No Need for Shame With Head Lice

But simple steps can protect your child -- and you

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By Dennis Thompson
HealthDay Reporter

FRIDAY, Sept. 29, 2006 (HealthDay News) -- If you're a parent, the call from school announcing that your child has an infestation of the six-legged insects known as head lice is one of the most mortifying experiences imaginable.

Deborah Altschuler, president of the National Pediculosis Association, said, "People have traditionally looked at head lice as a sign of a dirty home," an incorrect assumption. But with more and more two-income families, parents -- especially mothers -- can feel a sense of shame that somehow they've failed their child -- another wrong assumption.

"We're a very busy society, and the most embarrassing moment for a parent would be for someone else to be the first to notice their child has bugs in their hair. 'The school nurse has to call me and tell me my child is infested with lice? Why didn't I notice that?' " she said.

This shame is both unnecessary and preventable, said medical experts.

It's unnecessary because head lice -- about the size of a sesame seed -- are a fact of life and aren't the sign of a dirty home or a neglectful parent. And preventable because there are steps parents can take to lessen the chances their child will be exposed to the bugs.

"If you wait until your child has a very bad infestation, it's going to become a real crisis in your life," Altschuler said. "Too many of the policies today are reactive. They talk about treating the child without considering what you could have done proactively."

The first thing parents should do is familiarize themselves with head lice. "They should know what a louse looks like and be able to determine whether there are lice eggs in a child's hair," Altschuler said.

Lice eggs, also called nits, are about the size of a knot in thread, oval and usually yellow or white, according to the U.S. Centers for Disease Control and Prevention. They are laid at the base of the hair shaft nearest the scalp, and firmly attached to the hair.

After a week, the eggs hatch into a baby louse, also called a nymph. Within another week, the nymph will mature into an adult about the size of a sesame seed, with six legs and a color that can range from tan to grayish-white.

Adult lice can live on a person's head for up to 30 days, according to the CDC, feeding on blood and laying more eggs. If it falls off, it dies within two days.

Preschool and elementary school children and their families are infested most often. Girls get head lice more often than boys, and women more than men. Personal hygiene or cleanliness in the home or school has nothing to do with getting head lice.

They're typically found on the scalp, behind the ears and near the neckline at the back of the neck. They're usually not found on the body, eyelashes, or eyebrows, according to the CDC.

Once parents know what they're looking for, they can keep a close eye on their children, Altschuler said. They should watch for symptoms of head lice -- itching, scratching, irritability -- and examine their child's scalp regularly for nits or lice.

"As the child's head is bathed, this is the perfect time to check for head lice," Altschuler said. "It doesn't have to be disruptive. It should be part of normal hygiene."

Prevention primarily involves making sure your child doesn't share anything that touches their hair with another child, said Dr. Jim King of Selmer, Tenn., a spokesman for the American Academy of Family Physicians.

"Make sure kids don't share combs or brushes or other things they put on their heads," King said. "They don't need to share hats. If they sleep away from home, make sure you can send their own pillow and towel."

Contact with a person already infested is the most common way to get head lice, and head-to-head contact is frequent during play at school and home. That's why communication between parents is crucial, despite the stigma associated with head lice, Altschuler said.

"You need to talk with other parents and know when playmates have been infested," Altschuler said. "Keep it out in the open," she said, adding, that through constant examination, parents should be able to identify an infestation before it grows unmanageable.

Altschuler recommends combing the nits and lice out of a child's hair as the first line of treatment, especially if the problem is caught early.

"You should take every opportunity to avoid using a chemical or pesticide on a child's head," she said. "And if you remove the lice and nits manually as soon as they get there, the challenge is reduced dramatically."

However, King said he sees no problem in using a pesticide-based shampoo like Nix to kill off the lice, so long as it is used correctly.

"There are over-the-counter products now," he said. "You don't have to come to the doctor for head lice if you're sure they have it. Just pick up the treatment."

More information

To learn more about head lice, visit the National Pediculosis Association.

SOURCES: Deborah Altschuler, president, National Pediculosis Association, Needham, Mass.; Jim King, M.D., Selmer, Tenn., and spokesman, American Academy of Family Physicians; U.S. Centers for Disease Control and Prevention, Atlanta

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