Head lice are frequently spread among children in day care or school. They are not an indicator of poor hygiene, and children of all socioeconomic levels may become infested. Lice are transmitted by direct contact with an individual who has them or by contact with belongings such as combs, brushes, and hats. Itching is the most common symptom. The adult lice or their eggs, called nits (see photo from Headliceorg.) are usually discovered behind the ears or near the nape of the neck. The insects lay nits 3 to 4 millimeters from the scalp. Nits adhere tightly to hair shafts, whereas normal flakes of scalp (as in dandruff) are easily removed from the hair with tweezers.
The best initial treatment choice currently on the market is a nonprescription 10-minute hair rinse called Nix. Use Nix as directed on the package and then inspect the scalp and comb and remove all nits with a metal fine-toothed comb. Repeat inspecting and combing twice a day for a week and then reapply Nix. Lice are becoming increasingly resistant to the main ingredient in Nix, although the treatment is still likely to be effective if these recommendations are followed. Another effective product is a prescription shampoo called Kwell, but this has a disadvantage: there have been isolated cases of neurological side effects with frequent use. Kwell must be used twice also, one week apart, and you must inspect and comb twice a day after the first application. If Nix fails to work, Kwell is a reasonable second choice. Ovide, a shampoo containing malathion, is a newer prescription item. Other relatively less effective over the counter treatments include A-200, Rid, and R & C shampoos. They may work, but resistance is a growing problem.
A child who shares a room with an infested child should be treated prophylactically. Other family members should be examined and treated if lice or nits are found. Children may return to school as soon as they are treated. Some schools will require that your child is free of nits before permitting return. If a child is properly treated and develops another infestation, it is usually caused by reexposure to an untreated infested child.
Clothing, bedding, and cloth toys can be disinfected by machine washing or drying using hot cycles; temperatures above 129 degrees F for 5 minutes are lethal to lice and nits. Storing clothing, bedding, or toys in plastic bags for ten days is also effective. Combs and brushes may be disinfected by soaking in hot water for ten minutes or washing with Nix or a pediculocide shampoo. It is doubtful that spraying your home with a pediculocide spray is useful to prevent spread of lice.
You may be interested in the National Pediculosis Association's web site.
