Go ahead and shudder. It’s totally understandable.
Of course, lice are a manageable situation, but it is a problem that requires a lot of attention, a few steps and most importantly a sense of calm.
We asked area experts for advice on how not to panic when dealing with a lice outbreak and how to banish the bugs from your child’s scalp and your home.
To stay calm, Melissa King, DO, pediatrician at the Child’s Health Clinic and Dr. Mom Blogger at Dayton Children’s said. “Realize that lice are a pest and that it is treatable; it is not the cause of disease. Anyone can get them, and they are very common. Although they are tough to get rid of, and it can be embarrassing to have them, having lice does not mean that you are dirty or have poor hygiene. Carefully pick all nits out of hair with a fine tooth comb. Check your scalp every three to four days for both live louse and the nits.’
Joseph Allen, MD of Family Medicine of Vandalia, said that being informed will help with staying calm.
“Obviously, the personality of the individual kid or parent will dictate whether they panic or not about a lice infestation. However, even in the most anxious individual, I think education is the key. The more they know about lice the less likely they are to panic. Unlike body lice, head lice do not transmit disease and can easily be eradicated by following a strict regimen,” Allen said.
Getting rid of lice is a meticulous process.
“There may be topical medications that you can place on the scalp when there are live louse present, however, you still must painstakingly pick away the nits. It takes between seven to 12 days for the eggs to hatch, and so even after you feel you have picked all of the nits, continue to monitor the scalp every three to four days for two weeks to identify more nits,” King said. “The best measure is ridding the hair of the eggs by manually removing them. Your doctor may also consider treatments for itching or in cases where there is secondary infection. All household members should be evaluated and then treated if live louse are identified.”
Since lice can spread easily, before treatment and possibly during treatment especially in close quarters, there is some controversy over when a student who presents lice should be allowed back in school.
When asked how parents and schools could be better informed about lice and more successful in stopping lice from spreading, Amy Guiot, MD, associate director, Medical Student Education, pediatric hospitalist, Division of Hospital Medicine at Cincinnati Children’s Hospital Medical Center, said, “Schools have different policies on how to deal with head lice. Most schools require the student to be sent home and not return until treatment with a shampoo has been done. Some schools have no nit policies causing many children to miss school unnecessarily. Wet combing gets rid of the nits. Head lice are spread by casual contact between people, meaning sharing hats, scarves, combs, brushes, towels, headphones. Head lice do not jump nor fly. Head lice cannot survive more than 48 hours without a human body. To prevent lice from spreading, inform children not to share the above items.”
According to the Center of Disease Control’s website, www.cdc.gov, the “no-nit” policy that requires a child to be free of nits before they can return to school has been discredited by the American Association of Pediatrics and the National Association of School Nurses.
“Nits alone do not justify medication treatment. Children should not be sent home, nor excluded from school, as this has not been proven to reduce spread. Often we are seeing the egg casings and not live louse,” King said.
Deborah Z. Altschuler, President and co-founder of National Pediculosis Association (NPA), www.headlice.org, disagrees that no-nit policies should be ignored.
“No Nit Policy is a generic term for what in reality are endless different versions school to school. As we say in NPA’s No Nit statement: Opponents of No Nit Policies say that ‘overzealous’ enforcement can lead to inappropriate exclusion of children with residual nits, but whose infestation has otherwise been ‘treated.’ Those who judge enforcement to be ‘overzealous’ may not consider the broader public health values and preferences of the community. Few who oppose the No Nit Policies would accept infestations for themselves or for their own children. While absence from school or child care is a loss of educational opportunity and an encumbrance to working parents, readmitting an infested child is not the solution. A policy for head lice must consider not only the infested child, but also his or her peers who have already been successfully deloused or who have not yet been infested. All this considered, the No Nit Policy remains a sensible approach that sets the standard to serve and protect all the children in the group.”
When asked if all Ohio schools have to adhere to The No Nit Policy, Ann Connelly, head of the School Nursing Program at the Ohio Department of Health, said, “There is no state or federal requirement for schools to adopt a specific head lice policy. CDC does not recommend a no-nit policy, and more schools are moving toward a no-live lice policy rather than no-nit. Policies are developed and implemented at the local school level.”
To eradicate lice and nits from your surroundings, Guiot said, “Wash all clothes, bedding and towels in hot water and dry on the hottest setting. Vacuum carpet and furniture and car seats. If something cannot be washed, put it in a sealed plastic bag for two weeks. No need to have an ‘exterminator’ come to your house. No need to have house ‘sprayed’ with any chemicals.”
When asked if shampoos like Fairy Tales Rosemary Repel Shampoo that claim to keep lice away really work, Allen said, “I have not personally used the Fairy Tales product, but after reading about it and what it claims to do, I feel that it may provide a small benefit to help prevent lice. It appears that it works by coating the hair follicle in a light coat of different ‘natural’ oils. This would in turn make it difficult for a louse to attach to the hair follicle. I believe that these products may offer a bit of protection, but I am not sure that it would provide all out protection that it claims.”
King said she has not seen research to support the claims of the shampoo.
“Rosemary oil, tea tree oil and lavender oil may cause skin irritation. There may be skin absorption through the skin if it is used in high enough concentrations, so be sure to discuss with your physician before using all over the counter and/or home or natural remedies. Some of these agents may have benefits, but just as medications may have side effects, natural products may as well,” King said.
For additional information on head lice, go online to kidshealth.org, headlice.org, cdc.gov and aap.org.
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