Quick Guide: Head Lice Removal

Facts and general information about head lice removal: diagnosis, treatment methods, and cost.

I.     Introduction

Head lice are small insects that live on people’s heads and feed on human blood. Head lice infestation is a widespread problem in children and causes concern among parents and childcare workers. However, they don’t transmit infectious diseases.

II.   Symptoms and spreading

You may get a tickling feeling on your head with itching and sometimes redness. Itchiness does not mean that a person has head lice and head lice don’t always produce symptoms.

Head lice spread through direct contact among children (head-to-head), or indirectly on items such as hats, combs, hairbrushes, headbands, and helmets. The head lice that live on people cannot live on pets or other animals and vice versa.

III. Diagnosis

Carefully inspect each person’s hair and scalp. Look for head lice eggs (called nits), which are oval and about the size of a pinhead. You will find them firmly attached to the hair shaft and they cannot be brushed off easily.

A female louse may lay about three to eight nits per day. The louse attaches the nits to the hair fibers within 1.5 cm of the scalp and needs the warmth from the head to hatch. Head lice do not have wings or jumping legs, so they cannot fly or jump from head to head. They can only crawl.

The most effective way to find them is to use the conditioner and remove them with a comb weekly:

Step 1: Comb hair conditioner onto dry, brushed hair to make it easier to comb and slow the lice’s movement.

Step 2: Section the hair and go from root to ends with a fine-tooth head lice comb.

Step 3: Squeeze tightly around the comb and wipe it onto a paper towel.

Step 4: Look through the towel and comb for lice and nits.

Step 5: Comb through every part of the head at least four or five times in different directions.

Step 6: You must treat every person that shows signs infestation to eliminate head lice.

IV. Treatment

There are three basic self-treatment options for head lice:

• topical pediculicides

• wet combing, and

• oral medication.

Some salons offer head lice removal services. The only downside is the price. This services will cost you good money (it can cost a few hundred dollars per children), and you’ll have to go there more than once. Rates aren’t fixed, but the price for this service is about $100 per hour.

Another alternative is a head lice removal specialist, found in some areas of the country.

Topical pediculicides

Head lice products can be divided into four groups based on the active compound:

• pyrethrins

• synthetic pyrethroids

• organophosphates, and

• herbal products.

Effective pediculicides kill both lice and eggs. The pediculicide should be applied to dry or wet hair, left for the advised time, then rinsed thoroughly with warm water. No treatment kills 100% of eggs. Therefore, the procedure must be repeated 7–10 days after the first treatment to kill any nymphs that have hatched from remaining eggs.

If over-the-counter products containing pyrethroids do not work, it is unlikely that prescription strength (5%) permethrin will either. For children 2–12 years of age, preparations containing permethrin or pyrethrins are safe. All infected members of the patient’s family should be treated simultaneously.

Wet combing

Pediculicides are not recommended for children under two years of age. Therefore, mechanical removal of lice on wet hair with a hair conditioner and a fine-tooth comb is an alternative.

Oral Therapy

 A recent trial of oral trimethoprim-sulfamethoxazole (Bactrim) in addition to permethrin rinses, only increased the cure rate marginally (89–95%).

Ivermectin has also been investigated for the treatment of lice resistant to conventional pediculicides but is not approved for the treatment of head lice.

Post Treatment

The scalp might become itchy after the lice treatment. This does not mean that the treatment didn’t work. Anti-itch medicine, such as Benadryl or another antihistamine, may help.

Learn about: History of Lice Removal

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References

Center for Disease Control

Healthline: How to kill head lice

WebMD: Lice Treatment

Johns Hopkins Medicine