Clinical Reference Systems: Pediatric Advisor 10.0
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DESCRIPTION

• Nits (white eggs) are firmly attached to hairs. Unlike dandruff, nits can't be shaken off.
• Gray bugs (lice) are 1/16 inch long, move quickly, and are difficult to see.
• Your child's scalp itches and has a rash.
• The back of the neck is the favorite area.

The nits are easier to see than the lice because they are white and very numerous.

CAUSE

Head lice live only on human beings. They can be spread quickly by using the hat, comb, or brush of an infected person, or simply by close contact. Anyone can get lice despite good health habits and frequent hairwashing. The nits (eggs) normally hatch into lice in about 1 week.

Lice that live in the pubic area ("crabs") are slightly different but are treated the same way as head lice. They can be transmitted from bedding or clothing and do not signify sexual contact.

EXPECTED COURSE

With treatment all lice and nits will be killed. If the lice come back, it usually means your child has had contact with another infected person or the shampoo wasn't left on for 20 minutes. There are no lasting problems from having lice and they do not carry other diseases.

HOME TREATMENT

1. Anti-lice shampoo or rinse

   Use the shampoo your physician recommends.

   Follow the directions. Most must be used on dry hair. Pour about 2 ounces of the anti-lice shampoo into the dry hair. Add a little warm water to work up a lather. Scrub the hair and scalp for 10 to 20 minutes, by the clock. Rinse the hair thoroughly and dry it with a towel. These shampoos kill both the lice and the nits. Repeat the anti-lice shampoo once in 7 days to prevent reinfection.

2. Removing nits

   Remove the nits by backcombing with a fine-tooth comb or pull them out individually. The nits can be loosened using a mixture of half vinegar and half water. Apply the mixture to the hair and keep your child's hair under a towel wrap for 30 minutes. Even though the nits are dead, most schools will not allow children to return if nits are present. The head does not need to be shaved to cure lice.

3. Lice in the eyelashes

   If you see any lice or nits in the eyelashes, put plain petroleum jelly on the eyelashes twice a day for 8 days. The lice won't survive.

4. Cleaning the house

   Head lice can't live for more than 24 hours off the human body. Your child's room should be vacuumed. Combs and brushes should be soaked for 1 hour in a solution made from the anti-lice shampoo. Wash your child's sheets, blankets, and pillowcases in hot water. Items that can't be washed (hats or coats) can be sealed in plastic bags for 2 weeks (the longest that nits can survive). Anti-lice sprays or fumigation of the house is unnecessary.

5. Contagiousness

   Check the head of everyone else living in your home. If any have scalp rashes, sores, or itching, they should be treated with the anti-lice shampoo even if lice and nits are not seen. Your child can return to school after the first treatment with the shampoo. Remind your child not to share combs and hats.

CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:

• The rash and itching are not gone by 1 week after treatment.
• The sores start to spread or look infected.
• The lice and nits return.
• You have other questions or concerns.