Head, body, or pubic lice are tiny, parasitic insects, the size of a sesame seed that feed on your blood. They attach themselves to the base of hair follicles on the scalp, base of the neck, or body. Lice can also be found in eyebrows and eyelashes. Lice do not cause disease but are a treatable condition that requires immediate treatment. Tiny eggs (nits) are laid on hair follicles that look like dandruff flakes however, instead of flaking off; they stay on the hair and skin. Lice can spread easily, particularly among school children attending child care, elementary school, and household members of children who are in close contact with other children playing or in large group activities. According to the Centers for Disease Control and Prevention (CDC), an estimated 6 to 12 million cases of head lice occur each year in the United States in children primarily 3 to 11 years of age.
Causes of lice:
Mainly spread by direct contact with an infected person, lice can live up to 30 days on a human and the eggs can live for more than 2 weeks. Head lice will die in less than 1-2 days if they fall off a person and cannot feed. Lice do not fly or jump; they move by crawling and appear grayish-white in color. The actual lice can move fast so most of the time you can identify them by parting the hair in several places and looking for the nits. Nits do not come off the skin easily as they stay firmly attached to the hair so you need to examine the skin carefully. Having lice infection does not mean the person has poor personal hygiene or low social status.
Lice can be transferred from person to person in several ways:
- Close contact with a person who has lice; mainly hair-to-hair or body-to-body
- Touching/sharing the clothing or bedding of someone who has lice; hanging in closets, on hooks in classrooms
- Sharing/wearing hats, towels, brushes, or combs of someone who has lice
- Sitting/lying on contaminated furniture
- Sexual contact
Symptoms of lice can include:
- Intense itching of the scalp or skin where body hair is present
- Small, red bumps on the scalp, neck, shoulders or other areas of body hair - bumps may be crusty and ooze
- Tiny white specks (eggs or nits) on the bottom of each hair follicle
- Tickling feeling from movement of hair
- Lice visible on clothing or body
Excessive scratching over time can cause the skin to become raw creating an entry site for a possible bacterial skin infection. Usually you can get rid of lice by taking self-care steps that include using nonprescription shampoo that's specifically formulated to kill lice. If the shampoo does not kill the lice, you're pregnant, or the skin abrasions are not healing you should consult your health care provider.
Treatment of lice:
Lotions and shampoos containing 1% permethrin (Nix) work well. They can be purchased over the counter without a prescription. The medication should be used exactly as directed and applied directly to the skin in order to kill the lice and eggs. An important part of the treatment is to completely remove the eggs (nits). In some cases, a second treatment of the medication is needed. If this treatment does not work, make an appointment with your health care provider for stronger medication and direction. There are certain products that can be used to assist in the removal of the nits such as a nit comb, or metal combs with very fine teeth. Some dishwashing detergent can help dissolve the "glue" that makes the nits stick to the hair shaft. Treatment may cause side effects in children younger than 6 months, the elderly, and anyone weighing less than 110 pounds.
Prevention of lice:
- Never share hair brushes, combs, hair pieces, hats, bedding, towels, or clothing with someone who has lice.
- Avoid head-to-head contact during play and other activities at home, school, and elsewhere
- Disinfect all personal belongings used by the infected person
- Do not lie on furniture, beds or carpets recently infected with lice
- Machine wash & dry clothing, bed linens, and other items that an infected person wore or used during the 2 days before treatment using the hot water laundry cycle and the high heat drying cycle.
- Vacuum the floor and furniture where the infected person sat/lay.
- Do not use sprays or fogs; can be toxic if inhaled or absorbed through the skin.
- Teach children to avoid sharing personal items with others.
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