By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

HEAD LICE DON’T DISCRIMINATE, THEY CAN INFEST ANYONE!

Question: My daughter was sent home from school with head lice yesterday and cannot return until she is “nit-free.” We are a very clean family, and I keep my children clean. How did she get these? Will my son get them? What can I do to prevent head lice?

Answer: Pediculosis capitis, or head lice, are small parasites that live on the scalp and the neck hairs. They have been around for eons and are uniquely adapted to live only on heads. They can infest anyone at any time, without regard to cleanliness or hygiene. They are spread primarily by head-to-head contact, but can also be transferred from one person to another by combs, brushes and hats.

Lice are wingless insects that live on humans and most other animals. They cannot jump or fly and only live for a short period of time if not feeding on a host. They survive by using the host -- in this case your daughter -- as their food source, but can’t survive much more than a day without feeding. They bite the skin, consume blood, and the females lay their eggs -- about six a day -- in the unlucky person’s hair.
A young louse hatches eight days after the egg is laid. Then, just like its parents, the louse feeds on the host’s blood and grows to adulthood in nine to 12 days. Then the cycle starts all over again.

Children with lice often develop sores on their heads, and if your vision is reasonably good, you should be able to see the tiny grayish-white lice eggs in their hair. These eggs are cemented to the shaft of hair strands at scalp level. As the hair grows, the egg is carried further away from the scalp.

Lice eggs are also called nits, and in some areas many people refer to them as “cooties.” Since the eggs are so small, a special, fine-toothed comb is required to get them out of the hair. This type of comb, as well as the person who uses it, can be referred to, literally, as a “nit picker.” As you know, there is also a figurative use of this term!

After head lice are diagnosed, the scalp is treated with over-the-counter products that kill the adults as well as the eggs. This is when the nits are combed out of the hair using the aforementioned “nit picker.” Some sources recommend combing the hair with the nit comb and applying conditioner prior to treatment to remove as many lice and nits a possible.

After treatment, it is crucial to launder pillow cases, towels, and pajamas in hot water. It is also important to inspect the hair and comb out nits for several days following the treatment. These eggs are usually dead, but in some school districts, they could keep a child out of school.

You should check other family members for lice, but do not treat them unless live lice are seen. If live lice persist after two treatments, you should contact your physician.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.