head lice

You notice your children have been itching their scalps more often than usual. Yesterday, when you picked them up from day care, you noticed other children itching their scalps as well. You decide to go to the bathroom and dig out an old comb from the bottom drawer and check their scalps just make sure it’s nothing serious. As you start to rake through your first child’s hair, you see small, oval shaped sacs attached to the hair shaft. At that moment, you realize your children have been exposed to head lice.

Head lice are small, parasitic insects that feed on human blood. Head lice tend to live close to the scalp but can also be located on their eyebrows and eyelashes.

The insects are spread by having direct contact with the hair of a person who has head lice. While uncommon, head lice can also be spread by sharing personal items, such as towels, brushes, coats and hats.

Anyone at any age can get head lice. However, preschool and elementary students are the most likely group to experience head lice. This group is targeted the most because they tend to engage in head-to-head contact while playing on the playground at school or day care or to share personal items with their friends.

One of the hallmark sign of head lice is itching. Depending on skin sensitivity, scratching at the scalp could start immediately or two to three weeks after being exposed. Some report a tickling sensation or the feeling of something moving around on their head.

Head lice are not known to carry any diseases, but they can cause loss of sleep and related health issues, such as skin infection from the constant itching.

It is important to note that even those with excellent personal hygiene can still get head lice. However, there are steps you can take to help prevent the spread of head lice:

  • Try to avoid head-to-head contact with others when possible
  • Do not share clothing or personal items (i.e. towels, brushes or combs)
  • If you know someone has lice or has had head lice, wash all bed linens, clothing and other items in very hot water and dry them on high heat
  • Items that cannot be washed should be dry cleaned or put in a sealed plastic bag for two weeks
  • If an infested person laid or sat on your couch or carpet, be sure to vacuum well
  • Do not use fumigation sprays or fogs to be rid of head lice

Treatment for head lice is recommended for people with an active infestation. All members of the same household and other close contacts should be checked. Anyone in the household with evidence of an active infestation should be treated at the same time. Some experts believe prophylactic treatment is prudent for persons who share the same bed with actively infested individuals.

Some medicines, also called pediculicide, can kill lice eggs while others only kill live lice. Over-the-counter medications and special shampoos are available at most grocery stores or pharmacies. Apply medications or shampoos according to the instructions contained in the box or printed on the label, paying special attention to how long the medication should be left on the hair and how it should be washed out. If the infested person has very long hair (longer than shoulder length), it may be necessary to use a second bottle. See your primary care provider if the infestation is severe or you are unsure which medication or treatment option is best.

Having head lice can make your child extremely uncomfortable and embarrassing to children. It is very important to be supportive during treatment. Talking to your child about the situation and showing them how to take care of their hair and body can help. For young children, discussing personal hygiene and assisting them in keeping their hair neat and clean is important in preventing re-infection. Remind you child that anyone can get lice and provide emotional support if it becomes stressful for your child when they return to school or day care.

Even if COVID-19 prevents students from going back to school in-person and causes day care to close, it is still important to know how to handle the parasites if they try to make a new home in your child’s hair.

To schedule an appointment with a primary care provider, call 502-588-4343.

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Article by: Izegbea Cannon, APRN, FNP-C

Izegbea Cannon, APRN, FNP-C, is a family nurse practitioner who specializes in family medicine and primary care. She completed her bachelor of science in nursing at University of Louisville in 2000 and then earned her master of science degree at Spalding University in 2015. She holds a national board certification with the American Academy of Nurse Practitioners. Izegbea has been part of UofL Physicians for the last two years and has worked in a variety of settings throughout her career including occupational, urgent care and geriatric primary care. Currently, Izegbea is working in primary care with a goal of providing patients with education regarding their medical diagnosis in hopes of promoting a better patient experience and understanding of their medical care plan.

All posts by Izegbea Cannon, APRN, FNP-C
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