Toolbox Tip: Head Lice

Late September is back-to-school time. For some folks that means pencils, books and dirty looks. For others, it could mean head lice. Back-to-school time is boom time for head lice, which makes it easy to understand why September is National Head Lice Prevention Month. Here are some tips to help you and your family catch these lousy bugs early or, better yet, avoid them altogether.

Prevention

Sharing is one of the most important things we learn during childhood. Unfortunately, sharing certain items can lead to the transmission of head lice. Items such as headphones, hair brushes, combs, pillows, hats, bicycle or football helmets, hair clips, jackets, scarves and even plush dolls can transmit head lice from one person to another. Help your child to avoid sharing items like these when lice are on the loose. As sleepovers necessitate the sharing of pillows and blankets, these should especially be avoided for children with lice. If your child has long hair, keep it pulled back during the school day, and consider talking with your child’s teacher about storing their jackets and scarves in separate cubbies during class, rather than on racks where they may contact each other.

Early Detection

Early detection of individual lice is far easier to deal with than an advanced infestation. Throughout the school year children should be inspected weekly by parents.

To Inspect for Head Lice:

Look for eggs (also called “nits”) at the nape of the neck or behind ears. Unhatched eggs will be firmly attached to the hair shaft close to the scalp. These nits are camouflaged with pigment to match the hair color of the infested person. They are most easily seen at the hairline at the back of the neck. Empty egg casings are easier to see appearing white against the hair.

Getting Rid of Head Lice

There are many products available to control lice. Below are some options that have proven effective.

Comb Them Out: no matter what management technique you choose, you’ll need to do some combing. No treatments kill all lice. Even the pesticidal shampoos, some of which can be harmful, kill all lice with a single treatment. Up to 30% of adult lice can survive lice shampooing.

Special fine-toothed metal combs are needed to remove lice. They are effective if thorough combing is done every day for up to two weeks. Brand names include LiceMeister and LiceOut. These can be found at your local drugstore or ordered from the National Pediculosis Association (http://www.headlice.org/ or by phone at 1-800-446-4NPA).

* See bottom for proper lice combing procedure.

Heat Treatments

There is a new device known as the LouseBuster that has been proven very effective controlling lice. It is a 30 minute heat treatment.

Petroleum Jelly (Vaseline®)

One study found that petroleum jelly can be an effective way, if an extremely messy one, to deal with lice. Apply petroleum jelly generously to the hair, making sure the hair and scalp are saturated (use approximately two ounces depending on the thickness and length of the hair being treated). Cover the hair with a close-fitting shower cap. Leave the cap on for eight hours (avoid doing this overnight as the cap may become a suffocation hazard during sleep). This treatment works by suffocating the lice. Remove the shower cap and wash the hair with shampoo to remove most of the petroleum jelly (consider rinsing with a mild degreasing soap as it will be hard to remove). Remove all remaining lice by combing.

Treatments should be repeated 7-10 days later to ensure that all freshly hatched and surviving lice are killed.

Least Toxic Chemical Control

There is a new prescriptive treatment, Ulesfia, made with benzyl alcohol. Risks are minimal and the product has proven to be extremely effective.

Controlling Lice in Bedding and Clothes

Wash all clothes in hot soapy water. Pillowcases, sheets, blankets and stuffed animals should also be washed and placed in the clothes dryer on high heat. Any non-washable items should be dry cleaned or sealed in plastic bags and placed in the freezer at 5 F or lower for 10 hours or more. Vacuuming the home will remove shed hair and nits.

Avoid re-infestation with weekly head checks of the whole family. Don’t worry about scruffy or fluffy though. Head lice do not go after household pets.

* Proper Lice Combing Procedure

Preparation

1. Pull back your own hair.

2. Find bright natural light or a strong lamp with a flexible arm that allows you to direct the light.

3. Find something entertaining for your child, such as reading a book, drawing, or watching a video.

4. Apply vegetable oil to your child's hair to loosen the nits.

Combing

1. Sit with your child's head just below your eye level.

2. Brush hair with a large-toothed regular comb and separate into 1/2 to 3/4-inch sections.

3. Starting at the scalp, slowly comb through each section of hair several times with a metal lice comb.

4. Each time you comb out lice or nits, dunk the comb into a bowl of soapy water (frequently remove hair and other debris from the comb with a tissue, discarding into another bowl of soapy water).

5. Shampoo twice to remove the oil.

6. Let hair dry, and recheck for stray nits.

7. Cut out any nits with small scissors.

Cleaning

1. Flush the contents of both bowls of soapy water down the toilet.

2. Soak the comb and scissors for 15 minutes in hot soapy water, or boil in plain water for 15 minutes.

3. Wash towels in hot water and dry on high heat.

Combing steps taken from the EPA's "IPM for schools: A how-to manual." Document #909-B-97-001. March 1997.