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Head Lice: I Can't Stop Scratching!

Head Lice: I Can't Stop Scratching!

I believe we can all agree that sharing is a great concept – except when it comes to head lice. Head lice, on the other hand, are more than happy to be shared. In fact, sharing is quite essential for them to survive.

Head lice are blood-sucking parasites, meaning they must live, feed, and reproduce on the body of a living host, such as the human head.


·         Adult lice measure 2-3 mm, the size of a sesame seed, and have 6 legs that hold tightly to hair with hook-like claws. An adult female lays about 7 eggs per day, which she cements to the base of a host hair. Adult lice can live 30 days on a person’s head but will die within 1-2 days of falling off. They must feed every 4 - 8 hours

·         Nymphs are immature lice. To live, nymphs too must feed on blood. They mature into adulthood in 8 to 12 days

·         Nits (Eggs) are cemented firmly to the hair shaft and can be difficult to remove, even after the nymphs hatch and empty casings remain. They are oval, very small, and can be confused with dandruff. It takes 8-9 days for nits to hatch. Nits can’t hatch and will die within a week if they are not kept at the same temperature as that found close to the human scalp

Symptoms of Head Lice:

·         Tickling feeling of something moving in the hair

·         Itching, caused by an allergic reaction to the lice bites

·         Difficulty sleeping (head lice are most active in the dark)

·         Sores on the head caused by scratching

Head lice and nits can be found on the scalp, around the ears, near the neckline, and less commonly, on the eyelashes or eyebrows. Because nymphs and adult lice are very small, move quickly, and avoid light, they can be difficult to find.

Head lice spread by direct contact with the hair of an infested person. The greatest risk is head-to-head contact. It is less commonly spread by contact with clothing (such as hats or scarves) and personal items (such as combs or brushes) used by an infested person. Head lice move by crawling. They can’t fly or hop, and are not known to spread disease.

Do’s and Don’ts of Treating Head Lice:

Once one member of the family has head lice, all household members and close contacts should be checked. Those with evidence of head lice should be treated, along with all who share the same bed with the infested person. All should be treated at the same time.

When it comes time to treating a head lice infestation, consult with your healthcare provider or pharmacy to determine which product to use. If you are not sure if a person has head lice, the diagnosis can be made by your healthcare provider, health department, or school nurse.

·         Before applying the treatment, remove clothing that can become wet or stained. Have the infested person put on clean clothing after treatment

·         Apply the medicine according to the instructions. Pay special attention regarding how long the medication should be left on the hair and how it should be washed out

·         Don’t use hair conditioner before using lice medicine. (Conditioners prevent the medication from working.) Do not re-wash the hair for 1-2 days after the medication is removed

·        Keep medication out of the eyes. If it gets into your eyes, immediately flush them

·         If a few live lice are still found 8-12 hours after treatment, but are moving more slowly than before, do not retreat. The medicine may take longer to kill all the lice

·         If, after 8-12 hours of treatment, no dead head lice are found and lice seem as active as before, the medicine may not be working. Do not retreat until speaking with your healthcare provider. A different lice medicine may be necessary

·         Nit combs, often found in lice medicine packages, should be used to comb nits and lice from the hair shaft. Checking the hair and combing with a nit comb every 2-3 days over the next 2 weeks may decrease the chance of self-re-infestation

·         For some medications, retreatment is recommended routinely about a week after the first treatment, and for others, only if crawling lice are seen during this period

·         Do not use extra amounts of any lice medication unless instructed to do so by your physician or pharmacist

·         Do not treat an infested person more than 2-3 times with the same medication if it does not seem to be working

·         Do not use different head lice medications at the same time unless instructed to do so by your physician or pharmacist

Household Items:

·         Machine wash and dry clothing, bed linens, and other items that the infested person wore or used during the 2 days before treatment using hot water and high heat. Clothing and items that are not washable can be dry-cleaned or sealed in a plastic bag for 2 weeks

·         Soak combs and brushes in hot water (at least 130°F) for 5 - 10 minutes

·         Vacuum the floor and furniture, particularly where the infested person sat or lay. (The risk of getting infested by a louse that has fallen onto carpet or furniture is very small)

·         Do not use fumigant sprays; they can be toxic if inhaled or absorbed through the skin

For more information on Head Lice, visit the CDC at https://www.cdc.gov/parasites/lice/head/index.html


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