; Martinez-Diaz & Mancini; Dermatology Nursing; July/ August 2010
- "Current Diagnosis & Treatment Emergency Medicine"; 2010
