The ABCs of treating head lice

This column appears in the Nevada Appeal Wednesday health pages. It addresses topics related to the health of our community.

Q: What can parents do to protect their children from head lice?

A: This is a great question because information is power and there truly are steps that can be taken to keep these pests from our kids' scalps.

Let's begin with a quick briefing on lice terminology:

Lice: parasite insects found on the hair and, rarely, eyebrows and eyelashes of people.

Louse: singular of lice

Nit: lice egg

Pediculocide: a lice medication that kills the adult form

Pediculosis: a lice infestation

Pediculus: part of the nomenclature for lice: Pediculus humanus capitis

Myths

Next, let's dispel a few myths.

Myth: Lice spread disease.

Truth: Lice do not spread disease, but their bites can cause a lot of discomfort from itching and scratching.

Myth: Lice are an indication of poor personal hygiene.

Truth: Lice are not drawn to poor hygienic conditions. In fact, lice rather prefer squeaky clean hair.

Myth: Lice can hop from one person's head to another.

Truth: Unlike fleas, lice are only able to crawl, causing a tickling feeling when they do so in your scalp. They spread by direct contact with another infested head or infested hats, scarves, coats, scrunchies, brushes, combs or the like.

Myth: You can get lice from your dog or cat.

Truth: Pets do not play a role in the spread of human head lice.

DIAGNOSIS

Visual inspection can be a challenge. Lice feed like bed bugs and mosquitoes on human blood. When they are not feeding, they cling to a shaft of hair or lash with wee claw-like structures on ends of their legs. Like bed bugs, they prefer night and move quickly and stealthily. As shown in the photo, they are small but visible. Some people use a magnifying lens and a fine-toothed comb to discover their presence. When attempting to find lice, it may be necessary to use the presence of nits, which attach within a ? inch of the base of the hair shaft, as evidence. However, nits are often confused with other things found in the hair such as dandruff, hair spray or dust particles. Accurate diagnoses of pediculosis may have to be made by a health care provider or health department professional.

TREATMENt

Pediculocides should only be used if lice are present, not as a preventive measure. Over-the-counter treatments cost about $10, and at least two rounds of treatment are needed. This is because the pediculocides do not kill the nits and subsequent treatments are needed to interrupt the entire life cycle and fully eradicate an infestation.

A recent article in the Wall Street Journal (July 27, 2010) disclosed new guidelines from the American Academy of Pediatrics (AAP). New findings indicate that many of the prescription and over-the-counter pediculocides may require an additional round of treatment (three instead of two) because pests in some areas have built up a resistance. Explicitly following directions on the package is recommended.

In addition, AAP suggested that parents use special fine-toothed nit combs to "wet comb," which involves wetting the hair with water or other fluids, then combing out the lice and nits with the fine-toothed nit comb. The combing method is the most time-intensive and probably impractical for long hair, but for people who wish to avoid chemical treatments, it is most effective.

Another AAP alternative is applying the skin cleanser Cetaphil and letting it dry on the hair overnight to suffocate the head lice. Natural cedar oil-based products are also available. AAP cautions that at present, there is no guarantee the alternative treatments will work.

ERADICATION

A bit of good news is that unlike bed bugs, lice do not survive well away from a host. (You may recall that bed bugs can last up to 4 months without a meal.) The main ramification of this fact is that Herculean cleaning efforts such as disassembling furniture and fumigating are not required to eradicate them. Yes, it is true that anything that has been in contact with the infested person's head should be washed in hot water and dried in the dryer's hottest setting, but that is sufficient for inanimate objects. Items that cannot be washed may be sealed in a plastic bag for two weeks. Ten minutes in a hot dryer also works.

PREVENTION

According to the Centers for Disease Control and Prevention (CDC), the following steps can be taken to help prevent the spread of head lice:

Avoid head-to-head and hair-to-hair contact during play and other activities at home, school, sports, camp, slumber parties and the like.

Do not share clothing such as hats, scarves, coats, sports uniforms, scrunchies or barrettes.

Do not share combs, brushes, or towels. Disinfect these items if used by an infested person by soaking them in 130 degree water for 10 minutes.

Do not lie on beds, couches, pillows, carpets or stuffed toys that have been recently in contact with an infested person.

Machine wash and dry clothing, linens and other items used or worn by an infested person during the two days before treatment with the hottest settings available. Other items should be sealed in plastic bags for 2 weeks.

Vacuum the floor and furniture in the area where the infested person sat or lay.

Do not use fumigant sprays or fogs.

WHOOPING COUGH EPIDEMIC IN CALIFORNIA

In neighboring California, confirmed cases of whooping cough, or pertussis, is now four times that of last year. Local health officials encourage Tdap boosters for any adult up to 64 years of age that is in close contact with an infant. Whooping cough boosters for adults and vaccine for infants is available at Carson City Health and Human Services.

On the Web

www.gethealthycarsoncity.org

Take a quick survey about smoke-free parks and events. The survey is available at:

www.surveymonkey.com/s/26GV68W or through our Facebook page.

Clinics

Carson City Health and Human Services

Clinic Hours: Monday-Wednesday and Friday

9 a.m.-4 p.m., by appointment

900 East Long St., Carson City

775-887-2195

Thursday is Immunization Day

8:30-11:30 a.m.; 1-4:30 p.m.

No appointment needed

775-887-2195

• Pam Graber, public information officer for Carson City Health and Human Services 775-283-7906 pgraber@carson.org.