Headlice (aka cooties, riha, utu, kutu bugs, nits or pediculosis…)

Tracey Sullivan Pharmacy Features Writer

Hopefully the holidays put a stop to the headlice cycle at your child’s school. If you are one of the unlucky ones, the frustrating, time-consuming and often expensive battle against headlice may have begun again now that school is back.

Trying to prevent headlice in your child is one of the better options, but not always achievable as headlice are so common and easy to catch – and they are better than rabbits at breeding! School kids are often in close contact, roughing and tumbling with their heads together, giving headlice the opportunity to crawl on board. Direct hair to hair contact is the most common way of spread. Less common is indirect contact when head ware such as hats, headbands, helmets, combs and brushes are shared. Adult lice don’t live for long once they leave the safety of the human head.

Symptoms of headlice sound obvious but are not always easy to recognize. Some kids will be quite uncomfortable and scratch and itch their head and around their ears. They may have scratch marks or a rash behind their ears, on top of their head or around the hairline at the back of the neck. About 50% of children won’t scratch at all when they have headlice so that is why it’s so important to keep up with at least a weekly check. They will have headlice if you find a live insect (brown in colour, about 2 to 3mm long) and greyish/brown/tan-coloured eggs that are attached to a hair shaft within about 1.5cm from the scalp. Try sliding the egg to confirm it is a nit, they are attached firmly to the hair shaft and will be difficult to slide, unlike a piece of dandruff.

Brush hair every day. Sounds basic but this can kill or injure the adult lice. If their legs are broken they can’t hold onto the hair follicle to lay their eggs! Wear hair short, or long hair needs to be up off the face and neck tied in a ponytail (ideally plaited tightly as well).

Treatment choices are all about killing or disabling the adult lice so they can’t lay more eggs and are limited to either chemical treatment or physical removal. Both have pros and cons. Some chemical treatments will kill both lice and eggs, however some are less effective in killing the eggs which is why it is important the treatment is repeated in another 7 to 10 days. Chemical treatments often use organophosphates which are insecticides and as they can be absorbed by the skin they can be toxic if misused or overused. Lice seem to have developed resistance to some of the chemical treatments. It is recommended that you wash chemically treated hair over a sink rather than in a shower or bath. This limits skin exposure to the chemicals. Also use warm rather than hot water, again to limit absorption by the skin. There are natural alternatives, using essential oils such as tee tree, but again, they are not always effective. For both options, don’t use the same treatment more than two to three times as if it is not working after this time, it is likely that the lice have developed some resistance to the product.

Wet combing, while painstakingly slow is a chemical-free alternative. Use conditioner on your child’s wet hair, then use a fine-toothed nit comb to comb the lice and nits out. The combination of combing and conditioner stuns the lice and means they can’t grip onto the hair or crawl as well, giving you time to find and remove them. This needs to be done every couple of days until there have been no live lice spotted for 10 days. One of the older recommendations for headlice was to hot wash everything that had possibly come into contact with your infected child’s head. There is actually no evidence that this is needed, and is a huge stress and time waster for care givers. Just concentrate on getting rid of the lice on your child’s head – that in itself is a big enough job, and the only other thing that is worth washing is your child’s pillowcase. Do this in hot water of a least 60 degrees or put in a clothes dryer on a hot or warm setting.

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