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 Medical Self-Care: Lice 
 
American Institute for Preventive Medicine ©

Head lice are tiny parasites about the size of a sesame seed. These flat, wingless "bugs" survive by sucking human blood. Louse bites cause an intense itching and red spots on the skin that look like mosquito bites. The adult lice are rarely seen. Instead, you see what are called "nits", clusters of lice eggs deposited on hair strands that are often mistaken for dandruff.

Lice spread quickly from person to person by direct contact with someone who has them. No matter how well-groomed and clean your child is, he or she can get them in school, from toilet seats or from anyone who already has them. Female lice lay about six eggs a day. The eggs hatch in eight to ten days, after which they soon begin their annoying biting.

There are three types of lice: Head lice, pubic lice and body lice. All are very attracted to body-heat. Head lice is the most common type, especially among children in day-care centers, camps and schools. Pubic lice, found on the pubic hair, is called the "crabs", because the lice look like crabs. Body lice live in the seams of dirty clothes and bedding.



Prevention
To prevent head lice, children should be told:
  • Not to share hats, brushes or combs.
  • Not to lie on a pillow shared with another child.
  • To shampoo their hair and to bathe frequently.
You should:
  • Change bed linens often and wash them in hot water and dry them in a dryer, especially during an epidemic of lice at school.
  • Vacuum furniture, mattresses, rugs, stuffed animals and car seats if anyone in your family is infected with lice. Do not use insecticidal sprays for lice.
  • Immediately notify anyone who may have been in close contact with your child to help prevent infecting others with lice. Be sure to contact:
    • Your child's school.
    • Your child care provider.
    • Parents of your child's friends.
    • Neighbors.
  • Wash combs and brushes. Then soak them in hot, not boiling, water for 10 minutes.
  • Check your children for head lice and nits at least once a week. Check more often if your child is scratching his or her head. Look for nits around the nape of the neck and behind the ears. Use two round toothpicks to spread hairs apart to look for nits.


Self-Care Tips
Only insecticidal shampoos, lotions and creams kill lice. You can buy these products over-the-counter at your drug store. Your doctor can also prescribe medication to treat lice and kill the nits. All lice-killing products are pesticides, so must be used with caution and only as directed.

Everyone in your household should be checked for lice and nits. However, only treat those who are infested. Lice killing products are not to be used to prevent infestation.

When using an insecticidal shampoo:

  • Follow the directions exactly as given, and:
    • Remove your child's shirt.
    • Give your child a towel to cover his or her eyes. Do not use the shampoo around your child's eyes.
    • Lean your child over the sink as you apply the shampoo. Do not put your child in the shower or bathtub; the shampoo should only be applied to the head and neck.
  • Don't use too much shampoo or you'll make your child's scalp too dry.
  • If you have open sores on your hands, wear gloves or have someone else shampoo your child's hair.
To remove the nits:
  • Shine a flashlight into the scalp, or other infected body part. Nits may be gray and hard to see. If your child has blonde hair, check your child's scalp carefully because the nits will be harder to find.
  • Begin in one part of the scalp and move row by row, even strand by strand, when necessary.
  • Remove nits from the hair strands with tweezers, safety manicure scissors, a nit-comb (available at the drug store), or your fingernails. Some products come with a fine-toothed comb you can use to dislodge the nits.
    • Before using the comb, dip it in hot vinegar. This will help loosen the nits.
    • Comb the hair from the scalp toward the ends. After each pass, check the comb for nits.
    • Or, using hair clips to hold the hair, separate it into 4 to 5 sections. Starting in one section, lift about an inch of hair upward and outward. Place the comb on the scalp and comb the hair from the scalp to its tip. Repeat for each section of hair.
    • Soak all combs, brushes and barrettes for several hours in the insecticidal shampoo or for 10 minutes in hot water.
  • Check for nits every day for about 10 days.
  • If necessary, shampoo again a week later to kill any newly hatched nits. It is not necessary to remove nits after treatment is completed, except for cosmetic purposes.
You should also:
  • Immediately wash bedding and clothing in water hotter than 125oF. Heat kills the lice and destroys the nits. If an item cannot be washed, put it in an airtight plastic bag and seal. Do not open it for at least two weeks. Deprived of blood, the lice will die.
  • Dry clean clothing and hats that cannot be washed.
  • Vacuum all mattresses, pillows, rugs and upholstered furniture, especially in areas where children play. Using the long, narrow attachment, suck lice or nits out of car seats, toys, stuffed animals and other small areas. Dispose of the vacuum cleaner bags.


Questions to Ask
Are there open wounds on your child's scalp caused by scratching? Yes: Call Doctor
No
Have you found lice or nits in your child's eyebrows or eyelashes or on the hair shaft or skin? Yes: Call Doctor
No
Does your child's scalp itch, do you see red bite marks and are lymph glands in the neck swollen? Yes: Call Doctor
No
If your child has lice, does he or she have allergies or other health problems, or is your child under 2 years of age? Yes: Call Doctor
No
Provide Self-Care


Healthy Self: The Guide to Self-Care and Wise Consumerism
© American Institute for Preventive Medicine
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